Low Iodine - What are the "rules?"

The low iodine diet for thyroid cancer treatment is extremely hard to stick with, all the more so because there is no consensus on how long to stay on it or what foods are forbidden/allowed. Iodine isn't one of the nutrients marked on food labels, and no list exists anywhere with actual numbers for common foods. THYCA's list isn't the same as the Sloan-Kettering Cancer Center, and neither of those matches the NIH guidelines or the Mayo Clinic. Beans are a no-no. Beans are just fine. Soy is forbidden, but tofu is OK if your a vegetarian. Stay on it for 4 weeks pre-ablation or test. No, only 1-2 weeks is necessary for a good result.
 

The uncertainty is maddening, particularly because it is your health - and your life - hinging on accurate results. I don't want to be told that all fruits and vegetables are fine in any quantity, then get a false negative because I ate too many strawberries or too much broccoli.
 

I found and bookmarked this blog post a few years ago,  because it (and the comments) expressed much of what I was feeling about the experience of living with this cancer and coping with the diet. Treatment for thyroid cancer is isolating and frustrating. The lack of good information only adds to the frustration.

Low Iodine - Potato and Green Chile Stew

Cool weather will be upon us soon here in the mid-Atlantic, and vegetable soups of all kinds are perfect for a low-iodine diet. Try this tasty stew from noted author and vegetarian Deborah Madison if you want a little something different - use homemade chicken stock or water and leave out the sour cream. Go ahead and double this recipe, as it reheats very well.

Ingredients:

1 or 2 long green chiles or poblano chiles, roasted and peeled

1 tablespoon sunflower seed oil or other vegetable oil

1 small onion, diced

1/2 teaspoon ground coriander

1/4 teaspoon ground cumin

1 garlic clove, minced

1 large russet potato, peeled and chopped into 1 1/2-inch chunks

Salt and pepper

1 cup chicken stock (homemade with uniodized salt) or water

Sour cream to finish (leave out for low-iodine)

Chopped cilantro to finish

 

Directions:

1. Chop the chiles coarsely. Heat the oil in a wide pot; add the onion and cook over medium-low heat, stirring frequently until softened, about 4 minutes. Add the coriander, cumin, garlic, and potatoes, followed by the chile along with 1/2 teaspoon salt and give a stir. Cook together of a few minutes, then add the water or stock. Bring to a boil, then lower the heat to a simmer.

2. Cook and cover until the potatoes are completely softened, about 25 minutes. Taste and season with salt and pepper. At this point you can mash the potatoes, or at least a few of them to give the dish a creamy sort of background, if desired.

3. Pour into a bowl, and add the cilantro. (I also add a squeeze of lime)

Grilled Chicken With Herbs - from the 60 Minute Gourmet

Pierre Franey's long-running New York Times column, The 60-Minute Gourmet, was a treasure. This simple grilled chicken, from a column published in August of 1981, has been one of my mainstays since cutting it from the newspaper. All these years later I have made only two changes. In the original recipe, the chicken is brushed with butter just before serving. I omit the butter in favor of a drizzle of good olive oil, and add a sprinkle of minced flat-leaf parsley for a little herbal brightness. This combination of flavors really works.

Chicken breasts grilled with herbs

4 whole skinless, boneless chicken breasts, about 1 1/2 pounds or slightly more
1/4 cup olive oil
1/4 cup lemon juice
Kosher salt to taste, if desired
Freshly ground pepper to taste
1 teaspoon finely minced garlic
1/2 teaspoon ground coriander
1/8 teaspoon dried hot red pepper flakes
1 teaspoon dried oregano
2 Tablespoons olive oil (originally 1/4 cup hot melted butter) for serving
Minced parsley for serving      

                   

1. Preheat a charcoal or gas grill to a desired degree of heat for grilling.

 

 2. Cut each chicken breast down the middle in half. Cut away and discard any extraneous membranes or cartilage.

 

 3. Put the oil, lemon juice, salt and pepper in a flat dish and stir to blend. Add the garlic, coriander, pepper flakes and oregano. Stir to blend.

       

4. Add the chicken pieces and turn them in the marinade. Cover with foil and set aside until ready to cook. (I marinate for about an hour, while making the rest of dinner.)

 

 5. Add the chicken pieces to the grill and cook three or four minutes on one side. Turn and cook two or three minutes on the other side. Continue cooking, turning often, for a total of about 10 minutes.

 

Transfer the chicken to a warm serving dish. Drizzle with the olive oil and sprinkle with parsley. Serve with rice and a quickly cooked vegetable such as asparagus or corn on the cob.

Cool Summer Soups

A friend asked me to do a cooking demonstration at the Bloomingdale Farmer's Market this morning. What fun! I decided to do two cool summer soups: Cucumber with yogurt and herbs, and Peach Buttermilk. Both are easy-peasy, and take advantage of what is fresh and delicious at the market right now.


