Iodine is a mineral found in soil and seawater. It is something that the body does not make, but it is essential for the health of your thyroid; as it is a component of the thyroid hormones. Therefore our intake must come from our diet.
During pregnancy our iodine requirements increase from 150mcg/day to 220mcg/day. This is so we can support the needs of the rapidly growing foetus, and ensure that they have enough for their own brain and thyroid development, as well as enough for mums thyroid.
Mild iodine deficiency in pregnancy has been shown to be related to poor thyroid function in mum and the foetus, as well as implications on brain development. A severe deficiency can be associated with stillbirth, congenital abnormalities, speech and motor difficulties, and more. So it is quite a serious issue.
In New Zealand we have low levels of iodine in our soil, so our homegrown foods have low concentrations. The iodine status in New Zealand has been a concern for some time; Iodised salt was implemented in the 1920's, with levels bumped up in 1934. Still not combating the problem, in 2009 there was a change for mandatory use of iodised salt in commercially baked bread.
Good food sources of iodine are diary products, cooked fish and seafood, and eggs. Seaweed containing foods like sushi can also be a good source. While not advocating for an increase in salt use, I would also encourage using iodised table salt over the 'fancy' sea salt and himalayan salt when you are adding it to foods.
During pregnancy we have access to a funded iodine only supplement of 150mcg/day via your GP or lead maternity carer (LMC). This is now recommended to take along with a balanced diet as it is felt that it is unlikely most women will meet their iodine requirements through diet alone. If you are taking a pregnancy specific multivitamin, this should have extra iodine added to it, but it pays to check. We also want to be careful that we don't go overboard with supplementation from various sources, so please check with your GP, LMC or dietitian before taking any additional iodine containing supplements.
If you would like to see some of the research that has been done in NZ relating to iodine there is some information at :
If you are concerned that you are not getting a good balanced diet and want to chat about how to change this, then give me a call :)
Polycystic Ovary syndrome (PCOS) effects 5-10% of women of reproductive age, and impacts those with the condition in a number of different ways. In fact 25% of people with PCOS may not show any symptoms.
PCOS is an endocrine disorder, and diagnosis includes having at least two of the following: irregular periods, androgen excess (high levels of male sex hormones), and cysts on the ovaries. Other conditions that may cause these symptoms should also be ruled out first.
Women with PCOS may experience insulin resistance, weight gain/difficulty losing weight, increased facial or body hair, acne, metabolic syndrome (leading to an increased risk of CVD and type 2 diabetes), infertility, higher risk of gestational diabetes, and increased risk of miscarriage.
So how does nutrition come into it?
Some of the features are obesity, insulin resistance and metabolic syndrome (high lipid levels, high blood pressure, high blood sugar levels); therefore what we eat can play a significant role in the health for PCOS women. The main goals of nutrition are usually to improve insulin resistance and reduce androgen excess.
A 5-10% weight reduction can improve the androgen excess symptoms and improves fertility chances. How you go about this weight loss could come in many different ways, but making sustainable changes and keeping a positive relationship with food are important.
Both the type and amount of carbohydrate are important in managing insulin resistance. We are clear on what the type of carbohydrate should be – less refined carbohydrate, lower GI and lower glycemic load. How much, is still a debatable topic. Cutting all carbohydrates out is most likely a little drastic, and for many not sustainable long term; but given the westernised diet, I would say many do need to make a change to their carbohydrate intake.
Think moderate portions of whole-grains such as oats, quinoa, freekah, barley, wheat bran, spelt etc. While minimising your intake of biscuits, cakes, crackers, lollies, white bread, and added sugar in food and drinks.
EAT MORE! You cannot have too much of the non-starchy varieties.
One in three New Zealanders do not get in the minimum 3 serves a day. Vegies are high in important vitamins, minerals, fibre and antioxidants. They are useful for filling up without providing an excess of calories in those trying to lose weight.
There has been some research suggesting that omega-3 may help with lowering testosterone, help with insulin resistance, and lower triglyceride levels. More research is needed to make this a firm recommendation particularly around supplementation levels, but in the meantime consuming regular oily fish in place of meat to increase your intake of omega-3 is good for you, even outside of having PCOS. Other good sources of omega-3 are walnuts, chia seeds and flaxseeds.
Exercise is not only good for your mental health, but helps improve insulin resistance and will be important in helping with weight loss.
We should be aiming for a minimum of 150mins of exercise a week with a mixture of cardiovascular and resistance training. This doesn’t have to be in a gym, there are plenty of home-based exercises you can do.
Finally there is also some interesting research and approaches going on in the areas of magnesium, chromium, vitamin D, resveratrol, isoflavanoids and inositol. Watch this space, and I think I’ll write about some of these individually, but perhaps some of you with PCOS may need extra support in these areas.
