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Week 4

Welcome to the fourth week of the BTF weight loss and wellbeing programme.

To read the advice, tips and suggestions from our experts please follow the links to this week’s articles below. The other resources you can use are:

  • Expert advice - learn more about thyroid disease and weight management from our medical experts
  • Patient stories – find out about how other thyroid patients have managed to successfully lose weight and improve their wellbeing
  • Community - share your weight loss journey with other people who are taking part in this programme by joining our closed Facebook group

Portion sizes

Now we have an idea of what is a healthy balanced diet (see week 3) we are going to look at portion sizes. There are too many food items to go through every single one, but hopefully with a few key ones you will be able to adapt it to what you are eating within the different food groups, i.e. carbohydrates, fruits and vegetables, protein, dairy and fats.

Where to find information about portion sizes

There are some good online resources about portion sizes (e.g. the British Heart Foundation, the Carbs & Cals app/book and the British Dietetic Association – see links below) Some provide weights/measures for different foods. Weighing food is not something that we would encourage long term, however it can be useful, especially with foods like rice and pasta to weigh them out at the start to get a better idea of portion sizes.

Are there good and bad foods?

When approaching weight loss, I often hear foods labelled as ‘good’ or ‘bad’. Even though as dietitians, we try to avoid labelling foods in this way, and we will discuss in a later article why this is so, over consumption of ‘bad’ foods is often thought to be the reason for weight gain. This then leads to a complete overhaul of our current diet and cutting out all the ‘bad’ foods. But these often include the foods we like and enjoy so this approach is often unsustainable in the long term. So, to avoid getting trapped in the weight gain/loss cycle, what should we do?

Getting our plate balance right

The first place to start is to get the balance of our plate right. At each meal we want to have a portion of carbohydrate, protein and two portions of vegetables. Each of these food groups provides us with nutrients that we need. Carbohydrates provide a source of glucose (sugar) which is the brain’s main fuel source. Protein is for growth and repair. Fruits and vegetables are for fibre and other nutrients which help reduce constipation, lower blood pressure, cholesterol and reduce the risk of some conditions like heart disease, diabetes and colorectal cancer. Fats are needed for the absorption of fat-soluble vitamins – A, D E & K -and dairy is for bone health.

Pizza is an example of a food that is labelled as ‘bad.’ But take a closer look and what is it made of? The base is a starchy carbohydrate like bread. On top of the base is a tomato-based sauce which is from the fruit and vegetable group. Sprinkled with cheese it provides us with a source of dairy and the toppings may provide protein or extra vegetables. Do you still think it is a ‘bad’ food?

When it comes to foods like pizza, we can make healthier choices. If we do, we might be making a better choice for our health and the goals we want to achieve around weight loss. Think of healthy choices as being a spectrum with the healthiest option at one end to one that is less healthy at the other. The healthiest is potentially homemade where we can control what goes into it – making the base, tomato sauce, portioning out the cheese, grating it and choosing our own toppings. And then of course getting the portion size right.

At the other end of the spectrum a shop bought or takeaway pizza may be higher in added fat and sugar, due to the processed nature of it, and the only control you have is for the amount consumed. It is more nutrient dense in that it has more energy per mouthful than the homemade version. Simply put, you end up consuming more energy from the shop bought pizza than from the homemade one.

Portion sizes

We don’t all have the skills to cook, budget or even the time, however. A halfway house could be to buy the base, add your own toppings, get the portion size right and serve it with a side salad to make it a more balanced meal. Alternatively have the takeaway version, but less often. You choose. A portion size of pizza is about two slices whereas how many of us would think it’s not that big and have all 6 slices? Just because it’s there? Or because we’ve or paid for it we want our money’s worth? Why not save leftover slices for lunch the next day?

Portion sizes have increased over the years as have glasses and crockery whilst our activity levels have reduced. These are just some of the factors that have contributed to weight gain. When focusing on portion sizes, planning your meals can also help, as does aiming to be consistent, i.e. don’t just make your healthy changes a few days a week.

The following are guideline portion sizes for each food group:

  • Carbohydrates – one closed hand. For example, two Weetabix, two slices of bread (but think about the loaf you’re having as the nutrient content and slice size will vary), one baked potato.
  • Fruits and vegetables – two open hands of vegetables and one open hand of fruits. The ratio should be more vegetable portions than fruit, i.e. for five a day have three portions of vegetables and two of fruit.
  • Protein – size of one palm for red meat/processed meat, slightly bigger for chicken/fish.
  • Dairy – thumb size
  • Fats – thumb size

Further information on portion size

www.bhf.org.uk
www.carbsandcals.com/
www.bda.uk.com

Resistance exercise, what is it?

Resistance physical activity or exercise is any bodily movement which requires musculoskeletal movement and energy expenditure. To gain general benefits to our health, the physical activity guidelines recommend we get two sessions of muscle strengthening exercise alongside 150 minutes of aerobic physical activity per week.

The benefits of resistance physical activity often occur independently of those we achieve through aerobic activity. They include:

  • Reduced blood pressure
  • Increased strength
  • Reduced injuries and falls
  • Increased bone density
  • Improved mental health

Another important benefit is that as our muscles grow and become leaner, due to a richer blood supply and more functionality, more energy is sent to our muscles even whilst resting. This leads to an increase in the energy we use each day and can help with weight management.

Once again, it is important to draw the distinction between exercise and physical activity. Exercise is always structured. It can include a visit to the gym, sports or an exercise class. Physical activity is usually unstructured but is often just as beneficial for our health. It might include gardening or a similar form of leisurely manual labour. A simple rule to remember is that exercise always involves physical activity, however physical activity is not always exercise.

Why is it beneficial for hypothyroidism?

Research carried out in recent years has shown certain, important benefits of resistance physical activity for people living with hypothyroidism. These studies have shown that doing resistance exercise, often in addition to aerobic exercise, leads to healthier cholesterol levels in people with hypothyroidism.

Other benefits to emerge from research include reduced body fat, improved muscle mass, healthier arteries and blood sugar levels, and greater ability to use sugar as energy. Very importantly, research has shown that exercise can help to reduce blood pressure. So, completing resistance activities can be very beneficial to anyone with hypothyroidism, it is therefore important that we find a form of resistance training that we enjoy and can stick to.

How can we do it?

If you do not currently do any resistance activity the most important thing is to start to do it. If you already do resistance activity, you should try to manage at least two sessions per week, and if you are already managing to do at least two sessions per week, make sure you keep it up!

If you like to exercise at home perhaps you can invest in some resistance bands or some other form of resistance equipment, such as dumbbells. There are plenty of good, qualified instructors online who can introduce you to simple but effective exercises at home. If you prefer the gym, you might choose to do a class which does full body resistance exercises. Check out your local gyms to see whether they offer this. Some sports clubs will also offer circuit classes as part of their programmes. For example, running and boxing clubs often run circuit training sessions.

The key is to find something you know you will enjoy. If exercise isn’t your thing, then physical activities like gardening, Nordic walking, fly fishing, woodwork, housework or other manual hobbies or jobs can help us to become stronger and give us the same health benefits as most exercises.

Watch

Chartered psychologist, Dr Sue Jackson shares tips about how to keep up with your healthy eating plans in a social situation, including:

  • Managing your mindset around eating
  • Beware of empty calories
Week 3 info Week 5 info