Are you getting enough iodine?
You might not realise it, but your body needs this essential trace element. Resident dietitian Orla Walsh takes a closer look
Park earlier this year, a challenge she relished. Not too surprisingly, however, her mum was protective about seeing her daughter, who’d already been through so much, push herself to the limits of physical endurance.
“There is a tendency for people to say, ‘Relax, put your feet up,’ when you’re diagnosed with cancer, but you do enough of that during treatment,” she says. “The last thing I needed was to sit around thinking about my cancer.
“Thankfully, things are changing in the healthcare system. There’s a growing recognition of the need to be physically active. I felt desperately weak after my cancer treatment, and sport and exercise helped me feel normal again.”
But while things are changing, Mairéad Cantwell suggests that healthcare professionals often don’t recommend sufficient exercise to benefit their patients following cancer treatment. In a study of 43 medical oncologists, radiation therapists, clinical nurse specialists, GPs and surgeons, she found that while recognising the importance of exercise in their patients’ lives, many didn’t propose enough to meet the recommended physical activity guidelines for cancer survivors.
“Evidence shows that a minimum of 150 minutes of moderate intensity aerobic exercise combined with two to three resistance [weights] workouts a week aids cancer recovery.
“Yet many people are not active enough to reap the benefits of this simple but powerful treatment,” says Mairéad.
It’s not a one-size-fits-all kind of therapy, however, as exercise programmes have to be tailored to suit the abilities of each individual, and in a hard-pressed health system, doctors’ time is already under pressure. Added to that is a chronic lack of community-based exercise programmes to rehabilitate cancer survivors, despite the proven benefits that physical activity brings.
“Exercise boosts fitness levels, physical function, mental well-being, quality of life, and helps people manage the side effects of treatment,” says Mairéad.
“If a doctor were to prescribe a pill that could do all that, patients would be sure to take it regularly. But exercise is a powerful medicine, and cancer survivors need to take a daily dose to maintain their health.”
As part of her research, Mairéad conducted a series of focus groups in which people were asked to share their experiences of cancer treatment. While everyone’s cancer journey is different, one commonly expressed feeling was one of loneliness at the end of treatment.
“People spoke of a period of isolation when they were discharged from the hospital system,” says Mairéad. “Having spent months or years going from one appointment to another, suddenly they were on their own, and they described that as being a very lonely place. It’s not easy to go back to work and pick your life up where you left off when you’ve been through such a long, difficult and life-changing experience.
“There’s a gap in the cancer care pathway when people have finished treatment, and as a vehicle for recovery, exercise is very empowering. After passively going through the rigours of treatment, this is something positive that people can do for themselves. They’re in charge, setting their own goals and finding ways to achieve them.”
Enlisting friends and family to join in activities will boost your chances of sticking to an exercise regime, she says. Evidence shows that people are more likely to follow through if they’ve committed to meeting others for a walk or a workout, and exercising in a group is more social than hitting the trail alone.
And with a recent upsurge in jive, céilí and step dancing sweeping the nation, keeping fit has never been more fun.
Another activity that’s gained in popularity in the past decade is dragon boat racing, a Chinese-inspired activity that’s been shown to help breast cancer survivors build muscle strength and recover from lymphoedema and other side effects of surgery. Since the first club, Dublin’s Plurabelle Paddlers, was set up in 2010, a network of similar clubs continues to spread across the country, providing a platform for breast cancer survivors to paddle their way to recovery.
Bríd O’Connell, who set up the Shannon Dragons in Limerick last year, says it’s been a life-saver in more ways than one.
“We bring the best version of ourselves to the water,” she says. “There’s a kindness afloat. We carry each other and laugh with each other, and that’s more life-giving than you can imagine.”
Mairéad Cantwell says the dragon boat racers are an inspiration to other cancer survivors.
“Our focus groups have shown that cancer survivors enjoy exercising with people who’ve been through a similar experience,” she says. “Through that shared experience, they don’t feel self-conscious and it gives them a safe, encouraging and supportive environment to regain their physical and emotional strength.”
Using the information from MedEx studies with both healthcare professionals and focus groups, Mairéad and the research team set about designing a programme that could increase cancer survivors’ physical and mental well-being, optimise their quality of life and support them to make physical activity part of everyday life.
“In addition to the twice weekly exercise classes, participants received additional resources, including a home exercise guide and information sessions on how to incorporate activity into their lives,” says Mairéad.
“We’re now in the final stages of this study and hope to have the results ready in early 2019.”
