tag:theconversation.com,2011:/fr/topics/iodine-5999/articlesIodine – The Conversation2024-01-29T14:53:48Ztag:theconversation.com,2011:article/2215112024-01-29T14:53:48Z2024-01-29T14:53:48ZFrom mud and vinegar to 3D printing skin, the way we treat wounds still challenges humanity<p>Whether it’s the sting of a paper cut or the trauma of battle injury, wounds are woven into the tapestry of human experience. And since ancient times, we’ve fought the enemy that lurks within them – infection. </p>
<p>The constant threat of injury on the battlefield led to the search for new ways to combat wound infection. But early surgical procedures lacked the sterile instruments available today, meaning that for many years, surgery came with the added risk of post-operative <a href="https://cha.com/wp-content/uploads/2017/11/AJIC-2012-Infection-Control-Through-the-Ages.pdf">wound infection</a>, resulting in high numbers of deaths. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601883/">Ancient practices</a>, such as using oils, mud, turpentine, or honey to treat wounds, were common around 2000BC. The Greek physician Hippocrates (460-377BC) <a href="https://www.dermatologytimes.com/view/acetic-acid-and-wound-healing">used vinegar</a> to clean wounds, followed by bandaging to keep dirt at bay.</p>
<p>While the first hospitals were <a href="https://scientificsurgery.bjs.co.uk/article/the-surgery-of-theodoric-ca-a-d-1267-translated-from-the-latin-by-eldridge-campbell-m-d-and-james-colton-m-a-volume-i-books-i-and-ii-8-38-x-5-12-in-pp-223-xi-with-coloured-front/">established</a> in Europe in the middle ages, they were dangerous and brutal places. Wound infection rates were high because of unsanitary conditions and the use of cautery, which involved pushing a burning iron into a patient’s wound until it reached the bone.</p>
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<img alt="A drawing of a pot containing a fire with several medical instruments poking out of it." src="https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=403&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=403&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=403&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571587/original/file-20240126-19-5nmbkg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A receptacle for burning coal to heat cautery instruments.</span>
<span class="attribution"><a class="source" href="https://wellcomecollection.org/works/gcg933n2/images?id=jghkdnp4">Wellcome Collection</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>By the 1860s, the pioneering surgeon Joseph Lister had revolutionised wound infection treatment by introducing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895849/">carbolic-acid-soaked bandages</a>. And Robert Wood Johnson, who founded Johnson & Johnson, <a href="https://wounds-uk.com/journal-articles/sterilised-gauze-and-baby-powder-robert-wood-johnson-i-and-frederick-barnett-kilmer/">produced</a> the first sterile gauze bandages by 1890. The combination of antiseptic and sterile bandage marked a turning point in the evolution of wound treatment and infection control.</p>
<p>The discovery of penicillin by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520913/">Alexander Fleming</a> in 1928 was also a pivotal moment in the treatment of wound infections. By the 1940s, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369031/">penicillin</a> was being used to treat second world war soldiers who had wound infections that would have been deemed fatal in previous years. For less serious wounds, Lister’s approach of using a dressing and an antiseptic was still used.</p>
<p>Substances like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756674/">silver</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/12914356/">iodine</a> have also been recognised for their antimicrobial properties since the 1800s. Iodine, though effective, caused pain and skin discolouration until safer and less painful formulations were developed in 1949. <a href="https://bnf.nice.org.uk/wound-management/antimicrobial-dressings/">These formulations</a> endure in modern wound dressings.</p>
<p>For everyday cuts and scrapes, a simple cleaning with water and application of antiseptic cream is usually enough. This helps to prevent the inadvertent introduction of bacteria into the wound, minimising the risk of additional pain and swelling. </p>
<p>But while most wounds nowadays heal without issue, some become become infected. Research published in 2021 showed that <a href="https://wounds-uk.com/wp-content/uploads/sites/2/2023/02/68803cd147c4d81a02b9cc56823f19a1.pdf">3.8 million</a> people were having their wounds managed by the NHS between 2017 and 2018, up 71% from between 2012 and 2013. They included surgical wounds, leg ulcers and burns. This shows how hard it can be to care for wounds that are difficult to heal and particularly susceptible to infections.</p>
<h2>Modern-day challenges</h2>
<p>One of the biggest challenges in the modern-day treatment of wound infection is <a href="https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance">antibiotic resistance</a>. This happens when bacteria develop the ability to defeat the drugs designed to kill them. Resistant infections can be difficult, and sometimes impossible, to treat. </p>
<p>Many bacteria have also become resistant to the antimicrobial ingredients used in wound dressings. This is the case for <a href="https://www.sciencedirect.com/science/article/pii/S0195670104005201">silver-based</a> wound dressings, which are often used to treat chronic wound infections. This type of wound characteristically <a href="https://www.nature.com/articles/s41572-022-00377-3">fails to heal</a>, and can remain an open, infected wound for many months – or even years. As well as the devastating effect on people’s quality of life, this also places a huge financial burden on the NHS.</p>
<p>The constant fight against wound infections drives extensive research for new, safe and effective treatments. While progress is being made, a crucial hurdle lies in the <a href="https://academic.oup.com/jacamr/article/3/1/dlab027/6186407">limitations</a> of laboratory testing methods. These tests, while necessary for regulatory approval, often fail to capture the nuanced realities of wounds in the human body. </p>
<p>No two people are the same and no two wounds are the same either. This can lead to situations where treatments shine in the lab but ultimately prove ineffective in real patients.</p>
<h2>Creating wound models</h2>
<p>In response to this, scientists are tackling the limitations of lab tests by creating more realistic synthetic wound models. Some are even <a href="https://pubmed.ncbi.nlm.nih.gov/30172300/">3D printing</a> human skin (using leftovers from surgical procedures), or animal skin, complete with artificial body fluids, such as pus. The aim is to create a model environment that mimics real wounds more accurately. </p>
<p>Recently, my own <a href="https://pubmed.ncbi.nlm.nih.gov/36678466/">research group</a> has made strides in developing lab models that act like real chronic wounds when treated with antimicrobial dressings. While not perfect, our models are a step in the right direction, contributing to the development of formulations with promising potential for treating wound infections in the future.</p>
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Read more:
<a href="https://theconversation.com/we-built-a-human-skin-printer-from-lego-and-we-want-every-lab-to-use-our-blueprint-203170">We built a human-skin printer from Lego and we want every lab to use our blueprint</a>
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<p>As we navigate the complexities of wound care, the quest for new, effective and safe treatments continues, driven by the efforts of scientists worldwide. We are working towards a future where the management of difficult-to-heal wounds and infections improves, enhancing both individual wellbeing and the efficiency of health systems.</p><img src="https://counter.theconversation.com/content/221511/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Maddocks does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Keeping wounds clean and infection free has challenged people for thousands of years.Sarah Maddocks, Lecturer in Microbiology, Cardiff Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1853602022-08-24T12:25:57Z2022-08-24T12:25:57ZDiet can influence mood, behavior and more – a neuroscientist explains<figure><img src="https://images.theconversation.com/files/478375/original/file-20220809-15110-gw5chs.jpg?ixlib=rb-1.1.0&rect=0%2C379%2C1200%2C1085&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">What we eat matters, and having just the right amount of essential nutrients is key to our overall health.</span> <span class="attribution"><a class="source" href="https://sites.lsa.umich.edu/dus-lab/ ">Niusha Shodja and Saina Heshmati, Storylab</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>During the long seafaring voyages of the 15th and 16th centuries, a period known as <a href="https://www.britannica.com/topic/European-exploration/The-Age-of-Discovery">the Age of Discovery</a>, sailors reported experiencing <a href="https://www.nationalgeographic.com/science/article/scurvy-disease-discovery-jonathan-lamb">visions of sublime foods and verdant fields</a>. The discovery that these were nothing more than hallucinations after months at sea was agonizing. Some sailors wept in longing; others threw themselves overboard. </p>
<p>The cure for these harrowing mirages turned out to be not a concoction of complex chemicals, as once suspected, but rather the simple antidote of lemon juice. These sailors <a href="https://www.nationalgeographic.com/science/article/scurvy-disease-discovery-jonathan-lamb">suffered from scurvy</a>, a disease caused by a deficiency of vitamin C, an essential micronutrient that people acquire from eating fruits and vegetables. </p>
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<p>Vitamin C is important <a href="https://doi.org/10.1186/s12888-020-02730-w">for the production and release of neurotransmitters</a>, the chemical messengers of the brain. In its absence, brain cells do not communicate effectively with one another, which can lead to hallucinations.</p>
<p>As this famous example of early explorers illustrates, there is an intimate connection between food and the brain, one that researchers like me are working to unravel. <a href="https://lsa.umich.edu/mcdb/people/faculty/mdus.html">As a scientist</a> <a href="https://scholar.google.com/citations?user=MbZxwzMAAAAJ&hl=en">who studies the neuroscience of nutrition</a> at the University of Michigan, I am primarily interested in how components of food and their breakdown products can alter the <a href="https://theconversation.com/what-you-eat-can-reprogram-your-genes-an-expert-explains-the-emerging-science-of-nutrigenomics-165867">genetic instructions that control our physiology</a>. </p>
<p>Beyond that, my research is also focused on understanding how food can <a href="https://www.bloomberg.com/news/videos/2022-05-12/can-a-different-diet-reprogram-your-dna-video">influence our thoughts, moods and behaviors</a>. While we can’t yet prevent or treat brain conditions with diet, researchers like me are learning a great deal about the role that nutrition plays in the everyday brain processes that make us who we are.</p>
<p>Perhaps not surprisingly, a delicate balance of nutrients is key for brain health: Deficiencies or excesses in vitamins, sugars, fats and amino acids can influence brain and behavior in either negative or positive ways. </p>
<h2>Vitamins and mineral deficiencies</h2>
<p>As with vitamin C, deficits in other vitamins and minerals can also precipitate nutritional diseases that adversely impact the brain in humans. For example, low dietary levels of vitamin B3/niacin – typically found in meat and fish – <a href="https://apps.who.int/iris/handle/10665/66704">cause pellagra</a>, a disease in which people develop dementia. </p>
<p>Niacin is essential to turn food into energy and building blocks, protect the genetic blueprint from environmental damage and control how much of certain gene products are made. In the absence of these critical processes, brain cells, also known as neurons, <a href="https://doi.org/10.3390%2Fijms20040974">malfunction and die prematurely</a>, leading to dementia. </p>
<p>In animal models, decreasing or blocking the production of niacin in the brain promotes neuronal damage and cell death. Conversely, enhancing niacin levels has been shown to mitigate the effects of neurodegenerative diseases such as <a href="https://doi.org/10.3390%2Fijms20040974">Alzheimer’s, Huntington’s and Parkinson’s</a>. Observational studies in humans suggest that sufficient levels of niacin <a href="https://doi.org/10.3390/ijms20040974">may protect against these diseases</a>, but the results are still inconclusive.</p>
<p>Interestingly, niacin deficiency caused by consumption of excessive amounts of alcohol can lead to similar effects as those found with pellagra.</p>
<p>Another example of how a nutrient deficiency affects brain function can be found in the element iodine, which, like niacin, must be acquired from one’s diet. Iodine, which is present in seafood and seaweed, is an essential building block for thyroid hormones – signaling molecules that are important for many aspects of human biology, including development, metabolism, appetite and sleep. Low iodine levels prevent the production of adequate amounts of thyroid hormones, impairing these essential physiological processes. </p>
