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Variations in Breast Milk Iodine Concentration over 24 h among Lactating Women in Northern China. J Nutr 2023; 153:208-214. [PMID: 36913455 DOI: 10.1016/j.tjnut.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Adequate breast milk iodine concentration (BMIC) is essential for the growth and cognitive development of exclusively breastfed infants; however, data on variations in BMIC over 24 h are limited. OBJECTIVE We aimed to explore in lactating women the variation in 24-h BMIC. METHODS Thirty pairs of mothers and breastfed infants aged 0-6 mo were recruited from the cities of Tianjin and Luoyang, China. A 3-d 24-h dietary record, including salt intake, was performed to assess the dietary iodine intake of lactating women. Breast milk samples before and after each feeding for 24 h and 24-h urine samples were collected from the women for 3 d to estimate iodine excretion. A multivariate linear regression model was used to analyze the factors influencing BMIC. A total of 2658 breast milk samples and 90 24-h urine samples were collected. RESULTS The median BMIC and 24-h urine iodine concentration (UIC) of lactating women for a mean of 3.6 ± 1.48 mo were 158 μg/L and 137 μg/L, respectively. The interindividual variability of BMIC (35.1%) was higher than that observed within individuals (11.8%). The variation in BMIC showed a "V" shaped curve over 24 h. The median BMIC at 08:00-12:00 (137 μg/L) was significantly lower than that at 20:00-24:00 (163 μg/L) and 00:00-04:00 (164 μg/L). A progressively increasing curve was obtained for BMIC until it peaked at 20:00 and plateaued at a higher concentration from 20:00 to 04:00 than at 08:00-12:00 (all P < 0.05). BMIC was associated with dietary iodine intake (β: 0.366; 95% CI: 0.004, 0.018) and infant age (β: -0.432; 95% CI: -1.07, -0.322). CONCLUSIONS Our study shows that the BMIC presents a "V" shaped curve over 24 h. We recommend that breast milk samples be collected between 08:00 and 12:00 for evaluation of the iodine status of lactating women.
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Andersson M, Braegger CP. The Role of Iodine for Thyroid Function in Lactating Women and Infants. Endocr Rev 2022; 43:469-506. [PMID: 35552681 PMCID: PMC9113141 DOI: 10.1210/endrev/bnab029] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 12/18/2022]
Abstract
Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.
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Affiliation(s)
- Maria Andersson
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
| | - Christian P Braegger
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
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Breast Milk Iodine Concentration (BMIC) as a Biomarker of Iodine Status in Lactating Women and Children <2 Years of Age: A Systematic Review. Nutrients 2022; 14:nu14091691. [PMID: 35565659 PMCID: PMC9104537 DOI: 10.3390/nu14091691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 01/01/2023] Open
Abstract
Background: Iodine is needed for the production of thyroid hormones, which are essential for infant growth and development. Given that there are wide variations in breast milk iodine concentration (BMIC) and urinary iodine concentration (UIC), it is unclear if BMIC is associated with UIC in populations residing in iodine sufficient or deficient areas. Aim: To investigate if BMIC can be used as a biomarker for iodine status in lactating women and children <2 years of age. Methods: Electronic databases; PubMed, Web of Science and Scopus were searched until year 2021, for studies investigating the relationship between BMIC and UIC. Studies were reviewed for eligibility, according to inclusion and exclusion criteria, followed by data extraction, according to the PRISMA guidelines. Results: Overall, 51 studies met the criteria for inclusion in the systematic review. BMIC ranged from 18 to 1153 µg/L. In iodine-deficient and iodine-sufficient lactating women, BMIC ranged from 26 to 185 µg/L and 15 to 1006 µg/L, respectively. In most studies, the categorisation of iodine status assessed by median UIC was consistent with the categorisation of iodine status assessed by median BMIC cut off of ≥100 µg/L, to determine iodine sufficiency in lactating women and children <2 years of age. Conclusions: The systematic review indicated that BMIC is a promising biomarker of iodine status in lactating women and children <2 years of age. However, these data need to be interpreted cautiously, given the study limitations in the included studies. Future studies should consider investigating the optimal median BMIC, as there is a lack of high-quality observational and intervention studies in lactating women and infants.
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Breast Milk Micronutrients and Infant Neurodevelopmental Outcomes: A Systematic Review. Nutrients 2021; 13:nu13113848. [PMID: 34836103 PMCID: PMC8624933 DOI: 10.3390/nu13113848] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 12/22/2022] Open
Abstract
Micronutrients are fundamental for healthy brain development and deficiencies during early development can have a severe and lasting impact on cognitive outcomes. Evidence indicates that undernourished lactating individuals may produce breast milk containing lower concentrations of certain vitamins and minerals. Exclusively breastfed infants born to mothers deficient in micronutrients may therefore be at risk of micronutrient deficiencies, with potential implications for neurodevelopment. This systematic review aims to consider current knowledge on the effects of breast milk micronutrients on the developmental outcomes of infants. The databases Medline, Global Health, PsychInfo, Open Grey, and the Web of Science were searched for papers published before February 2021. Studies were included if they measured micronutrients in breast milk and their association with the neurodevelopmental outcomes of exclusively breastfed infants. Also, randomised control trials investigating neurocognitive outcomes following maternal supplementation during lactation were sought. From 5477 initial results, three observational studies were eligible for inclusion. These investigated associations between breast milk levels of vitamin B6, carotenoids, or selenium and infant development. Results presented suggest that pyroxidal, β-carotene, and lycopene are associated with infant neurodevelopmental outcomes. Limited eligible literature and heterogeneity between included papers prevented quantitative synthesis. Insufficient evidence was identified, precluding any conclusions on the relationship between breast milk micronutrients and infant developmental outcomes. Further, the evidence available was limited by a high risk of bias. This highlights the need for further research in this area to understand the long-term influence of micronutrients in breast milk, the role of other breast milk micronutrients in infant neurodevelopmental outcomes, and the impact of possible lactational interventions.