◊ The Irish Cancer Society is holding a ‘Decoding Cancer’ public talk on the effects of exercise on cancer and how physical activity can help a person going through cancer treatment. ‘Keeping Fit, Stopping Cancer’ takes place this Wednesday at 1pm in the Wisdom Centre, Cork Street, D8.
IODINE is an essential trace element, and it is one of the most important and most overlooked minerals your body needs. Although found in a range of foods, the richest sources are fish and dairy. Iodine deficiency is a major public health problem throughout the world. Recent research was conducted to investigate the dietary intake and status of iodine in the Irish population. While this study found that the overall dietary intake seems to be adequate, the average intake was at the low end of the range identified as sufficient by the World Health Organisation (WHO), so it’s worth exploring further.
Iodine has become a feature of nutritional chitchat in the last number of years because children and pregnant women appear to be at risk of deficiency, leading to serious consequences.
So what do we know about this mineral and the major impact it has on our health?
IODINE DURING PREGNANCY
Research conducted on Irish women set out to determine dietary iodine status in mothers during the first trimester of pregnancy. They observed that values suggestive of iodine deficiency were found in 55pc of pregnant women tested in summer months and 23pc in winter months. This is a concern as iodine is essential during pregnancy. Deficiency during pregnancy can result in irreversible brain damage for the foetus.
The WHO considered iodine deficiency to be the single most important preventable cause of brain damage worldwide. In fact, in populations that are iodine deficient the IQ is 13.5 points lower than populations with an adequate iodine intake. Not only is iodine status in pregnant mothers linked to lower IQ , but also reading scores and neurocognitive functioning. After birth and early in life, iodine remains essential for neurodevelopment.
Although the important role of iodine in brain health might be news to some people, its role in metabolism is probably better known. Iodine is a major component of thyroid hormones T3 (triiodothronine) and T4 (thyroxine). These hormones are required for many functions including normal growth, metabolism and the creation of new cells.
Therefore, iodine deficiency can lead to an underactive thyroid. Iodine deficiency can result in a whole host of health consequences — from thyroid enlargement or goitre to defective reproduction, growth impairment and neurodevelopmental
Seaweed Haddock Crab Cod Mussels
Yoghurt Milk Eggs Cheese
30 grams 140 grams 140 grams 140 grams 40 grams
150 grams 200 ml 2 large 40 grams
SO HOW MUCH IODINE IS NEEDED?
305 210-225 100
50-70 60-65 65-70 20-25
damage. Results suggest that approximately one in every 3,500 babies born in Ireland has congenital hypothyroidism — an endocrine condition — which results from failure of the thyroid gland to produce thyroid hormones.
The RNI for iodine is 60 mcg per day for infants and increases to 140 mcg per day in those above the age of 15 years. However, the WHO recommends slightly higher levels of 150 mcg to 250 mcg per day.
Fish is one of the best sources of iodine. Unfortunately, a shockingly low number of people eat fish. The average consumption of fish in Irish adults aged 18 to 64 years was a measly 23 grams per day, with an average portion size of 120g for fresh cod and 100g for fresh salmon fillet.
There are many reasons why Irish people report not eating fish, which include expense, the presence of bones, smell, a perception that fish is difficult to cook and tastes bland and a belief that fish needs to be eaten on the day of purchase. In Ireland, milk is the main food source of iodine.
The amount of iodine in plants and other foods does change depending on the amount of iodine in the soil, the time of year and farming techniques. For example, the iodine in milk is higher in winter when compared to summer. Additionally, there will be more iodine in the milk if the farmer provides cattle feed that contains iodine and if the farmer uses iodine as an antiseptic for the cows. In a sample of 22 milks, there was no difference in iodine concentrations between organic and regular milk.
The growing interest in a plant-based diet may have an impact on the iodine status of the Irish population as dairy and fish are often excluded. A study was conducted in the University of Surrey which examined the iodine content of 47 milk-alternative drinks including soya, almond, coconut, oat, rice, hazelnut and hemp and compared it with that of cows’ milk. They found that the majority of milk-alternative drinks did not have adequate levels of iodine, with concentration levels found to be around 2pc of that found in cows’ milk. Therefore, it’s important to check your milk alternative to see if it has iodine added to it. Some are fortified with iodine and may be the more suitable choice.
Another option for those that are following a plant based or vegan diet is to consider enjoying seaweed in their diet regularly. With the availability of sushi this shouldn’t be too difficult.
For the rest of the population, if you are consuming the recommended three portions of dairy a day as well as eating fish a few times a week, it is likely that you are meeting your iodine requirements.
There is a tendency for people to say ‘relax, put your
feet up when you’re diagnosed
Dietitian, Orla Walsh