How a PCOS friendly day might look:
Porridge made with oats and milk. Topped with some chopped walnuts and berries
Chopped up carrots, cucumber and celery with hummus
Tinned salmon tipped onto leftover roast veggies, spinach and quinoa. Topped with some feta, and chopped almonds, and a lemon juice or olive oil vinaigrette dressing.
Piece of fruit and yoghurt
Chicken, chickpea and vegetable curry on brown rice
If you suffer from PCOS and want some support and advice on a way forward in managing your nutrition in this condition then get in contact with me to talk.
Over the last few months there have been a few articles about weight loss surgery, and I keep reading comments about surgery being “an easy way out” and that they should try “insert diet here” or “ stop being lazy”.
As someone who has worked on and off in this area for the past 7 years I find these comments really frustrating, and I know clients often feel disappointed when people they know have this type of negative reaction, rather than finding out more information about the surgery and supporting them in their choice to improve their health in this way.
So with this in mind I thought I would pop down a few of the things those undergoing bariatric surgery have to go through and why it isn’t “the easy way out”.
Now that may all seem a little bleak, BUT, I have seen many peoples lives changed for the better because of surgery supported weight loss, and these were people who had tried all sorts of different weight loss methods for years. Why it was successful has so many different factors both related to the surgery itself, but also related to the person having surgery.
I have also seen real struggles and major problems post surgery. It is not the easy way out by any means and comes with real risks (short and long term). This is why surgery is not for everyone, and I think anyone considering this option needs to go in with their eyes wide open to the reality of it, be in a good psychological space, know that it is only a tool and not a quick fix, and be prepared to put themselves first on this journey.
So, if you know someone who is thinking about surgery, or had surgery. Be kind to them, their journey is their choice, and having a supportive group around them will aid in their success.
Are you thinking about trying for a baby? Be it your first or your fourth; Here are 5 diet and lifestyle aspects to consider when starting this journey.
Find your healthy weight
Did you know your fat cells produce oestrogen? So if you have too little fat you may not be getting enough, and if you have too much fat you might be producing too much. Neither of which is helpful for a woman’s chance of falling pregnant.
Higher than normal oestrogen levels in men due to high body fat levels may also impact on sperm quality and count.
What to do? Restrictive crash dieting to lose weight, or eating lots of high fat/sugar foods to gain weight, is not the way to go! I would suggest talking with a professional about safely ensuring you are eating not only for the weight loss/gain goal but also getting in adequate nutrition to maximise your fertility chances.
Start your lifestyle changes early
If you perhaps are not living the healthiest of lifestyles and are thinking you would like to start a family in the not too distant future, then it might be worth starting to make changes now.
Did you know that sperm cells take 72 days to mature? So the one swimmer fertilising your partners’ egg today, was actually a product of your lifestyle a few months ago. Is it the best swimmer it can be?
This is also why any changes to diet and lifestyle may take a number of months to be effective in terms of increasing fertilisation chances.
Watch your alcohol intake
Alcohol has been shown to negatively impact both male and female fertility. We do not know how much alcohol exactly that is though, which makes recommendations for safe limits hard.
Do you need to cut out alcohol completely? Probably not, but if you want the best chances you shouldn’t be out there binge drinking. Minimise your alcohol intake as much as you can, but don’t guilt yourself over the glass of bubbles at your mums birthday either.
Look at your iron and selenium intakes
Iron needs double during pregnancy. So if you are already low pre-conception, make sure you get yourself replete before getting pregnant – the quickest way to do this may be an iron supplement, but you should discuss this with your GP.
Red meat is the highest and most bioavailable source of iron in the diet. We should be aiming for a couple of serves a week. If you do not eat red meat there are other ways to achieving a good iron intake, it can just take a bit more thought and planning to ensure there is enough.
Selenium may have a role to play in male sperm quality. We have naturally low levels in our NZ soil, so the amount we get from food may be reduced. Maximise your intake with regular high selenium containing foods like brazil nuts, tuna, turkey and chicken.
Take your folic acid
Folic acid supplementation has been proven to reduce the risk of neural tube defects that can occur during the first trimester. In NZ, recommendations are that you should be taking 800mg of folic acid daily a month before falling pregnant and up to 12 weeks gestation. There are some instances where the recommendation is more though. As soon as you start thinking about trying for a family, then go and see your GP to discuss your folic acid needs.
Good food sources of folate are green leafy vegetables (such as spinach and broccoli), citrus fruits and juices, wholemeal bread and legumes. It can be difficult to get the increased folate needs for preventing neural tube defects from diet alone though, which is why we recommend supplementation on top of a good diet.