<p>Iodine is particularly important to the developing human brain; before table salt was supplemented with this mineral in the 1920s, iodine deficiency was a <a href="https://web.archive.org/web/20060930020824/http://www.who.int/nutrition/topics/idd/en/">major cause of cognitive disability worldwide</a>. The introduction of iodized salt is thought to have contributed to the <a href="https://doi.org/10.1093%2Fjeea%2Fjvw002">gradual rise in IQ scores in the past century</a>.</p>
<h2>Ketogenic diet for epilepsy</h2>
<p>Not all dietary deficiencies are detrimental to the brain. In fact, studies show that people with drug-resistant epilepsy – a condition in which brain cells fire uncontrollably – <a href="https://doi.org/10.3390/nu12092645">can reduce the number of seizures</a> by adopting an ultralow-carbohydrate regimen, known as a <a href="https://nutrition.ucdavis.edu/outreach/nutr-health-info-sheets/pro-ketogenic-diet">ketogenic diet</a>, in which 80% to 90% of calories are obtained from fat. </p>
<p>Carbohydrates are the preferred energy source for the body. When they are not available – either because of fasting or because of a ketogenic diet – cells obtain fuel by breaking down fats into compounds called ketones. Utilization of ketones for energy leads to profound <a href="https://doi.org/10.1038/s41392-021-00831-w">shifts in metabolism and physiology</a>, including the levels of hormones circulating in the body, the amount of neurotransmitters produced by the brain and the types of bacteria living in the gut. </p>
<p>Researchers think that <a href="https://doi.org/10.1038/ejcn.2013.116">these diet-dependent changes</a>, especially the higher production of brain chemicals that can quiet down neurons and decrease levels of inflammatory molecules, may play a role in the ketogenic diet’s ability to lower the number of seizures. These changes may also explain the <a href="https://doi.org/10.15252%2Femmm.202114418">benefits of a ketogenic state</a> – either through diet or fasting – on cognitive function and mood. </p>
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<figcaption><span class="caption">Some foods can negatively affect your memory and mood.</span></figcaption>
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<h2>Sugar, saturated fats and ultraprocessed foods</h2>
<p>Excess levels of some nutrients can also have detrimental effects on the brain. In humans and animal models, elevated consumption of refined <a href="https://health.clevelandclinic.org/which-is-worse-for-you-fat-or-sugar/">sugars and saturated fats</a> – a combination commonly found in ultraprocessed foods – promotes eating by <a href="https://doi.org/10.3389/fnbeh.2021.746299">desensitizing</a> the brain to the hormonal signals known to regulate satiety. </p>
<p>Interestingly, a diet high in these foods also <a href="https://doi.org/10.1016%2Fj.tem.2020.11.011">desensitizes the taste system</a>, making animals and humans perceive food as less sweet. These sensory alterations may affect food choice as well as the reward we get from food. For example, research shows that people’s responses to ice cream in brain areas <a href="https://doi.org/10.3945/ajcn.111.027003">important for taste and reward</a> are dulled when they eat it every day for two weeks. Some researchers think this decrease in food reward signals may <a href="https://theconversation.com/foods-high-in-added-fats-and-refined-carbs-are-like-cigarettes-addictive-and-unhealthy-165441">enhance cravings for even more fatty and sugary foods</a>, similar to the way smokers crave cigarettes. </p>
<p>High-fat and processed-food diets are also associated with lower cognitive function and memory <a href="https://doi.org/10.3389%2Ffnbeh.2021.746299">in humans</a> and <a href="https://doi.org/10.3389%2Ffnbeh.2021.746299">animal models</a> as well as a higher incidence of neurodegenerative diseases. However, researchers still don’t know if these effects are due to these foods or to the weight gain and insulin resistance that <a href="https://doi.org/10.3389/fnbeh.2021.746299">develop with long-term consumption of these diets</a>.</p>
<h2>Time scales</h2>
<p>This brings us to a critical aspect of the effect of diet on the brain: time. Some foods can influence brain function and behavior acutely – such as over hours or days – while others take weeks, months or even years to have an effect. For instance, eating a slice of cake rapidly shifts the fat-burning, ketogenic metabolism of an individual with drug-resistant epilepsy into a carbohydrate-burning metabolism, increasing the risk of seizures. In contrast, it takes weeks of sugar consumption for taste and the brain’s reward pathways to change, and months of vitamin C deficiency to develop scurvy. Finally, when it comes to diseases like Alzheimer’s and Parkinson’s, risk is influenced by years of dietary exposures in combination with other genetic or <a href="https://cshperspectives.cshlp.org/content/10/4/a033118.long">lifestyle factors such as smoking</a>.</p>
<p>In the end, the relationship between food and the brain is a bit like the delicate Goldilocks: We need not too little, not too much but just enough of each nutrient.</p><img src="https://counter.theconversation.com/content/185360/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Monica Dus receives funding from the National Science Foundation, the National Institute of Health, the Sloan Foundation, the Rita Allen Foundation, and the Klingenstein Foundation. She is affiliated with The University of Michigan, Ann Arbor. She is on the Advisory Board for the Trends in Endocrinology & Metabolism journal, the Editorial Board for the Chemical Senses journal, and the Advisory Board for the University of Michigan Museum of Natural History.</span></em></p>Diets high in fat, sugar and processed foods are associated with higher calorie intake, poorer memory and lower cognitive function.Monica Dus, Associate Professor of Molecular, Cellular, and Developmental Biology, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1835612022-05-27T12:50:25Z2022-05-27T12:50:25ZVegan and vegetarian diets may lack certain nutrients – here’s how to get more of them<figure><img src="https://images.theconversation.com/files/465720/original/file-20220527-11-h3yqf7.jpg?ixlib=rb-1.1.0&rect=9%2C0%2C6312%2C4217&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Vitamin supplements may help you avoid deficiencies. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/smiling-girl-bottle-vitamins-sitting-kitchen-1572303289">YAKOBCHUK VIACHESLAV/ Shutterstock</a></span></figcaption></figure><p>Vegan and vegetarian diets are certainly trendy, with more people than ever before <a href="https://www.vegansociety.com/news/media/statistics">making the switch</a>. While some people are choosing to go plant-based for environmental reasons, others are adopting these diets because of their health benefits. It’s hardly surprising, given studies have linked vegetarian and vegan diets to a lower body mass index (BMI) and a lower risk of certain diseases – including <a href="https://theconversation.com/vegetarian-pescatarian-or-low-meat-diets-may-reduce-cancer-risk-new-research-177787">cancer</a>, <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002039">type 2 diabetes</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S0735109717375216?via%253Dihub">heart disease</a>.</p>
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<p>But while plant-based diets may have many health benefits, they can, without some planning, also result in nutrient deficiencies. In fact, <a href="https://www.hsis.org/vegetarian-and-vegan-trends-pushing-more-people-into-deficiency-risk/">one survey</a> suggests around 28% of vegans and 13% of vegetarians show one or more nutrient deficiencies. This is because many plant-based diets don’t contain high levels of <a href="https://www.sciencedirect.com/science/article/pii/S0261561420306567#bib5">certain nutrients</a>, such as vitamin B12, omega-3 fatty acids, iodine, calcium, selenium, <a href="https://www.gov.uk/government/statistics/ndns-results-from-years-9-to-11-2016-to-2017-and-2018-to-2019/ndns-results-from-years-9-to-11-combined-statistical-summary">iron</a> and zinc. </p>
<p>Research shows that veganism in particular is linked with <a href="https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30656-7/fulltext">significantly low intakes</a> of vitamin B12 and calcium – especially in people who aren’t taking any vitamin supplements. Intakes of <a href="https://www.sciencedirect.com/science/article/pii/S0261561420306567?via%3Dihub">selenium, zinc</a>, vitamin D and iodine are <a href="https://pubmed.ncbi.nlm.nih.gov/35010904/">also low</a> in this group.</p>
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<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/do-these-three-popular-anti-ageing-skincare-ingredients-work-heres-what-the-evidence-says-182200?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Do these three popular anti-ageing skincare ingredients work? Here’s what the evidence says</a></em></p>
<p><em><a href="https://theconversation.com/barbell-exercises-arent-essential-for-getting-fit-heres-what-you-can-do-instead-181743?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Barbell exercises aren’t essential for getting fit – here’s what you can do instead</a></em></p>
<p><em><a href="https://theconversation.com/five-tips-for-young-people-dealing-with-long-covid-from-a-gp-180464?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Five tips for young people dealing with long COVID – from a GP</a></em></p>
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<p>While <a href="https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30101-1/fulltext">vegetarian diets</a> may contain slightly higher levels of amino acids, B12, calcium and protein compared to vegan diets, intake may still be lower than when following an omnivorous diet. </p>
<h2>Proper planning</h2>
<p>Vitamins and minerals are important for good health. For example, vitamin B12 is important for brain function and producing red blood cells. But our body doesn’t naturally produce many important vitamins and minerals (including vitamin B12, iron, selenium, and iodine) which is why it’s essential to get them from the foods we eat.</p>
<figure class="align-center ">
<img alt="A person's hands. One hand is open with two tablets held in the palm, while the other holds a medicine bottle." src="https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/465721/original/file-20220527-23-bhvjss.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Be sure to consult your GP before taking any supplements.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hands-young-women-holding-medicine-herbs-1989054578">Gumbariya/ Shutterstock</a></span>
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<p>But not getting enough of these important vitamins and minerals can lead to deficiencies. These can have a range of side effects, including excessive tiredness and brain fog. If left untreated, over time, this can lead to serious <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/plantbased-diets-and-longterm-health-findings-from-the-epicoxford-study/771ED5439481A68AD92BF40E8B1EF7E6">nervous, skeletal and blood disorders</a>.</p>
<p>If you’re someone who’s thinking of making the switch to a vegetarian or vegan diet, here are a few things to consider to avoid vitamin deficiencies: </p>
<ol>
<li><strong>Seek expert advice</strong> to help you plan your diet to ensure that it contains all the essential nutrients you need, especially if you’re transitioning from a vegetarian diet to a vegan diet, if you are or may become pregnant, or if you’re older than 60 years of age. </li>
<li><strong>Focus on your nutrients.</strong> Aim to pick plant-based food products that have been fortified with important vitamins and minerals, or foods that naturally contain high amounts of important nutrients. For example, Brazil nuts are rich in selenium, while seaweed is a good source of vitamin B12 and iodine. </li>
<li><strong>Eat a varied diet.</strong> This is especially important when it comes to the plant-based proteins you eat to ensure you get all the essential amino acids from your diet. Some foods that contain these include lentils, pulses, beans, soy, tofu, nuts and seeds.</li>
<li><strong>Pair certain nutrients.</strong> Certain nutrients can help others be better absorbed into the body. For example, vitamin C can increase iron absorption. Vitamin B12 supplements should also be taken with food to help the body absorb it more easily.</li>
<li><strong>Keep an eye on your health.</strong> If you start experiencing fatigue, memory problems, or even low mood, it might be a sign of a vitamin deficiency. Be sure to consult a doctor before taking any supplements to be sure you’re taking the right ones. </li>
</ol>
<p>If you need to use a vitamin supplement, be sure to look for supplements that are labelled <a href="https://ispe.org/initiatives/regulatory-resources/gmp">GMP certified</a>, as these will contain proper nutrition. But long-term supplement use <a href="https://theconversation.com/vitamins-and-minerals-arent-risk-free-here-are-6-ways-they-can-cause-harm-165399">may have its downsides</a>, such as being costly or interacting with certain drugs. There is also a danger of over-supplementation, which can lead to an accumulation of certain unmetabolised nutrients in our body. It’s currently unknown how common this is and what the long-term effects might be. For all of these reasons, it’s important to consult a GP before taking any supplements. </p>
