Don’t forget your iodine in your diet

In 1509, Michelangelo wrote to a friend that his goiter was so large his “chin and belly meet perforce in one (and) my beard doth point to heaven.” A goiter is an abnormal swelling of the thyroid, the butterfly-shaped gland at the base of the neck, commonly caused by an iodine deficiency. In the early 20th century, the upper part of the U.S. was called the Goiter Belt. Iodized salt was introduced in 1924, and dairy cow feed was supplemented with iodine; those additions have been credited with the near eradication of goiters.

So why has the Counsel for Responsible Nutrition recently sounded an alarm about the need for supplemental iodine? Iodine intake has dropped almost 20 percent in the past 50 years as people reduced their salt intake and now use fancy (Himalayan pink salt anyone?), unsupplemented salts.

Besides avoiding goiter (you don’t want them coming back again), iodine is required for normal fetal brain development in utero and during infants’ first 12 months, when they’re often breastfeeding. That’s why the CRN says multivitamin/mineral supplements intended for pregnant and lactating women should include at least 150 mcg of iodine to make sure they get a total daily intake of 220-290 mcg. (Other adults need a total of 150 mcg daily.) If you take your appropriate multivitamin/minerals and eat fish such as wild salmon (70 mcg per serving), you’ll get plenty of iodine.

Alternatives to endoscopes

When James Garner starred as Lt. Kenneth Braden in “Up Periscope” (1959), the submarine commander knew that infiltrating Japanese waters to retrieve secret radio codes was risky business. But getting super-scoped in a hospital can be more perilous.

Recently, headlines revealed that “Fatal Superbugs at UCLA Medical Center” killed two people, and another 170 may have been exposed to a multiple-antibiotic-resistant infection. The cause was a super-complex endoscope (duodenoscope) used in a procedure called ERCP. This duodenoscope is fed through your mouth into your small intestine so that X-rays can be taken to detect disease in and around ducts of the liver and pancreas; docs can also provide treatment or do surgery via the duodenoscope.

Unfortunately, at UCLA the device was persistently contaminated, even though it was repeatedly cleaned properly. Reuse introduced bacteria into a series of patients receiving ERCP.

The Food and Drug Administration now recommends stepped-up disinfection for these devices. Unfortunately, that may not be enough. They also say, “Meticulously cleaning duodenoscopes prior to high-level disinfection should reduce the risk of transmitting infection, but may not entirely eliminate it.”

So what can you do if you need any type of endoscopy or an ERCP? Discuss risks and benefits (risks remain small overall) with your doc and ask about alternatives: For ERCPs, percutaneous cholangiography (X-ray of the bile ducts), ultrasound, CT or MRI cholangiography are non-invasive; all deliver very similar information. Open surgery is often an option for removal of gallstones and treatment of tumors. The good news? These recent events will increase the safety of endoscopies for everyone.

Walking football

We knew Landon Donovan’s career was winding down when he wasn’t named to the most recent U.S. World Cup Soccer Team. After he retired in 2014, everyone assumed his competitive playing days were over. However, in the U.K., something interesting is happening in the world of amateur soccer. The Brits call it “Walking Football,” and it has taken the country by storm. It’s designed for men and women (there are “mixed sex” teams) in their 50s 60s and even 70s who like to go out and have a friendly, but competitive, kick-about.

Established in 2011, Walking Football has slightly flexible guidelines: The field is roughly a third the size of a regulation soccer field (between 15-30 yards wide and 20-40 yards long); you use a slightly smaller, indoor ball; substituted players are allowed to return; no contact or side tackles allowed; you can walk briskly; and the penalty for sprinting, running or jogging is a free kick for the other team. But that doesn’t mean it doesn’t work up a sweat.

A British Journal of Sports Medicine study IDs the health benefits for people joining walking groups: reduced blood pressure, body fat, body mass index, resting heart rate and total cholesterol. And Walking Footballers? Last year, the Surrey Walking Footballers collectively covered a total of 6,412 miles – and this year over 175 players will take part. Let’s hope this sport walks across the pond soon. Maybe Landon Donovan could get the ball rolling. Brilliant way to get in 10,000 steps a day.

This story was originally published March 13, 2015 at 5:14 PM with the headline "Don’t forget your iodine in your diet."