Most of you have probably heard the word protein. You possibly associate it with body builders, athletes and gym bunnies trying to gain muscle. What you may not be aware of is that protein is essential for everyone and we are becoming more aware of how important it is as we age.
Protein is a key nutrient that makes up and/or is involved in a wide range of functions –think muscle mass maintenance/growth, hormones, outer membranes of cells, enzymes and antibodies for our immune system.
There has been research showing that after the age of 50 muscle loss increases and it also becomes harder for our bodies to make more muscle! Not a great combination.
This little situation does matter too, as good muscle mass can help maintain strength and mobility. Good strength and mobility can mean greater independence for the person, and potentially reduces the risk of falls and fractures. A good protein intake also ensures that all those functions described above can work optimally.
It is not all doom and gloom however, with good quality protein sources and resistance exercise, those over 50 can help minimise this issue. There is limited research into exactly the amount needed for each age group, but there is plenty of experts that believe that 1-1.2g/kg body weight/day is a good place to aim for *. Current recommendations are for a minimum of 0.8g/kg body weight/day.
So what is good quality protein?
Animal meats provide you with the most protein per typical serve of food, and are also high in leucine which has been shown to trigger muscle synthesis if you reach a level high enough.
Your next best sources of protein per typical serves are things like:
Ideally a combination of foods should be eaten to get a whole host of nutrients as well as protein.
What do we do about it?
While most adults in NZ do not struggle to get in enough protein, as per the 2008/2009 national nutrition survey, in practice I found a lot of our older population were not meeting their protein needs (particularly those with illness). There would often be a reduction in their protein foods choices; I think most often because they can be a bit more time consuming to cook, and also cost. It would not be unusual to have breakfast of being a piece of marmalade on toast with a cup of tea, a cup of vegetable soup at lunch with a slice of bread, and then maybe a small frozen piece of fish with some vegetables at dinner.
If you are older or have older loved ones, I encourage you to make sure that you/they are having regular high protein sources in the diet everyday and encourage some resistance exercise a few times a week for an optimal muscle profile.
Also don’t think because you are younger that you are off the hook either – if you are not getting good sources of protein and not doing regular resistance exercise then you are potentially losing overall muscle mass too and not setting yourself up well for your future older adult self.
*If you have any kidney impairment, I would ensure that you talk to your doctor or dietitian before increasing protein intake, as too much protein could compromise your kidney function.
There is no need to panic about healthy eating come Christmas day. Believe it or not, these two things do not have to be mutually exclusive.
I am all about enjoying the food we eat, and so should you. There is nothing worse than feeling completely guilty at the end of a delicious meal with your loved ones to ruin a day.
So how can we be both healthy, but not feel deprived....
Remember it is just ONE day and our health is not determined by a single day.
Merry Christmas :)
How many of you listen to your bodies hunger cues and stop eating when you are full? Or don't start eating until you feel hungry?
This is a skill that as healthy adults we are not always good at implementing. There are lots of reasons why we don't, but I think a major one is that we eat not only for fuel, but for taste, enjoyment and emotion. Which of course is not always a bad thing, but we need to make sure we are getting the balance right.
Young children are much more in tune with eating for their hunger levels. If you have spent time with them you will notice how some days they may eat much less or much more than usual. They will happily leave food on their plate, yet they are growing and developing. They are listening to their bodies, fuelling themselves with amounts of food they need for that point in time.
This is my nephews plate from lunch yesterday, not much left, but some. He had gone from regularly putting it into his mouth to eat, to just playing with his food and being interested in other things around him - indicating he was done. As an adult, if that was your plate, how many of us would just eat that little bit left on the plate thinking "I'm full, but there is not much left on the plate so i'll eat it anyway" Or as a parent, eat that leftover of the childs plate for no other reason but to finish it.
If you think you are someone who does not eat to their hunger cues well then I encourage you to practice it.....you don't get good at anything overnight....you need to practice and most likely fail at it a few times before you get it right.
✔️ Take a moment before eating and think about how you feel - are you actually hungry? or are you about to eat for another reason?
✔️ Reassess that feeling through the meal
✔️ Slow down with your eating you so you can allow your body to realise it is getting fed. It is a complex system and can take 20mins for the feedback loop to get back to your brain.
✔️ Stop eating when you feel just comfortable (ie hunger cues are gone)
✔️ If you are going through the motions of eating and not enjoying/tasting your food; if you are feeling quite full in the stomach area; if you feel sluggish, you have passed the point of comfortably being full and eaten too much.
Don't feel compelled to continue eating if you have not finished your plate, put it away for later/another meal. If you are regularly not finishing your plate, then you need to reassess how much you are putting on your plate in the first instance.
Go on, give it a go 😀