<p>A well-planned, plant-based diet can be good for both your health and the planet. But it’s important to keep an eye on what foods and nutrients you might be eating to avoid deficiencies of essential nutrients.</p><img src="https://counter.theconversation.com/content/183561/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Martin Warren receives funding from the BBSRC and the Royal Society. </span></em></p><p class="fine-print"><em><span>Kourosh Ahmadi has received funding from BBSRC, MRC, Welcome Trust, Chronic Diseases Research Foundation and the Royal Society. </span></em></p><p class="fine-print"><em><span>Liangzi Zhang works for Quadram Institute.</span></em></p><p class="fine-print"><em><span>Maria Traka receives funding currently from BBSRC, Horizon2020 and EITfood, and previously from Prostate Cancer Foundation.</span></em></p>Plant-based diets may lack a number of important nutrients, such as vitamin B12 and iodine.Martin Warren, Chief Scientific Officer and Group Leader, Synthetic Biology and Biosynthetic Pathways, Quadram InstituteKourosh Ahmadi, Reader in Precision Nutrition, University of SurreyLiangzi Zhang, Research scientist, Food Composition and Dietary Assessment, Quadram InstituteMaria Traka, Research Leader, Personalised Nutrition and Gut Microbiome, Quadram InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1833912022-05-20T09:59:02Z2022-05-20T09:59:02ZPlant-based milk products: what you need to know before making the switch<figure><img src="https://images.theconversation.com/files/464463/original/file-20220520-15-t00qfr.jpg?ixlib=rb-1.1.0&rect=8%2C8%2C5599%2C3724&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Plant-based milk alternatives may not contain the same nutrients as cow's milk.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/dairy-free-milk-drink-ingredients-breakfast-1762870238">matka_Wariatka/ Shutterstock</a></span></figcaption></figure><p>Over the last decade, the number of people drinking cow’s milk has dropped – with people <a href="https://www.gov.uk/government/statistical-data-sets/family-food-datasets">swapping dairy</a> for plant-based alternatives, such as oat and almond milk. With <a href="https://theconversation.com/how-potato-milk-measures-up-against-other-plant-based-milk-alternatives-176938">new types of plant-based milks</a> seemingly emerging every week, this trend is unlikely to stop any time soon.</p>
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<iframe id="noa-web-audio-player" style="border: none" src="https://embed-player.newsoveraudio.com/v4?key=x84olp&id=https://theconversation.com/plant-based-milk-products-what-you-need-to-know-before-making-the-switch-183391&bgColor=F5F5F5&color=D8352A&playColor=D8352A" width="100%" height="110px"></iframe>
<p><em>You can listen to more articles from The Conversation, narrated by Noa, <a href="https://theconversation.com/uk/topics/audio-narrated-99682">here</a>.</em></p>
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<p>There are a number of reasons why people are making the switch from dairy to plant-based alternatives. For one, many people aren’t able to consume dairy. Not only are around <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03557.x">5% of UK adults lactose intolerant</a>, dairy is also the <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12318">most common allergen</a> in early childhood.</p>
<p>Another major reason that people are switching to plant-based dairy alternatives is because of animal welfare and environmental concerns. Studies show that dairy milk produces more environmental emissions and requires more <a href="https://pubmed.ncbi.nlm.nih.gov/29853680/">land and water usage</a> than plant-based dairy alternatives.</p>
<p>But despite being marketed as alternatives to dairy, plant-based products may not be exactly the same as dairy. So if you’re thinking of making the switch, here are a few things to be aware of.</p>
<h2>Pay attention to nutrients</h2>
<p>Cow’s milk is a rich source of many important nutrients, such as protein, calcium, iodine and vitamin B12. But many plant-based dairy alternatives don’t naturally contain the same amount of these nutrients and micronutrients as dairy milk – if any at all.</p>
<p>On average, most plant-based alternatives contain almost no protein – while one glass of cow’s milk containing around eight grams of protein. Soya milk is the exception, containing a similar amount of protein per glass as dairy. </p>
<p>Protein is essential for healthy growth and development. While everyone needs protein, some groups may need more than others. For example, older adults need it to maintain muscle strength with ageing and children require it for growth.</p>
<p>On average, most UK adults get <a href="https://www.gov.uk/government/collections/national-diet-and-nutrition-survey">around 15% of their protein intake</a> from dairy products. But if plant-based dairy alternatives are used as like-for-like replacements, this number could be <a href="https://www.sciencedirect.com/science/article/abs/pii/S0963996921004853">less than 1.8%</a>. So if you do make the switch to plant-based dairy products, soya milk may be your best bet for getting protein. If you use other types of plant-based milk alternatives, it will be important to include other high-protein foods in your diet, such as tofu or eggs, to make sure you’re getting enough.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/vegetarian-and-vegan-diet-five-things-for-over-65s-to-consider-when-switching-to-a-plant-based-diet-144088">Vegetarian and vegan diet: five things for over-65s to consider when switching to a plant-based diet</a>
</strong>
</em>
</p>
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<p>Most plant-based dairy alternatives also don’t naturally contain the same vitamins and minerals that dairy does. As such, many need to have these added during the manufacturing process, which is called “fortification”. It’s worth noting, however, that any plant-based dairy alternatives labelled “organic” will not contain any fortified vitamins and minerals as this would go against regulations.</p>
<p>Calcium is a very important micronutrient found in milk. It’s needed for good bone health, particularly in children and adolescents. But my <a href="https://www.sciencedirect.com/science/article/abs/pii/S0963996921004853">own research has shown</a> that only 57% of milk alternatives, 63% of yogurt alternatives and 28% of cheese alternatives are fortified with calcium. So to ensure you’re <a href="https://www.bda.uk.com/resource/calcium.html">getting enough in your diet</a>, check the label and look for products that have been fortified with calcium. Or, focus on eating foods that contain calcium – such as fortified breads and cereals or tinned sardines or salmon. </p>
<figure class="align-center ">
<img alt="An opened can of tinned sardines." src="https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/464464/original/file-20220520-14-27imdv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Other food sources, such as tinned sardines, can help you get enough calcium in your diet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tin-can-sprats-sardines-top-view-244227574">Photosiber/ Shutterstock</a></span>
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<p>Iodine is another <a href="https://www.bda.uk.com/resource/iodine.html">important nutrient</a>, especially for pregnant women and young children as it’s important for brain development. It also helps make thyroid hormones, which are important for both growth and metabolism. Despite milk and dairy products being the <a href="https://www.bda.uk.com/resource/iodine.html">main source of dietary iodine</a>, only a small handful of plant-based dairy products are fortified with iodine. Again, it’s important to read the product’s label to see if it’s been fortified with iodine or not. Otherwise, focus on eating foods that contain iodine, such as fish, shellfish or seaweed – or if this is not possible by taking a supplement.</p>
<p>Also look out for vitamin B12 in any plant-based dairy alternatives you may buy. This vitamin is essential for the brain, nerves and blood cells. While some plant-based dairy alternatives contain vitamin B12, most don’t, so you’ll need to focus on getting vitamin B12 from other food sources. Meat typically contains the highest levels of vitamin B12, but if you follow a vegetarian or vegan diet you may need to consume yeast extract, fortified breakfast cereals or supplements to make sure you’re getting enough. </p>
<h2>Other considerations</h2>
<p>Plant-based dairy alternatives aren’t cheap – costing almost <a href="https://www.sciencedirect.com/science/article/abs/pii/S0963996921004853?via%3Dihub">three times the price</a> of cow’s milk and other dairy products (such as yoghurt). For a family of two adults and one child, the cost of consuming dairy products is around £310.89 a year – while plant-based alternatives may cost closer to £856.70 a year. Purchasing own-brand products which are fortified may be a cheaper way to avoid dairy while sticking to a budget. </p>
<p>But of course, there are many reasons why a person may need to switch to plant-based dairy alternatives – whether that’s due to allergies or environmental concerns. If you’re worried about you or your child getting enough vitamins and minerals in your diet after <a href="https://www.bda.uk.com/resource/milk-allergy.html">making the switch</a> to plant-based alternatives, it’s worth consulting with a registered dietitian or doctor. Plant-based milks are generally not recommended for children under two years. After that, fortified soya milk is likely the best alternative as it will contain important vitamins and minerals, as well as high amounts of protein.</p>
<p>If you prefer other plant-based milk alternatives, look for one that’s fortified. Avoid rice drinks if you have children under the age of five as they may contain high levels of arsenic. But thanks to increasing interest in plant-based diets, there’s now a wealth of choice when it comes to plant-based dairy alternatives – just make sure you read the label before buying one.</p><img src="https://counter.theconversation.com/content/183391/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Miriam Clegg receives funding from the Medical Research Council, Biological Sciences Research Council, EIT Food, Horizon 2020, Apetito, and Tanita Healthy Weight Community Trust.</span></em></p>Look out for products fortified with important vitamins and minerals.Miriam Clegg, Associate Professor in Human Nutrition, University of ReadingLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1679462021-09-20T11:38:23Z2021-09-20T11:38:23ZGargling with iodine won’t stop you getting COVID<p>Social media is awash with bogus COVID treatments. First, there was <a href="https://theconversation.com/hydroxychloroquine-for-covid-19-a-new-review-of-several-studies-shows-flaws-in-research-and-no-benefit-137869">hydroxychloroquine</a>, then <a href="https://www.theguardian.com/world/2020/sep/19/bleach-miracle-cure-amazon-covid">bleach</a>, followed hard on the heels by <a href="https://theconversation.com/ivermectin-is-still-not-a-miracle-cure-for-covid-19-despite-what-you-may-have-read-144569">ivermectin</a> – a cattle dewormer. The latest on the scene is <a href="https://www.rollingstone.com/culture/culture-news/betadine-anti-vaxxer-covid-treatment-iodine-1225438/">povidone-iodine</a>, an antiseptic. </p>
<p>Some people have claimed on social media that gargling with iodine can prevent the spread and severity of a COVID infection, suggesting it as an alternative to getting the vaccine. </p>
<p>Iodine has been used as an antiseptic for almost two centuries, with povidone-iodine being a commonly used modern preparation. Laboratory studies have shown that it is <a href="https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2770785">effective against coronavirus</a>, inactivating it in as little as 15 seconds. This caused the researchers who made the discovery to suggest that using povidone-iodine in the nose and mouth could help to reduce the person-to-person spread of coronavirus and limit the severity of the disease in those infected. This presumes that what happens in the test tube will also happen in humans, which is a significant leap of faith.</p>
<p>The idea of halting infection in the mouth has been around for a while. Until the 1970s, the makers of Listerine mouthwash claimed that using it regularly could prevent colds and sore throats, until they were obliged to remove this claim because of <a href="https://www.nytimes.com/1978/04/04/archives/ftc-upheld-on-listerines-ads-as-supreme-court-bars-a-review-93.html">lack of evidence</a>. Trials since then that have looked at gargling to reduce colds and flu have shown conflicting results, with little evidence of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041358/">any worthwhile benefit</a>.</p>
<p>In Japan, daily gargling for hygienic reasons has been a <a href="https://pubmed.ncbi.nlm.nih.gov/16242593/">common cultural practice for centuries</a>, using everything from water, to tea, to antiseptics. During a press conference in August 2020, the state governor of Osaka prefecture, responding to a very small research study, suggested that gargling with povidone-iodine <a href="https://www.japantimes.co.jp/news/2020/08/04/national/gargle-medicine-coronavirus-osaka-governor-hirofumi-yoshimura/">would help prevent COVID</a>. When questioned about the strength of the scientific evidence, he side-stepped the question, replying: “It’s worth giving a try.” </p>
<p>Similar advice – based on a hunch – has been offered by <a href="https://www.kcl.ac.uk/news/could-a-cheap-iodine-mouthwash-really-help-to-beat-covid">oral-health experts in the UK</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1437477930368524288"}"></div></p>