Buttermilk Peach Soup

2 ½ lb ripe peaches, peeled and chopped
1 cup buttermilk (whole or low-fat, not fat-free)
2 T. lemon juice, fresh
1 T. Honey (or brown sugar)
⅛ t. ground cinnamon
¼ t. salt
Fresh mint, or basil


Peel the peaches with a sharp vegetable peeler over a large bowl, then chop coarsely. Save all the peach juice.

Add the peaches to a blender jar. Add buttermilk, lemon juice, honey, cinnamon, and salt. Put the top tightly on the blender jar, and set the blender to its highest setting. Process for about 3-4 minutes, or until it looks smooth. Taste and add more honey or salt if necessary. Add up to 1 cup water if the soup seems too thick. Pour into a clean pitcher with a lid, and refrigerate for several hours or overnight.

Chill six soup bowls. To serve, stack mint or basil leaves, roll into a cigar shape, then cut into thin ribbons with a sharp knife. Pour the cold soup into the chilled bowls, and garnish with the mint.


Chilled Cucumber Soup with Yogurt and Herbs

4 large cucumbers, peeled, seeded and chopped
2 shallots, peeled and quartered
2 cloves garlic, peeled
1 cup plain yogurt
¼ - ½ cup good quality olive oil
⅓ cup loosely packed dill, plus 1 T. for garnishing
¼ cup loosely packed flat-leaf parsley leaves
2 Tablespoons loosely packed tarragon leaves
2 T. sherry vinegar
1 t. salt
¼ t. white pepper


Add half of the cucumbers to a blender jar with half of the yogurt, half of the olive oil, 1 garlic clove, 1 shallot, and half of the herbs. Blend at high speed for 3-4 minutes, or until very smooth. Pour into a large bowl. Add the remainder of the cucumbers, yogurt, olive oil, shallot, garlic, and herbs to the blender jar, and process at high speed until smooth. Pour into bowl. Whisk in the sherry vinegar, salt, and pepper. Taste and correct the seasonings. Pour into a clean pitcher and refrigerate for several hours or overnight.

Chill six soup bowls. To serve, mince once tablespoon of fresh dill. Pour the cold soup into the chilled bowls, and garnish with the dill.

Low Iodine: Pasta!

One of the few bright spots of the low iodine diet is that it permits pasta within certain parameters. Fresh pasta with abundant egg yolks is, of course, off limits. Dried pasta containing nothing but semolina & durum flour is just fine, and makes a perfect backdrop for all sorts of fantastic flavors.

If you have the good fortune to be on the low-iodine diet during the summer, then get yourself to the local farmer's market for some field-grown tomatoes and fresh basil. A mix of tomato varieties like Purple Cherokee, Lemon Boy, Green Zebra and cherry tomatoes like Sungold make a vibrant-looking and -tasting dish. Cook up some orrichiette and toss it with this easy no-cook tomato sauce:

Italian Salsa Cruda

2 lb. ripe field grown tomatoes, cored and diced (about 4 cups) - do not seed the tomatoes!
1/2 cup good-quality extra-virgin olive oil
2 T. Red wine vinegar
1/3 cup roughly chopped basil
1 T. coarsely chopped fresh thyme
2 cloves minced fresh garlic
1/4 tsp. freshly ground black pepper; more to taste
1 lb. dried orrichiette, rigatoni, or other short ridged pasta that will hold the sauce.

Kosher salt for the finished dish. Adding salt to the sauce early will draw the moisture from the tomatoes and adversely affect the texture.

Combine all ingredients except salt in a large bowl and let stand for up to three hours to let the flavors combine. Taste and add more pepper if desired. Toss with cooked pasta. Sprinkle with kosher salt to taste.

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Another summer favorite pasta is this herbed, lemony, garlicky pasta salad recipe by Joanne Weir, originally published in Fine Cooking magazine years ago. Perfectly low-iodine friendly and flavorful, this salad needs nothing more than a chilled glass of white wine to accompany it.

Herbed Farfalle with Grilled Chicken

Kosher salt
12 oz. dried farfalle pasta
10 Tbs. extra-virgin olive oil
2 large boneless, skinless chicken breasts (about 1 lb. total)
Freshly ground black pepper
7 Tbs. fresh lemon juice
2 cloves garlic, minced
1 tsp. ground cumin
1/4 cup packed fresh flat-leaf parsley leaves
1 cup packed fresh cilantro sprigs
1/2 cup lightly packed fresh basil leaves, torn
1/4 cup packed fresh mint leaves, torn
1 cup packed fresh arugula (tough stems removed)
6 lemon wedges


In a large pot, bring 6 qt. water and 2 Tbs. salt to a boil. Add the farfalle and cook until al dente, 10 to 12 min. Drain the pasta and toss it immediately with 1 Tbs. of the olive oil. Let the pasta cool completely in the refrigerator.