<p>A recent <a href="https://www.sciencedirect.com/science/article/pii/S1882761621000065">review of the evidence</a> attempted to answer the question: does povidone-iodine reduce the transmission of COVID? Much of this research turned out to be laboratory studies, with relatively few trials carried out on patients. </p>
<p>While these patient-based studies suggest that povidone-iodine can inactivate coronavirus in the mouth for a period of time - an unsurprising finding - there is not a single study to date that shows it will stop the transmission of coronavirus or reduce the severity of the disease in those already infected. Using a simple analogy, cleaning down a work surface with antiseptic wipes will only ever provide temporary disinfection.</p>
<h2>Questionable argument</h2>
<p>The “worth giving a try” argument is questionable. From a practical point of view, povidone-iodine is difficult for many patients to use in the mouth and nose as it tastes and smells disgusting. While side-effects of povidone-iodine are mostly tolerable, irritation of the skin is common and sometimes severe. More rarely, but more seriously, povidone-iodine can cause an underactive thyroid gland, particularly in <a href="https://bnf.nice.org.uk/drug/povidone-iodine.html">pregnant women</a>. </p>
<p>The makers of povidone-iodine are <a href="https://betadine.com/covid-19/#1596710159395-1cf8cac7-1b26">clear in advising people</a> that their products are not designed for gargling or putting in the nose to prevent COVID.</p>
<p>Aside from the immediate risks of using povidone-iodine inside the body, is the harmful effect of promoting treatments for a pandemic that are not based on reliable evidence, particularly when there are measurably effective alternatives. Gargling with iodine won’t stop you from getting COVID, but it may distract you from something that will: vaccines.</p><img src="https://counter.theconversation.com/content/167946/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Roger Tisi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Misinformation is spreading on social media that gargling with povidone-iodine can prevent COVID.Roger Tisi, Associate Professor, Head of Undergraduate Medicine, School of Medicine, Anglia Ruskin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1077082019-04-30T20:13:26Z2019-04-30T20:13:26ZHave you gone vegan? Keep an eye on these 4 nutrients<figure><img src="https://images.theconversation.com/files/271649/original/file-20190430-194630-1afyvj1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Legumes are a good source of calcium.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthy-homemade-chickpea-veggies-salad-jar-535446037?src=vLw9oCI1nLotsXy-87sbEw-1-34">Saschanti17/Shutterstock</a></span></figcaption></figure><p>There are <a href="https://veganuary.com/au/why/">many reasons</a> people go vegan, from wanting to be healthier, to reducing their environmental footprint, to concerns about animal welfare.</p>
<p>No matter what the reason, many people find it difficult to meet the <a href="https://www.nrv.gov.au/nutrients">nutrient intake targets</a> for specific vitamins and minerals while on a vegan diet. These include vitamin B12, iron, calcium, and iodine. </p>
<p>Here’s how to make sure you’re getting enough of these vitamins and minerals while following a vegan diet.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/vegan-diet-how-your-body-changes-from-day-one-100413">Vegan diet: how your body changes from day one</a>
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</em>
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<h2>1. Vitamin B12</h2>
<p><a href="https://www.nrv.gov.au/nutrients/vitamin-b12">Vitamin B12</a>, or cobalamin, is essential for making red blood cells, DNA (your genetic code), fatty acids located in <a href="https://en.wikipedia.org/wiki/Myelin">myelin</a> (which insulate nerves), and some neurotransmitters needed for brain function. </p>
<p>Vitamin B12 is stored in the liver, so a deficiency probably won’t happen in adults in the short term.</p>
<p><strong>Symptoms of B12 deficiency</strong></p>
<p>Symptoms of vitamin B12 <a href="https://www.healthline.com/health/vitamin-b12-level">deficiency</a> include tiredness, lethargy, low exercise tolerance, light-headedness, rapid heart rate or palpitations, bruising and bleeding easily, weight loss, impotence, bowel or bladder changes, a sore tongue, and bleeding gums. </p>
<p>Other <a href="https://www.nrv.gov.au/nutrients/vitamin-b12">symptoms related to the nervous system</a> include a loss of sensation in the hands or feet, problems related to movement, brain changes ranging from memory loss to mood changes or dementia, visual disturbances, and impaired bowel and bladder control. </p>
<p><strong>Testing for B12 deficiency</strong> </p>
<p>Your doctor may request a <a href="https://www.healthdirect.gov.au/vitamin-b12-test">blood test</a> to check your vitamin B12 status and determine whether indicators are in the <a href="https://www.labtestsonline.org.au/learning/test-index/vitamin-b12">healthy range</a>.</p>
<p><strong>Vegan food sources of B12</strong></p>
<p>Vitamin B12 is <a href="https://www.nrv.gov.au/nutrients/vitamin-b12">abundant in animal foods</a> including meat, milk and dairy products. </p>
<p>For vegans, plant sources of vitamin B12 include some algae and plants exposed to bacterial action or contaminated by soil or insects. While traces of vitamin B12 analogues can be found in some mushrooms, nori or fermented soy beans, more reliable sources include vitamin B12-supplemented soy or nut “milks”, or meat substitutes. Check the nutrition information panel on the label for the the B12 content. </p>
<p><a href="https://www.nrv.gov.au/nutrients/vitamin-b12">Crystalline vitamin B12</a> added to these products can boost the B12’s absorption rate to a level similar to that from animal products. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/271660/original/file-20190430-194609-1dzhtrz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Meat substitutes are often supplemented with B12.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/407288122?src=7DIfZxJLmk1QUWRMkz3hPA-1-14&size=huge_jpg">Stephanie Frey/Shutterstock</a></span>
</figcaption>
</figure>
<h2>2. Calcium</h2>
<p><a href="https://www.healthdirect.gov.au/calcium">Calcium</a> is needed to develop and maintain the skeleton bones, and is stored in the teeth and bones. It is also essential for heart, muscle and nerve function. </p>
<p><strong>Testing for calcium deficiency</strong> </p>
<p>Low calcium intakes are associated with <a href="https://www.osteoporosis.org.au/what-it">osteoporosis</a> or “brittle bones” and a higher risk of bone fractures. </p>
<p>A <a href="https://www.osteoporosis.org.au/diagnosis">bone scan is used</a> to measure bone density, with <a href="https://www.healthdirect.gov.au/osteoporosis-diagnosis">osteoporosis diagnosed</a> when bone density is low. </p>
<p>Both low calcium intakes and low vitamin D levels increase the risk of osteoporosis. Check your bone health using the <a href="https://www.knowyourbones.org.au/">Know Your Bones online quiz</a>. </p>
<p><strong>Vegan food sources of calcium</strong></p>
<p>Although the richest sources of calcium are milk and milk-based foods, vegans can get calcium from tofu or bean curd, some fortified soy or nut beverages, nuts, seeds, legumes, and breakfast cereals. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/271650/original/file-20190430-194603-e1fvju.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Nut and soy milks are a good source of calcium.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/soymilk-may-be-used-substitute-dairy-1294096993?src=Z28w0wPZMiLq6Rg4mQv3vA-1-9">Rodica Ciorba/Shutterstock</a></span>
</figcaption>
</figure>
<p>Calcium needs can be higher for vegans and vegetarians due to the relatively high <a href="https://en.wikipedia.org/wiki/Oxalic_acid">oxalic acid</a> content of foods such as spinach, rhubarb, beans, and the high <a href="https://en.wikipedia.org/wiki/Phytic_acid">phytic acid</a> content of seeds, nuts, grains, some raw beans, and soy products. These specific acids can lower the calcium absorption from these foods by 10-50%.</p>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/24667136">study of calcium intakes of 1,475 adults </a>, vegans were below national recommendations and had lower calcium intakes compared with vegetarians, semi-vegetarians, pesco-vegetarians, and omnivores.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-how-do-our-bones-get-calcium-and-why-do-they-need-it-75227">Explainer: how do our bones get calcium and why do they need it?</a>
</strong>
</em>
</p>
<hr>
<h2>3. Iodine</h2>
<p><a href="https://www.nrv.gov.au/nutrients/iodine">Iodine</a> is needed to make thyroxine, a thyroid hormone used in normal growth, regulation of metabolic rate, and development of the central nervous system. <a href="https://www.healthdirect.gov.au/iodine">Iodine</a> is concentrated in the thyroid gland.</p>
<p><strong>Symptoms of iodine deficiency</strong></p>
<p><a href="https://www.thyroidfoundation.org.au/Iodine-Deficiency">Iodine deficiency</a> can lead to the enlargement of the thyroid gland, a <a href="https://www.healthdirect.gov.au/goitre">goitre</a>, or hypothyroidism. </p>
<p><a href="https://www.thyroidfoundation.org.au/Iodine-Deficiency">Symptoms of hypothyroidism</a> include lethargy, tiredness, muscular weakness, feeling cold, difficulty concentrating, poor memory, weight gain, depression, facial puffiness, hair loss, dry skin, constipation, and slower heartbeat. </p>
<p>In women, iodine deficiency can increase risk of miscarriage and stillbirth, and congenital anomalies, including mental retardation and <a href="https://en.wikipedia.org/wiki/Congenital_iodine_deficiency_syndrome">cretinism</a>. </p>
<p><strong>Testing for iodine deficiency</strong> </p>
<p>Your iodine status can be assessed by a range of tests, including thyroid hormones in your blood, the size of your thyroid gland, or the presence of a goitre. Talk to your doctor about these tests. </p>
<p><strong>Vegan food sources of iodine</strong></p>
<p>The <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/iodine">iodine content of food</a> depends on the iodine content of plants, which in turn depends on soil iodine content. When soil content is low, iodine may need to be supplemented. </p>
<p>Major sources of iodine are seafood, dairy products, and eggs. </p>
<p>For vegans, iodised salt, commercial bread made using iodised salt, fortified soy or nut milks (check the product label) and seaweed are important. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/271663/original/file-20190430-194609-1c673kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Iodine is added to some salts.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/266034749?src=a3U1zoGU9rYfErdHsdPCoA-1-22&size=huge_jpg">IlzeTheBeast/Shutterstock</a></span>
</figcaption>
</figure>
<p>Substances called goitrogens, which are found in <a href="https://en.wikipedia.org/wiki/Brassica">brassica vegetables</a> – including cabbage, broccoli and Brussels sprouts, sweet potato and maize – can interfere with the production of thyroid hormones. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lack-of-dietary-iodine-threatens-brain-development-in-children-14996">Lack of dietary iodine threatens brain development in children</a>
</strong>
</em>
</p>
<hr>
<h2>4. Iron</h2>
<p><a href="https://www.nrv.gov.au/nutrients/iron">Iron</a> is needed to make <a href="https://en.wikipedia.org/wiki/Hemoglobin">haemoglobin</a> in red blood cells, which carries oxygen around your body. </p>
<p>Iron is <a href="https://www.healthshare.com.au/factsheets/12147-iron-deficiency/">also needed for the production of energy</a> in your muscles, and for concentration and a healthy immune system. </p>
<p><strong>Symptoms and testing for iron deficiency and anaemia</strong></p>
<p>Not having enough iron leads to <a href="https://www.healthdirect.gov.au/iron-deficiency">iron deficiency</a>, and is associated with reduced work capacity, impaired brain function, lower immunity, and delayed development in infants. </p>
<p>The first stage of iron deficiency is referred to as <a href="https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/iron-deficiency-adults">low iron stores</a> and your doctor may refer you for a <a href="https://www.healthdirect.gov.au/iron-studies">blood test</a> to check your iron status. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ive-been-diagnosed-with-iron-deficiency-now-what-87670">I've been diagnosed with iron deficiency, now what?</a>
</strong>
</em>
</p>
<hr>
<p><strong>Vegan food sources of iron</strong></p>
<p>In Australia and New Zealand, the biggest contributors to iron intake are wholegrain cereals, meats, chicken, and fish. </p>
<p>The amount of iron absorbed from food depends on a person’s iron status (with those who are iron-deficient absorbing more), as well as the iron content of the entire meal, and whether iron is haem (from animal foods) or non-haem iron from plant sources such as grains and vegetables. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/271657/original/file-20190430-194633-1sxme7g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Whole grains are rich in iron.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1135582598?src=K3o6CoVyDdqRkgkQLKBNpw-1-0&size=huge_jpg">Photka/Shutterstock</a></span>
</figcaption>
</figure>
<p>Although iron from plant sources is less able to enter the body, you can boost your absorption by adding lemon or lime juice (citric acid) or other vitamin C-rich vegetables and fruits, which convert non-haem iron to a form than is better absorbed. </p>
<p>Take care with food components that inhibit absorption of both haem and non-haem iron, including calcium, zinc and phytates in legumes, rice and other grains, and <a href="https://foodwatch.com.au/blog/super-foods/item/top-100-polyphenols-what-are-they-and-why-are-they-important.html">polyphenols</a> and vegetable proteins that can inhibit absorption of non-haem iron. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-iron-is-such-an-important-part-of-your-diet-69974">Why iron is such an important part of your diet</a>
</strong>
</em>
</p>
<hr>
<p>Long-term vegans will also need to keep an eye on levels of <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/vitamin-d">vitamin D</a>, <a href="https://www.heartfoundation.org.au/news/omega-3-fatty-acid-the-importance-of-fat-in-a-healthy-diet">omega-3 fat</a> and <a href="https://www.betterhealth.vic.gov.au/health/HealthyLiving/protein">protein</a>.</p>
<p>A good strategy is to check in with your GP periodically to review your health and well-being, and an <a href="https://daa.asn.au/find-an-apd/">accredited practising dietitian</a> can check whether you’re getting all the nutrients you need.</p><img src="https://counter.theconversation.com/content/107708/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and 2017 evidence review on dietary patterns for the Heart Foundation.</span></em></p>Are you getting enough vitamin B12, calcium, iodine and iron? Here’s what can happen if you don’t get enough – and how to ensure you do.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/942952018-05-24T20:04:03Z2018-05-24T20:04:03ZPlain, Greek, low-fat? How to choose a healthy yoghurt<figure><img src="https://images.theconversation.com/files/218000/original/file-20180508-46353-4spjww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">With all the different types of yogurt on offer, making a decision on which one to buy can be difficult.</span> <span class="attribution"><span class="source">from shutterstock.com</span></span></figcaption></figure><p>Yoghurt is one of the oldest fermented dairy foods in the world. Its origins date back to the <a href="https://academic.oup.com/nutritionreviews/article/73/suppl_1/4/1819293">dawn of civilisation</a>. When humans began domesticating animals for milk production, milk’s short shelf life required solutions for storing it. </p>
<p>The word “yoghurt” itself <a href="https://www.elsevier.com/books/tamime-and-robinsons-yoghurt/tamime/978-1-84569-213-1">comes from Turkish</a>, meaning something like “curdled” or “thickened milk”, which is pretty much what happens to milk during yoghurt production.</p>
<p>Like milk, yoghurt is a rich source of calcium and protein. And it <a href="https://academic.oup.com/ajcn/article/99/5/1243S/4577504">provides other nutrients</a> such as iodine, vitamins D, B2 and B12, and zinc. </p>
<p>But yoghurt is actually more nutritious than milk. The main reason is that the fermentation process makes it easier to digest, so the nutrients can be absorbed more easily into the body.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/from-bulgaria-to-east-asia-the-making-of-japans-yogurt-culture-76598">From Bulgaria to East Asia, the making of Japan's yogurt culture</a>
</strong>
</em>
</p>
<hr>
<p>Yet with all the various types, like Greek and liquid yoghurts, and ones with added fruits and probiotics, how do you know which one is healthiest?</p>
<h2>Making yoghurt</h2>
<p>Yoghurt is made by introducing certain bacteria into fresh milk – typically <em>Streptococcus thermophilus</em> and <em>Lactobacillus delbrueckii subsp. bulgaricus</em>. </p>
<p>Usually, both these bacteria are present in yoghurt and form the yoghurt starter culture. Their synergistic relationship is a key factor in the consistency of the final product. These cultures may also provide some health benefits, such as reducing the <a href="https://www.ncbi.nlm.nih.gov/pubmed/14627358">severity and duration of diarrhoea</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/217999/original/file-20180508-46364-gsqsl6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Yoghurt is made by introducing a starter culture of bacteria into milk.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/inthe-arena/10372695863/in/photolist-gNAM6R-a41WoE-axxDjL-a2qdFb-cJ4KiQ-zaiG5-9Y5u1V-bwktpH-dZ1WpZ-axxESN-PFwbv-9e57PA-6aaynh-quG5pa-4pQyL1-6Y4eiy-9ZSM8P-9AXD83-6LMsD4-aavUZL-oejucg-axxD3s-axuXvv-axuYuR-6LRBJL-axuXQx-6DnSyf-QDWHf4-6o6EZa-QGLYwE-axxDAj-5hSCbx-GmBLc-7A5ypG-dRGUct-7Szc93-8bhcPt-6eHCk5-29yKSq-7TwfT5-9v9n8t-SBbdNf-dtoEBA-buwu2p-9WgKAp-aoxrax-8ZFTF-eyrRok-9Deo3D-nZqQc">Andrew Seaman/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The bacteria ferment the naturally occurring milk sugar (lactose) for energy and growth. During this process, lactose becomes lactic acid. The acidity development leads to the main milk protein, casein, breaking down and losing some of its elementary structure. </p>
<p>This partial breakdown results in the semi-solid, gel-like structure we know as yoghurt. The lactic acid is also responsible for yoghurt’s sour flavours, as well as helping it stay fresher for longer than milk. </p>
<h2>What makes yoghurt healthy?</h2>
<p>Yoghurt is easier to digest than milk because enzymes involved in the fermentation process break down substances, such as lactose, into <a href="https://academic.oup.com/ajcn/article/99/5/1243S/4577504">smaller compounds</a>, which can be readily absorbed and used by the body. And certain minerals, such as calcium, phosphorus and iron, are <a href="https://www.sciencedirect.com/science/article/pii/B9780128051344000018">better used by the body</a> when they come from yoghurt.</p>
<p>And because lactose is broken down and converted to lactic acid during fermentation, lactose-intolerant people can consume yoghurt without adverse effects. </p>
<p>Consuming yoghurt is associated with <a href="https://www.elsevier.com/books/yogurt-in-health-and-disease-prevention/shah/978-0-12-805134-4">many health benefits</a>, including maintaining a healthy microbiota (the colony of bacteria in your gut). Yoghurt can feed the good bacteria and help them fight against <a href="https://www.ncbi.nlm.nih.gov/pubmed/26995128">disease-causing microorganisms</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-the-gut-microbiota-and-how-does-it-affect-mind-and-body-40536">Explainer: what is the gut microbiota and how does it affect mind and body?</a>
</strong>
</em>
</p>
<hr>
<p>Yoghurt consumption helps to maintain bone structure and has even been found to reduce the risk of <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.26193">certain cancers</a> and infectious diseases, as it enhances the immune response. Yoghurt <a href="https://academic.oup.com/ajcn/article/80/2/245/4690304">can help reduce symtpoms of conditions</a> such as constipation, inflammatory bowel disease, infection with a bacterium that can damage the stomach lining (<em>Helicobacter pylori</em>), <a href="http://www.who.int/en/news-room/fact-sheets/detail/diarrhoeal-disease">diarrhoeal diseases</a> and some allergic reactions, such as to certain foods. </p>
<h2>Types of yoghurt</h2>
<p>Cow’s milk is the most widely used raw ingredient for yoghurt manufacturing. But other types, such as sheep and goat milk yoghurt, are available. There are slight differences in the nutritional composition among these milk types. </p>
<p>Although cow’s milk is generally more appealing (as goat and sheep milk may have <a href="https://wakethewolves.com/goats-milk-vs-cows-milk-is-there-a-difference/">unpleasant smells</a>), the latter two may provide additional health benefits. For instance, <a href="https://www.sciencedirect.com/science/article/pii/S0308814612009971">goat’s milk is easier to digest</a> than cow’s milk and is less likely to cause an allergic reaction.</p>
<p>Non-dairy alternatives such as soy and coconut milk yoghurt are becoming increasingly popular too.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/218004/original/file-20180508-46364-qvpfkx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Goat’s milk is easier to digest than cow’s milk.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
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</figure>
<p>The most commonly known types of yoghurt are plain set yoghurt, flavoured yoghurt, Greek yoghurt, frozen yoghurt and drinking yoghurt.</p>
<p><em>Plain set yoghurt</em> is usually made from dairy ingredients and fermented in the cups or tubs with no sugar or sweeteners.</p>
<p><em>Flavoured yoghurt</em> is made by adding sugar and fruit or other flavourings to plain yoghurt. Often, the milk mixture is fermented in large vats, cooled and then stirred for a creamy texture with various fruits or other flavours. These stirred yoghurts are also known as Swiss-style yoghurts.</p>
<p><em>Greek yoghurt</em> is a thick yoghurt. It’s traditionally prepared by straining the water known as whey from plain yoghurt to make it thicker, richer and creamier. It contains more protein than regular yoghurt and has no added sugar.</p>
<p><em>Frozen yoghurt</em> is frozen ice milk with a typical yoghurt flavour. It tastes more like ice-cream with a hint of yoghurt.</p>
<p><em>Drinking yoghurts</em> are prepared from a yoghurt mix with reduced milk solids. They come in almost every variety and flavour. They’re usually more watery, but some thick varieties are also available. Kefir and lassi are the popular drinking yoghurt types.</p>
<h2>Added ingredients for health purposes</h2>
<p>Many yoghurts contain added ingredients. These include <a href="https://www.benecol.co.uk/our-products/yogurts/garden-fruits?utm_medium=cpc&utm_source=google&utm_term=benecol-yogurt&utm_content=text&utm_campaign=mec---brand---product---yogurt-(b)&gclid=CjwKCAjw2dvWBRBvEiwADllhn7saBYlt7KTGzuaG_kj7emog2j957TlcdEyjB46RLqqdjIfeKp5AzBoCV68QAvD_BwE&gclsrc=aw.ds">cholesterol-lowering compounds</a> (such as stanol and sterol esters) and <a href="https://www.ncbi.nlm.nih.gov/pubmed/26619790">fibre</a> aimed at improving gut health. </p>
<p>Some yoghurts also have added probiotics. These are <a href="http://www.mdpi.com/2311-5637/3/4/67">live microorganisms</a> that can help establish a healthy gut microbiota. The most widely used probiotics are the acidophilus strain, known as <em>Lactobacillus acidophilus</em>, and <em>Bifidobacterium</em>. These could be useful for people who have gastrointestinal problems such as <a href="https://link.springer.com/article/10.1007/s00535-016-1224-y">irritable bowel syndrome (IBS)</a>.</p>
<p>Probiotics can be more effective when <a href="https://www.sciencedirect.com/science/article/pii/S0963996909002749">consumed in yoghurt</a> than through capsules or <a href="https://www.sciencedirect.com/science/article/pii/S096399691300330X">other beverages</a>.</p>
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Read more:
<a href="https://theconversation.com/so-you-think-you-have-ibs-coeliac-disease-or-crohns-heres-what-it-might-mean-for-you-39128">So you think you have IBS, coeliac disease or Crohn’s? Here’s what it might mean for you</a>
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<p>The two bacteria in yoghurt starter culture – <em>S. thermophilus</em> and <em>L. delbrueckii</em> ssp. <em>bulgaricus</em> – are not <a href="https://www.elsevier.com/books/yogurt-in-health-and-disease-prevention/shah/978-0-12-805134-4">natural inhabitants</a> of the intestine and cannot survive the acidic conditions and bile concentrations in the gastrointestinal tract. So they don’t do much to change the microbiota in your gut. In contrast, probiotics can survive and colonise the large intestine.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/218012/original/file-20180508-46359-c4cs2i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">It’s healthier to add your own fruit to yoghurt than to buy fruity yoghurt.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/MFs_fEGsoqY">Peter Hershey/Unsplash</a></span>
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<p>Regular intake of yoghurt that contains microbial cultures such as probiotic acidophilus has also been found to potentially reduce the risk of coronary heart disease by helping to <a href="https://www.tandfonline.com/doi/abs/10.1080/07315724.1999.10718826">decrease cholesterol absorption</a>. </p>
<h2>Which yoghurt is better for you?</h2>
<p>When whole milk is used to produce plain yoghurts, these may contain 3.5-4.4 grams of fat per 100g. Low-fat yoghurt contains less than 3g of fat per 100g, and non-fat or fat-free yoghurts must contain less than <a href="http://www.legendairy.com.au/%7E/media/Legendairy/Documents/Health/Fact%20sheets/2012%20Proximate%20Composition%20Booklet.ashx">0.15g fat per 100g</a>. </p>
<p>High fat and high sugar in any food can lead to health problems. So, a low-fat and low-sugar yoghurt product, like a low-fat Greek yoghurt, would be ideal if you’re looking to keep healthy.</p>
<p>Yoghurt products incorporating fruit or nuts can provide additional nutritional and health benefits, but many of these can also contain added sugar. Adding fresh fruit or nuts to a yoghurt yourself is a healthier option.</p>
<p>If you would like to have probiotic effects, you can choose a product with acidophilus or bifidobacteria. </p>