Heat a cast-iron ridged grill pan or an outdoor grill. Brush the chicken breasts with 1 Tbs. of the olive oil. Grill the chicken breasts until golden on one side, 4 to 5 min. Turn the breasts, season with salt and pepper, and continue to grill until golden and cooked through, another 6 to 8 min. Let the chicken cool and then cut it on the diagonal into thin strips. Set aside.

In a large bowl, whisk the remaining 8 Tbs. olive oil with the lemon juice, garlic, and cumin. Season to taste with salt and pepper. Add the farfalle, sliced chicken, parsley, cilantro, basil, mint, and arugula and toss well. Season to taste with salt and pepper.

Put the salad into a serving bowl and serve immediately, garnished with the lemon wedges.

Low Iodine: "Enchilada" casserole

One of my most irresistible cravings during the low-iodine diet is for enchiladas and tacos. Dairy-loaded and therefore forbidden on the diet. In an effort to combat those cravings, I came up with this improvised, veggie-loaded, non-dairy casserole.

Quick, homemade enchilada sauce: 

1 small onion, peeled and quartered
3 tomatillos, husked and washed
2 large poblano chiles
splash of cider vinegar
1-2 T cilantro leaves, washed and dried
2 C water or unsalted chicken stock
kosher salt to tast
freshly ground pepper, to taste
pinch of sugar

Preheat the oven to 400F.

Roast the onion, garlic, tomatillos and green chiles on a baking sheet until softened and slightly blackened. Put the chiles in a paper bag to soften the skins. Once they are cool enough to handle, scrape off the skins. 

 Stem and seed the chiles, then put all of the vegetables in the blender with the vinegar, cilantro, water or unsalted chicken stock, kosher salt, pepper, and sugar. Blend until it becomes a smooth, thin sauce, adding more water or stock if necessary. It can be used immediately, or simmered briefly on the stove top to further blend the flavors. Taste and correct the seasoning.

To make the casserole:

Preheat the oven to 350, brush a 9x13 pyrex dish with olive oil, then layer:

1/3 enchilada sauce
corn tortillas* torn to fit the dish, about 4-5
1/2 the "filling" (mix any shredded leftover meat, a can of unsalted black beans, 1-2 cups of veggies like corn, and diced zucchini, cumin, kosher salt, pepper, & a hit of cinnamon)
another layer of tortillas
1/3 sauce
the rest of the chicken mixture
another layer of tortillas
the rest of the sauce
Cover with foil and bake for 30 minutes, and served it topped with chopped cilantro, minced onion, and a squeeze of lime. My doctor allows me a small amount of dairy every day, so I add a teaspoon of sour cream.

*Be sure to check the ingredients in the corn tortillas. Whole Foods brand tortillas include only corn and lime.

Low Iodine: Indian flavors

The cookbooks I turn to again and again on the low-iodine diet are almost all Indian. Many, many Indian recipes can be adapted for the low-iodine diet. Up until 2 years ago, when I really began researching gourmet recipes for the low-iodine regime, I had a picture in my mind of Indian food being full of dairy. Then a cursory page-through of one of my favorite books turned up a dozen recipes that could be made without substitutions. The complex spicing and fresh herbs wake up everything.

"Indian cuisine" is a pretty generic phrase. "Cuisines" is more accurate, as modern India encompasses a huge area and over a billion people.

This recipe is truly satisfying, especially with a small portion of Basmati rice.

Masoor Dal

Ingredients:

1 cup whole red lentils
1 tsp garam masala
1 tsp turmeric
1 tsp kosher salt
2 - 3 medium tomatoes, chopped
1/3 cup light olive oil
1 onion, diced
4 - 5 cloves garlic, minced
1 inch ginger root, grated
2 green chilies (I use serrano) seeded and minced
1 bunch coriander, washed, spun dry, and roughly chopped
Water

Preparation:

• Rinse the lentil thoroughly in several changes of water
• Put the washed lentils into a large saucepan with 3-3.5 cups of water with the turmeric, garam masala, and kosher salt
• Bring to a simmer, then turn down the flame and cook on low for 30 minutes, stirring often, adding more water as necessary to keep the texture creamy.
• Heat oil in wok. When oil is hot, add onions and cook until tender and translucent but not browned.
• Add garlic, ginger and chillies. Continue to saute until garlic is fully cooked. Add garam masala and chili powder.
• Do not allow spices to burn. Keep stirring until mixture starts to stick. And immediately pour this over the cooked dal.
• Stir and let simmer to blend in the flavors. Taste and add more salt if needed.
• Garnish with chopped coriander.