<p>You should check the product label as it is a legal requirement to list all the ingredients, cultures and nutritional information in commercial yoghurts. When it comes to probiotic yoghurts, it’s always better to choose a fresh product rather than one closer to the expiry date, as <a href="http://www.mdpi.com/2311-5637/3/4/67">probiotics die during storage</a>.</p><img src="https://counter.theconversation.com/content/94295/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor is a director, council member and spokesperson of the British Dietetic Association</span></em></p><p class="fine-print"><em><span>Nenad Naumovski, Said Ajlouni, and Senaka Ranadheera do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Consuming yoghurt is associated with many health benefits. But with all the varieties of yoghurt, and added ingredients like fruits and probiotics, it can be hard to know which is best for your health.Senaka Ranadheera, Tutor, The University of MelbourneDuane Mellor, Senior Lecturer, Coventry UniversityNenad Naumovski, Asistant Professor in Food Science and Human Nutrition, University of CanberraSaid Ajlouni, Associate Professor, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/835892017-09-26T13:36:19Z2017-09-26T13:36:19ZMost milk substitutes are low in iodine – here’s why it matters<figure><img src="https://images.theconversation.com/files/187211/original/file-20170922-17306-1i0bwo5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">shutterstock</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/357947024?src=DZkNKEZiit41MKn-gWbUdg-1-4&size=medium_jpg">Alexander Prokopenko/Shutterstock</a></span></figcaption></figure><p>Milk and dairy products are the main source of iodine in many diets, and an important iodine source in many countries. However, our <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/iodine-concentration-of-milkalternative-drinks-available-in-the-uk-in-comparison-with-cows-milk/C0EB7183E42B81548331405F83332258">latest research</a> found that the iodine concentration of most alternatives to cows’ milk – such as soy and almond “milk” – is very low. This matters because deficiency of iodine, especially during pregnancy, affects brain development and is linked to lower intelligence.</p>
<p>As people increasingly <a href="http://www.mintel.com/press-centre/food-and-drink/is-it-game-set-and-match-for-traditional-cream-at-years-wimbledon">switch</a> from cows’ milk to alternative drinks, and their <a href="https://dairy.ahdb.org.uk/market-information/dairy-sales-consumption/liquid-milk-market/#.WcUuR7KGNaR">sales grow</a>, we wanted to know if consumers of these products would be able to match the amount of iodine in cows’ milk. To do this we measured the iodine concentration of 47 milk substitutes available in the UK, including a range of different types: soya, almond, oat, rice, coconut, hazelnut and hemp (but excluding those marketed for infants and children). </p>
<p>We found that most milk substitutes were naturally low in iodine; their concentration was around 2% of that of cows’ milk. And only three of the 47 drinks were fortified with iodine. While some manufacturers replace the calcium found in cows’ milk, the vast majority, including big brands, do not replace the iodine. </p>
<p>We are aware that consumers may choose these alternatives for a variety of reasons, including allergy or intolerance to cows’ milk, so it is important that they are aware of the low iodine content of milk substitutes and the potential health consequences. </p>
<h2>Iodine matters</h2>
<p>Most people don’t know that iodine is found in cows’ milk and are unaware that they need a certain amount in their diet. In the UK, iodine is not listed on the nutrition information labels on milk containers, and there is <a href="https://www.ncbi.nlm.nih.gov/pubmed/27855727">little knowledge</a> that iodine intake matters – <a href="https://www.ncbi.nlm.nih.gov/pubmed/26005740">even among pregnant women</a>. </p>
<p>Cows’ milk is an excellent source of iodine, with a glass (200g) providing around 70μg (micrograms), a considerable proportion of the 150μg iodine intake <a href="https://www.efsa.europa.eu/en/efsajournal/pub/3660">recommended for European adults</a> every day. By contrast, our study found that a glass of milk substitute would provide only around two micrograms. </p>
<p>The drinks with added iodine (as stated on the ingredients label) provided a reasonable amount of iodine (between 45μg and 60μg per glass). But, as these drinks were not from a market leader, most consumers will probably not get enough iodine in their diet from this source.</p>
<p>Severe iodine deficiency during pregnancy is well known to cause impaired brain development and lead to lower IQ in the infant. It is for that reason that many countries have added iodine to table salt (iodised salt) in order to improve iodine intake and reduce the impact of deficiency on population health. As a result, the number of countries with severe iodine deficiency has been reduced, <a href="http://www.ign.org/scorecard.htm">but some countries</a> are still classified as mildly-to-moderately iodine deficient. </p>
<p>But as our <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60436-5/abstract">earlier research</a> has shown, even mild-to-moderate iodine deficiency in pregnant women is linked to lower IQ and reading scores in their children, up to nine years of age. </p>
<h2>Other dietary sources</h2>
<p>Of course, milk is not the only source of iodine. Other <a href="https://www.bda.uk.com/foodfacts/Iodine.pdf">rich sources</a> include seafood – particularly white fish, such as cod. Eggs are also a good source of iodine. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/187213/original/file-20170922-17241-moeltf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Cod is a good source of iodine.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/266014253?src=26qfMuvzhcjfef7xRopVyA-1-0&size=medium_jpg">TunedIn by Westend61/Shutterstock</a></span>
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<p>For people who cannot or will not eat these alternative sources – such as vegans or those who dislike fish – it can be hard to meet the recommended iodine intake. Some people may therefore need to consider a suitable iodine supplement to ensure that their intake is adequate. </p>
<p>It is very important that kelp supplements – often sold as an iodine source in health food shops – are not used, as they can provide excessive amounts of iodine. </p>
<p>Unfortunately, there is no test for iodine deficiency. To know if you’re getting enough iodine, you need to consider whether iodine sources are part of your diet. We have written <a href="https://www.bda.uk.com/foodfacts/Iodine.pdf">a fact sheet on iodine</a>, available through the British Dietetic Association, that can help you understand how to meet the recommendations.</p><img src="https://counter.theconversation.com/content/83589/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Sarah Bath has previously received funding from The Medical Research Council and lecture fees from the Dairy Council. </span></em></p><p class="fine-print"><em><span>Margaret Rayman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The low iodine concentration in milk substitutes may mean consumers are at risk of iodine deficiency.Sarah Bath, Lecturer in Public Health Nutrition, University of SurreyMargaret Rayman, Professor of Nutritional Medicine, University of SurreyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/763522017-04-21T04:44:35Z2017-04-21T04:44:35ZFive ways to boost your nutrition before pregnancy<figure><img src="https://images.theconversation.com/files/166204/original/file-20170421-20068-11p72p7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women (and their partners) can give their baby the best start in life by eating well even before they conceive.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/613852691?src=fbc33egthBZ5G0EgfU_9PA-2-27&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Thinking about trying to have a baby? Then now is the time for <a href="https://www.ncbi.nlm.nih.gov/pubmed/22742616">future mums</a> (<a href="https://www.ncbi.nlm.nih.gov/pubmed/25523615">and dads</a>) to “spring clean” food and lifestyle habits. Here are our five nutrition tips <em>before</em> pregnancy. </p>
<h2>1. Aim for a healthy weight</h2>
<p>In your 20s and 30s it’s common to have “weight creep”, an extra kilogram or two gained each year, without realising. Carrying too much weight increases the risk of pregnancy complications, including <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-gestational">gestational diabetes</a>, <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-pre-eclampsia">pre-eclampsia</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/19173021">delivery complications</a>. So, it’s worth trying to shift some of the “extra kilos” before trying to conceive.</p>
<p>A mother’s pre-pregnancy weight also has a direct <a href="https://www.ncbi.nlm.nih.gov/pubmed/23613888">effect on her baby’s birth weight</a>. Compared with mothers who are in the healthy weight range, mothers who are overweight or obese are 1.5-2 times more likely to have babies with a high birth weight, increasing the risk of birth complications. For these infants, there is an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pubmed/19173021">obesity, heart disease</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/25940642">type 1 diabetes</a> later in life. </p>
<p>But improving eating and physical activity helps you achieve <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">a healthy weight right for you</a>. For women carrying excess weight, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/25336072">loss of 5-10% of pre-pregnancy weight</a> is enough to improve fertility and reduce the risk of weight-related pregnancy complications.</p>
<h2>2. Improve your food and drink choices</h2>
<p>Increasing the variety of food you eat each week across the basic food groups – vegetables, fruit, wholegrains, vegetarian foods (including legumes like baked beans, kidney beans, lentils, eggs, nuts and seeds), lean meats/poultry/fish and dairy foods – also boosts the vitamins and minerals needed from the very beginning of pregnancy. </p>
<p>Start by assessing the quality of your diet using the free <a href="http://healthyeatingquiz.com.au/">Healthy Eating Quiz</a> and check how it suggests you boost your score. You can also use the <a href="https://www.eatforhealth.gov.au/node/add/calculator-servings">eat-for-health calculator</a> linked to the <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian Guide to Health Eating</a>. This calculates recommended daily serves from each of the five basic food groups, and gives an idea of daily serves to aim for to optimise your nutrients.</p>
<p>Getting your nutrients from food in the first instance is recommended, but some nutrients do need extra attention before conception and early in pregnancy.</p>
<h2>3. Take a folate supplement</h2>
<p><a href="https://en.wikipedia.org/wiki/Folate">Folate</a> is a B-group vitamin. It is needed to complete the development of the <a href="https://en.wikipedia.org/wiki/Neural_tube">neural tube</a>, which forms the baby’s brain and spinal cord in the first few weeks of pregnancy. This can be before you even know you’re pregnant. If the neural tube doesn’t close it can cause a neural tube defect like <a href="https://en.wikipedia.org/wiki/Spina_bifida">spina bifida</a>. </p>
<p>Taking a folate supplement (in the form of folic acid) from one month before pregnancy until the end of the first trimester is the best way to make sure you meet folate requirements during early pregnancy. </p>
<p>Choose a supplement with at least 400 micrograms of folic acid. Talk to your doctor if you have a family history of neural tube defects as you will need <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/folate-for-pregnant-women">higher levels of folic acid</a>. </p>
<p>A folate supplement is in addition to eating good food sources of folate, like green leafy vegetables, fruits, lentils and <a href="http://www.foodstandards.gov.au/consumer/generalissues/pregnancy/folic/Pages/default.aspx">breadmaking flour, most of which is fortified with folic acid in Australia)</a>. Organic breadmaking flour and most regular flour is not fortified, so check the ingredient list on flour you buy for home cooking.</p>
<h2>4. Take an iodine supplement</h2>
<p>In pregnancy, <a href="https://en.wikipedia.org/wiki/Iodine">iodine</a> is needed to support the baby’s developing brain and nervous system. Good food sources of iodine include <a href="http://www.foodstandards.gov.au/consumer/generalissues/pregnancy/Pages/iodineandpregnancy.aspx">seafood, dairy foods, eggs and iodine fortified breadmaking flour (except for regular and organic flour)</a>.</p>
<p>Although seafood is high in iodine, some types such as <a href="http://www.foodstandards.gov.au/consumer/chemicals/mercury/Pages/default.aspx">shark and swordfish should be avoided before and during pregnancy</a> as they may contain large amounts of mercury. </p>
<p>In Australia it is recommended that women planning to become pregnant, take an iodine supplement containing <a href="https://www.nhmrc.gov.au/guidelines-publications/new45">150 micrograms of iodine daily</a> and to continue this while pregnant or breastfeeding.</p>
<p>Talk to your doctor or pharmacist about vitamin supplements to meet your needs. For more personal advice on nutrition consult <a href="https://daa.asn.au/what-dietitans-do/choosing-your-nutrition-expert/">an Accredited Practising Dietitian</a>. </p>
<h2>5. Avoid alcohol</h2>
<p>All health authorities agree it is best to avoid alcohol from the time you start thinking about having a baby. There is no known safe level of alcohol during pregnancy. Alcohol consumed in moderate-to-large quantities can cause <a href="http://www.nofasd.org.au/resources/what-is-fasd-1">foetal alcohol syndrome</a> and increase the risk of having a baby <a href="https://www.ncbi.nlm.nih.gov/pubmed/21729235">preterm birth and of low birth weight</a>, which increases the chance of the baby having medical problems. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/17233797">risks to the baby at lower levels</a> are less clear. <a href="https://www.nhmrc.gov.au/health-topics/alcohol-guidelines">The safest option is drinking no alcohol</a> if you are pregnant, planning a pregnancy or breastfeeding.</p>
<h2>Putting it all together</h2>
<p>Now is the time to start make changes to improve the nutritional quality of your food. And it’s not all about mum.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/25523615">Dads-to-be can benefit</a> from eating a variety of nutritious foods, cutting down on alcohol, and <a href="https://theconversation.com/health-check-ten-ways-to-save-2-000-kilojoules-and-drop-a-clothes-size-37039">dropping a pants size</a>. One study found that overweight men were 1.2 times and obese men were 1.3 times <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521747/">more likely to be infertile</a>. But some good news in our study was that overweight and obese men who <a href="https://www.ncbi.nlm.nih.gov/pubmed/24459689">shed a few kilograms reported better erectile function</a>.</p>
<p>Any improvements you make to your food and lifestyle habits today will benefit you and your family in the future.</p><img src="https://counter.theconversation.com/content/76352/count.gif" alt="The Conversation" width="1" height="1" />
<h4 class="border">Disclosure</h4><p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research fellow. She has received a range of research grants including NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, the Heart Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers and the Sax Institute. She is a spokesperson for the Dietitians Association of Australia on some specific nutrition issues, including Australia's Healthy Weight Week.</span></em></p><p class="fine-print"><em><span>Jenna Hollis is affiliated with the Priority Research Centre for Physical Activity and Nutrition and the Priority Research Centre for Health Behaviour, at the University of Newcastle (Australia). She is a Project Officer at Hunter New England Population Health. She has received an Endeavour Postdoctoral Research Fellowship from the Department of Education and Training (Australian Government). She has also received funding from the Hunter Medical Research Institute (HMRI) and University of Newcastle, Australia. </span></em></p><p class="fine-print"><em><span>Siân Robinson is supported by the UK Medical Research Council and by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre.</span></em></p>Thinking about trying for a baby? Then now is the time for you and your partner to “spring clean” your food and lifestyle habits.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleJenna Hollis, Conjoint Lecturer, University of NewcastleSiân Robinson, Professor of Nutritional Epidemiology, University of SouthamptonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/579422016-04-25T13:49:12Z2016-04-25T13:49:12ZForget Fukushima: Chernobyl still holds record as worst nuclear accident for public health<p>The 1986 Chernobyl and 2011 Fukushima nuclear power plant accidents both share the notorious distinction of attaining the highest accident rating on the International Atomic Energy Agency (IAEA) <a href="http://www-ns.iaea.org/tech-areas/emergency/ines.asp">scale of nuclear accidents</a>. No other reactor incident has ever received this Level 7 “major accident” designation in the history of nuclear power. Chernobyl and Fukushima earned it because both involved core meltdowns that released significant amounts of radioactivity to their surroundings.</p>
<p>Both of these accidents involved evacuation of hundreds of thousands of residents. Both still have people waiting to return to their homes. And both left a legacy of large-scale radioactive contamination of the environment that will persist for years to come, despite ongoing cleanup efforts.</p>
<p>So the tendency is to think of these accidents as similar events that happened in different countries, 25 years apart.</p>
<p>But the IAEA scale isn’t designed to measure public health impact. In terms of health ramifications, these two nuclear accidents were not even in the same league. While <a href="http://www.who.int/ionizing_radiation/a_e/fukushima/faqs-fukushima/en/">Fukushima</a> involved radioactivity exposures to hundred of thousands of people, <a href="http://www.who.int/mediacentre/news/releases/2005/pr38/en/index1.html">Chernobyl</a> exposed hundreds of millions. And millions of those received substantially more exposure than the people of Fukushima.</p>
<p>On the occasion of the 30th anniversary of the April 26, 1986 Chernobyl accident in Ukraine, we do well to reflect on the health burden it caused – and compare it with what we expect to see from Japan’s Fukushima nuclear accident. As I report in my book “<a href="http://press.princeton.edu/titles/10691.html">Strange Glow: The Story of Radiation</a>,” from a public health standpoint, there’s really no comparison between the two events. </p>
<h2>Higher doses of radiation, more health harm</h2>
<p>Chernobyl was by far the worst reactor accident of all time. A total of 127 reactor workers, firemen and emergency personnel on site sustained radiation doses sufficient to cause radiation sickness (over 1,000 mSv); some received doses high enough to be lethal (over 5,000 mSv). Over the subsequent six months, <a href="http://pegasusbooks.com/books/atomic-accidents-9781605984926-hardcover">54 died from their radiation exposure</a>. And it’s been estimated that 22 of the 110,645 cleanup workers may have <a href="https://www.ucsf.edu/news/2012/11/13087/chernobyl-cleanup-workers-had-significantly-increased-risk-leukemia">contracted fatal leukemias</a> over the next 25 years.</p>
<p>In contrast, at Fukushima, there were no radiation doses high enough to produce radiation sickness, even among the reactor core workers. Two Fukushima workers who had leaky respirators received effective doses of <a href="http://pegasusbooks.com/books/atomic-accidents-9781605984926-hardcover">590 mSv and 640 mSv</a>. That’s above the Japanese occupational limit for conducting lifesaving rescue work (250 mSv), but still below the threshold for radiation sickness (1,000 mSv). Due to their exposure, the two workers’ lifetime cancer risks will <a href="http://press.princeton.edu/titles/10691.html">increase about 3 percent</a> (from the 25 percent background cancer risk rate to about 28 percent), but they are unlikely to experience other health consequences.</p>
<p>Beyond just the plant workers, over 572 million people among 40 different countries got at least some exposure to Chernobyl radioactivity. (Neither the United States nor Japan was among the exposed countries.) It took two decades to fully assess the cancer consequences to these people. Finally, in 2006, an international team of scientists completed a comprehensive <a href="http://dx.doi.org/10.1002/ijc.22037">analysis of the dose and health data</a> and reported on the cancer deaths that could be attributed to Chernobyl radioactivity.</p>
<p>Their detailed analysis included countrywide estimates of individual radiation doses in all 40 exposed countries, and regionwide estimates for the most highly contaminated regions of the most highly contaminated countries (Belarus, Russian Federation and Ukraine).</p>
<p>Using statistical models, the scientists predicted a total of 22,800 radiation-induced cancers, excluding thyroid cancers, among this group of 572 million people. Thyroid cancer warranted separate special scrutiny, as we will discuss presently; this hormonally important gland is uniquely affected by a specific radioactive isotope, iodine-131.</p>
<p>So that’s 22,800 non-thyroid cancers in addition to the approximately 194 million cancer cases that would normally be expected in a population of that size, even in the absence of a Chernobyl accident. The increase from 194,000,000 to 194,022,800 is a 0.01 percent rise in the overall cancer rate. That’s too small to have any measurable impact on the cancer incidence rates for any national cancer registries, so these predicted values will likely remain theoretical.</p>
<h2>Chernobyl’s iodine-131 thyroid effects far worse</h2>
<p>Unfortunately, at Chernobyl, the one type of cancer that could have easily been prevented was not. The population surrounding Chernobyl was not warned that iodine-131 – a radioactive fission product that can enter the food chain – had contaminated milk and other locally produced agricultural products. Consequently, people ate iodine-131-contaminated food, resulting in thyroid cancers.</p>
<p>For the local population, iodine-131 exposure was a worst-case scenario because they were already <a href="http://www.who.int/ionizing_radiation/chernobyl/backgrounder/en/">suffering from an iodine-deficient diet</a>; their <a href="http://www.thyroid.org/iodine-deficiency/">iodine-starved thyroids</a> sucked up any iodine that became available. This extremely unfortunate situation would not have happened in countries such as the United States or Japan, where diets are richer in iodine.</p>
<p>Thyroid cancer is rare, with a low background incidence compared to other cancers. So excess thyroid cancers due to iodine-131 can be more readily spotted in cancer registries. And this, in fact, has been the case for Chernobyl. Beginning five years after the accident, an increase in the rate of thyroid cancers started and continued rising over the following decades. Scientists estimate that there will ultimately be about <a href="http://dx.doi.org/10.1002/ijc.22037">16,000 excess thyroid cancers</a> produced as a result of iodine-131 exposure from Chernobyl.</p>
<p>At Fukushima, in contrast, there was much less iodine-131 exposure. The affected population was smaller, local people were advised to avoid local dairy products due to possible contamination and they did not have iodine-deficient diets.</p>
<p>Consequently, typical radiation doses to the thyroid were low. Iodine-131 uptake into the thyroids of exposed people was measured and the <a href="http://dx.doi.org/10.1038/srep00507">doses were estimated to average</a> just 4.2 mSv for children and 3.5 mSv for adults – levels comparable to annual background radiation doses of approximately 3.0 mSv per year.</p>
<p>Contrast this to Chernobyl, where a significant proportion of the local population received thyroid doses in excess of 200 mSv – 50 times more – well high enough to see appreciable amounts of excess thyroid cancer. So at Fukushima, where iodine-131 doses approached background levels, we wouldn’t expect thyroid cancer to present the problem that it did at Chernobyl. </p>
<p>Nevertheless, there has already been one report that <a href="http://mainichi.jp/english/articles/20160307/p2a/00m/0na/022000c">claims there is an increase</a> in thyroid cancer among Fukushima residents at just four years post-accident. That’s earlier than would be expected based on the <a href="http://dx.doi.org/10.1038/sj.bjc.6601860">Chernobyl experience</a>. And the study’s design has been criticized as flawed for a number of scientific reasons, including the <a href="http://www.sciencemag.org/news/2016/03/mystery-cancers-are-cropping-children-aftermath-fukushima">comparison methods used</a>. Thus, this report of excess thyroid cancers must be considered suspect <a href="http://dx.doi.org/10.1093/jjco/hyv191">until better data arrive</a>.</p>
<h2>Chernobyl has no comparison</h2>
<p>In short, Chernobyl is by far the worst nuclear power plant accident of all time. It was a totally human-made event – <a href="http://pegasusbooks.com/books/atomic-accidents-9781605984926-hardcover">a “safety” test gone terribly awry</a> – made worse by incompetent workers who did all the wrong things when attempting to avert a meltdown.</p>
<p>Fukushima in contrast, was an unfortunate natural disaster – caused by a tsunami that flooded reactor basements – and the workers acted responsibly to mitigate the damage despite loss of electrical power.</p>
<p>April 26, 1986 was the darkest day in the history of nuclear power. Thirty years later, there is no rival that comes even close to Chernobyl in terms of public health consequences; certainly not Fukushima. We must be vigilant to ensure nothing like Chernobyl ever happens again. We don’t want to be “celebrating” any more anniversaries like this one.</p><img src="https://counter.theconversation.com/content/57942/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Timothy J. Jorgensen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The meltdown at the Chernobyl Nuclear Power Plant in 1986 exposed 572 million people to radiation. No other nuclear accident holds a candle to that level of public health impact.Timothy J. Jorgensen, Director of the Health Physics and Radiation Protection Graduate Program and Associate Professor of Radiation Medicine, Georgetown UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/459142015-08-13T10:11:43Z2015-08-13T10:11:43ZA simple daily pregnancy pill could boost population IQ and save the NHS money<figure><img src="https://images.theconversation.com/files/91571/original/image-20150812-18096-6czfnu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Bottoms up</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>An estimated <a href="http://www.ncbi.nlm.nih.gov/pubmed/22892867">1.9 billion people</a> are at risk of iodine deficiency, a medical condition that can stunt your brain power. <a href="http://www.thyroid.org/iodine-deficiency/">Iodine deficiency</a> – which can be avoided by eating seafood, cereal and cow’s milk (due to iodine in cattle feed) – doesn’t just affect the developing world. Up to <a href="http://www.ign.org/cm_data/2012_Li_Teh_changing_epidemiology_of_iodine_deficiency_NatRevEnd.pdf">one-third of children</a> in Europe are thought to need more iodine in their diets.</p>
<p>Because of this, some argue that we should add iodine to salt or provide it in pill-form to pregnant and breast-feeding women, who need even more of it than everyone else. But would the benefits really be worth the cost?</p>
<p>Iodine is a micronutrient that is essential for the thyroid to produce hormones that are crucial for normal brain and neurological development. If you don’t get enough iodine when you’re a child it can result in intellectual disability. A <a href="http://www.ncbi.nlm.nih.gov/pubmed/21640375">recent national survey</a> demonstrated mild to moderate iodine deficiency in the UK and <a href="http://www.ncbi.nlm.nih.gov/pubmed/23706508">important observational evidence</a> has linked mild to moderate iodine deficiency to lower IQ scores in UK school children.</p>
<h2>Pregnant women need more</h2>
<p>Pregnant and breast-feeding women in particular need higher levels of iodine because they produce more thyroid hormones, transfer more iodine to their foetus and in breastmilk, and lose more through urination. Yet an estimated <a href="http://bit.ly/1IFB2Mk">two-thirds of pregnant women</a> in Europe don’t consume enough and <a href="http://www.ncbi.nlm.nih.gov/pubmed/25663363">regional surveys have confirmed</a> mild to moderate iodine deficiency in UK pregnant women.</p>
<p>This is why the <a href="http://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/9789241595827/en/">World Health Organisation</a> advocates adding iodine to salt. However, European households are cutting the amount of salt they add to food (in the UK salt added to food represents <a href="http://www.ncbi.nlm.nih.gov/pubmed/24172290">only about 15%</a> of all salt consumed).</p>
<p>An alternative solution is to give pregnant women iodine tablets. Indeed, many prenatal vitamin-mineral supplements already contain iodine. Yet there is no current UK guidance recommending iodine supplementation in pregnancy and the NHS-prescribed “Healthy Start” vitamins do not contain the nutrient.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/91572/original/image-20150812-18104-1pri0xv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Thyroid gland.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>My colleagues and I recently examined how the costs of giving women iodine pills during pregnancy weighed against the benefits. We carried out a systematic review of the available evidence and then used that to build a mathematical model that calculated how much iodine pregnancy supplements would boost children’s IQ ratings and the money this would save. </p>
<p><a href="http://bit.ly/1Elohm4">We found</a> that giving iodine to pregnant women could potentially boost the IQ of their children by an average of 1.22 points. This might not seem very much on an individual basis, but across the whole population it would significantly raise the intellectual ability of a large number of children with special needs. Because these children’s additional needs would be reduced, the policy would save the NHS an average of £199 per pregnant woman. Wider societal savings – such as better educational achievement leading to higher incomes in later life – were even higher, at about £4,476 per woman.</p>
<p>There are risks to iodine supplementation, namely <a href="http://www.ncbi.nlm.nih.gov/pubmed/20172475">thyroid dysfunction</a>. However, we calculated the cost of this problem would need to be more than £91,000 per woman affected to cancel out the overall benefits.</p>
<h2>Study limits</h2>
<p>It is important to realise that the predictions are only as reliable as the studies that contributed data. We did not investigate whether iodine supplements in pregnancy boost a child’s IQ ourselves but assumed the fact based on previous observational research. While there is <a href="http://bit.ly/1TsBS1P">compelling evidence</a> that iodine supplementation improves child IQ in areas of severe iodine deficiency, there is currently no trial evidence for mild-to-moderate deficient populations. However, we took a conservative approach to estimating the benefits and overestimated the potential harms, meaning the IQ and cost gains may be even greater than predicted.</p>
<p>Iodine tablets do have their drawbacks. Pregnancy supplements <a href="http://www.ncbi.nlm.nih.gov/pubmed/15918932">often do not reach</a> poorer, less educated women (unlike adding nutrients to salt). And as most women only become aware they are pregnant several months after conception, they are unlikely to take tablets during <a href="http://www.ncbi.nlm.nih.gov/pubmed/23062035">the early stages</a> when the developing fetal brain is especially vulnerable.</p>
<p>Overall, our study has to be considered alongside other research but it provides compelling evidence that iodine supplementation for pregnant women in the UK is potentially cost saving. And, importantly, it has implications for the 1.9 billion people in the 32 countries with iodine deficiency worldwide.</p><img src="https://counter.theconversation.com/content/45914/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kristien Boelaert does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research into iodine tablets suggests the case for giving them to all pregnant women is compelling.Kristien Boelaert, Reader in Endocrinology, School of Clinical and Experimental Medicine, University of BirminghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/149962013-06-18T20:41:12Z2013-06-18T20:41:12ZLack of dietary iodine threatens brain development in children<figure><img src="https://images.theconversation.com/files/25760/original/fwzxzz4b-1371538418.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pregnant and breast-feeding women have iodine needs that are 50% higher than the general population.</span> <span class="attribution"><span class="source">Teza Harinaivo Ramiandrisoa</span></span></figcaption></figure><p>Iodine is naturally present in a range of food, especially seaweed and fish. So it may seem odd that the people of an island nation (most of whom live along its vast coastline) are not getting enough of this vital mineral.</p>
<p>Insufficient iodine causes a range of problems including hypothyroidism (which can also be caused by too much of the mineral), high cholesterol, lethargy, fatigue and depression. But its most insidious impact is on brain development, and therefore, on children.</p>
<p><a href="http://www.nutritionj.com/content/12/1/32">Research recently completed in Adelaide</a> shows that our primary attempt to address iodine shortage (by requiring the use of iodised salt in bread) is failing to provide pregnant women with enough of the mineral. </p>
<p>This is just the latest in a growing body of recent research that should act as a public health wake-up call about our need for adequate iodine, especially during pregnancy, breast-feeding and childhood. </p>
<p>A <a href="http://www.ncbi.nlm.nih.gov/pubmed/23633204">prospective study from Tasmania</a> has shown that children of mothers with mild iodine deficiency during pregnancy have reduced educational outcomes by the time they are eight or nine (decreased NAPLAN performance of up to 10%). </p>
<p>And a <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60436-5/abstract">similar study from the United Kingdom</a>, published in the Lancet, has provided convincing evidence that mild maternal iodine deficiency results in decreased IQ in children by the age of eight.</p>
<h2>Growth and development</h2>
<p><a href="http://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/9789241595827/en/">Iodine deficiency</a> is considered by the World Health Organization to be “the single most important preventable cause of brain damage” worldwide. </p>
<p>But Australia’s public health programs have a primary focus on the prevention of excessive weight and obesity in children. They don’t address micronutrient deficiencies and other nutrition issues. </p>
<p>In its most drastic forms, <a href="http://www.ceecis.org/iodine/04a_consequences/02_int/chapt_on_i_brain.pdf">severe iodine deficiency</a> in pregnancy results in cretinism and mental retardation. <a href="http://apjcn.nhri.org.tw/server/apjcn/Volume14/vol14.1/fullArticles/Quian.pdf">Studies in China</a> indicate that iodine deficiency results in a population-level loss of intelligence in children up to the magnitude of about 13 IQ points.</p>
<p>Iodine is essential for human growth and development, as the thyroid gland depends on it for the production of hormones. These hormones play an essential role in regulating your metabolism.</p>
<p>Programs to address iodine deficiency were first introduced in Australia in the 1950s. These included the introduction of iodised salt and supplementation through medical practitioners. But they were stopped when communities were considered to be iodine sufficient in the 1980s.</p>
<p>Until the early 1990s, iodine was supplied to Australians mainly via milk through the use of iodised cleaning agents in the dairy industry. But then the cleaning agents changed and iodine deficiency returned.</p>
<p>A <a href="https://www.mja.com.au/journal/2006/184/4/are-australian-children-iodine-deficient-results-australian-national-iodine">national study</a> of schoolchildren published in 2006 identified mild to moderate iodine deficiency in some states. To address this, a mandatory iodisation was started in Australia and New Zealand in late 2009. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/25759/original/xtg6d7w6-1371538000.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Iodine deficiency can lead to hypothyroidism.</span>
<span class="attribution"><span class="source">Wen-Yan King</span></span>
</figcaption>
</figure>
<p>All bread-making flour, except organic breads, were to contain iodine. <a href="http://www.ncbi.nlm.nih.gov/pubmed/23682893">Early reports</a> have shown improvements in children since introduction of fortification. This is good news, but clearly not enough for prospective mothers. </p>
<p>Pregnant and breast-feeding women have iodine needs that are 50% higher than the general population. <a href="http://www.ncbi.nlm.nih.gov/pubmed/23541517">Our survey of pregnant women</a> three years after iodine was added to bread also found that they would be unable to obtain adequate iodine from their diets, even when it included fortified bread.</p>
<h2>A balancing act</h2>
<p>Authorities needed to balance the iodine requirements of children with avoiding excess intake across the population before fortifying food with iodine. This dilemma led the <a href="http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/new45_literature_review.pdf">National Health and Medical Research Council</a> to recommend iodine supplementation of 150 ug/day for pregnant and breast-feeding women.</p>
<p>But four in ten women are <a href="http://www.ncbi.nlm.nih.gov/pubmed/23541517">still not taking</a> recommended iodine supplements during their pregnancy. Breast-feeding women are also generally <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00791.x/abstract">iodine deficient</a> unless they are taking supplements.</p>
<p>Women have been poorly informed about the importance of iodine for development of their baby. <a href="http://www.mdpi.com/2072-6643/4/9/1317">Our research shows</a> they perceive the nutritional advice provided by their doctors to be insufficient.</p>
<p>In May 2013, updated <a href="http://www.health.gov.au/internet/main/publishing.nsf/content/13DFC2A40EEE9BAACA2574C700213A36/$File/ANC_Guidelines_Mod1_v32.pdf">clinical guidelines on antenatal care</a> were published by the Department of Health and Ageing. They recommend nutritional supplementation of 150 ug iodine every day throughout pregnancy. </p>
<p>New models of antenatal care will be required to implement these guidelines. Government actions could include:
- provision of free nutritional supplements to women during pregnancy, under the Pharmaceutical Benefits Scheme,
- improved information about optimal dietary and supplemental iodine intakes for women of reproductive age and
- better training of health professionals on the need for adequate iodine intakes.</p>
<p>Iodine deficiency during pregnancy appears to have been overlooked as a preventable cause of developmental delay in young children. Even subtle cognitive changes may affect school attainment, examination grades, and employment opportunities further down the track. </p>
<p>At the population level, a one-point increase in a nation’s average IQ <a href="http://ideas.repec.org/p/wpa/wuwpdc/0507005.html">has been associated</a> with a persistent 0.11% annual increase in gross domestic product per capita. </p>
<p>Pregnant and breast-feeding women need to know about the importance of iodine supplements so that their children are not disadvantaged.</p><img src="https://counter.theconversation.com/content/14996/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Yeatman is President of the Public Health Association of Australia, and she chairs the Consumer and Public Health Dialogue of FSANZ.</span></em></p><p class="fine-print"><em><span>Karen Charlton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Iodine is naturally present in a range of food, especially seaweed and fish. So it may seem odd that the people of an island nation (most of whom live along its vast coastline) are not getting enough of…Heather Yeatman, Associate Professor in School of Health Sciences, University of WollongongKaren Charlton, Associate Professor in School of Health Sciences , University of WollongongLicensed as Creative Commons – attribution, no derivatives.