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Machamba AAL, Priore SE, Macedo MDS, Franceschini SDCC. Ingestion of supplements and fortified food with iodine on the breast milk iodine concentration in deficiency areas: a systematic review. Afr Health Sci 2021; 21:1346-1354. [PMID: 35222600 PMCID: PMC8843278 DOI: 10.4314/ahs.v21i3.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction The level of iodine in breast milk may be inadequate and compromise the health of this, both due to excess and lack, some population groups remain deficient because of the low consumption of iodate salt, because there is an increase in consumption of other sources of iodine, such as supplements and fortified foods. Objective To evaluate the effect of the consumption of fortified foods and nutritional supplements with iodine on maternal milk levels. Methodology Systematic review based on the Prism method, using the descriptors provided by DeCS. The reading, selection and analysis of the methodological quality of the articles was done by two researchers independently. Results From 346 abstracts, 6 were eligible. The median iodination range between the studies ranged from 75 to 600 µg in supplements and 150 and 225 µg in fortified foods with effect on increased iodine concentration of breastmilk (BMIC), achieving the adequacy of the median BMIC in 4 of the 6 studies. Conclusion Iodine ingestion through supplements or fortified foods results in improved iodine levels in breast milk.
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Affiliation(s)
- Almeida Abudo Leite Machamba
- Almeida A. L. Machamba: PhD Student in the Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, Brazil
| | - Silvia Eloiza Priore
- Full PhD Professor in the the Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, Brazil
| | - Mariana de Souza Macedo
- Post-Doctoral in the Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, Brazil
| | - Sylvia do Carmo Castro Franceschini
- Full PhD Professor in the the Postgraduate Program in Nutrition Science, Department of Nutrition and Health and Pro-Rector of community affairs, Federal University of Viçosa (UFV), Viçosa, Brazil
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Nazeri P, Tahmasebinejad Z, Pearce EN, Zarezadeh Z, Tajeddini T, Mirmiran P, Azizi F. Does maternal iodine supplementation during the lactation have a positive impact on neurodevelopment of children? Three-year follow up of a randomized controlled trial. Eur J Nutr 2021; 60:4083-4091. [PMID: 33974129 DOI: 10.1007/s00394-021-02574-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/27/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to examine, for the first time, the neurodevelopmental outcomes in children whose mothers received different doses of iodine supplements during lactation. METHODS We conducted a follow-up study on children whose mothers participated in a randomized clinical trial to receive placebo, 150 µg/day or 300 µg/day of iodine until 12 months postpartum. Child neurocognitive development was assessed at 36 months of age using the Bayley Scales of Infant and Toddler Development Third Edition. Linear mixed-model analysis was preformed to assess iodine supplement dose effects on child cognitive, language, and motor functions. RESULTS A total of 122 children provided neurodevelopmental data as follows: 300 µg/d iodine group: 45; 150 µg/d iodine group: 35; and placebo group: 42. Cognitive scores were higher in children whose mothers received 150 µg iodine/d compared to children whose mothers received placebo [102.8 (SD 13.2) vs. 99.2 (SD 10.5); β = 4.43, P = 0.032]. However, supplementation with 150 µg iodine/d had no effect on language or motor development. No significant differences were observed in cognitive, language, or motor functions between children whose mothers received 300 µg iodine/d and those whose mothers received 150 µg iodine/d or placebo. CONCLUSION Maternal iodine supplementation with 150 µg/d during lactation may have a beneficial effect on child cognitive development; however, we found no evidence of either improved or delayed neurodevelopmental outcomes in children whose mothers received iodine supplements at doses higher than recommended. Further randomized controlled trials with larger sample sizes are needed to confirm these results. CLINICAL TRIAL REGISTRY IRCT201303164794N8; registration date: 2013-05-20.
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Affiliation(s)
- Pantea Nazeri
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhale Tahmasebinejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, USA
| | - Zinat Zarezadeh
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahere Tajeddini
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran. .,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
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Addison R, Hill L, Bode L, Robertson B, Choudhury B, Young D, Wright C, Relton C, Garcia AL, Tappin DM. Development of a biochemical marker to detect current breast milk intake. MATERNAL & CHILD NUTRITION 2020; 16:e12859. [PMID: 31216094 PMCID: PMC7038895 DOI: 10.1111/mcn.12859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 01/08/2023]
Abstract
The WHO recommends exclusive breastfeeding for 6 months, but despite interventions, breastfeeding rates remain stubbornly low. Financial voucher incentives have shown promise but require a biomarker for validation of intake. This study aimed to develop a simple biochemical assay of infant urine that would tell if an infant was receiving any breast milk to validate maternal report. Urine samples were collected and snap frozen from 34 infants attending with minor illness or feeding problems, of whom 12 infants were exclusively breastfed, nine exclusively formula fed, and 11 mixed breast/formula fed. High-performance anion exchange chromatography was used to identify discriminating patterns of monosaccharide composition of unconjugated glycans in a sequence of three experiments. The absolute concentration of all human milk oligosaccharides measured blind could detect "any breastfeeding" only with a sensitivity of 48% and specificity of 78%. Unblinded examination of N-acetylglucosamine (GlcNAc) measured as GlcNH2 after hydrolysis of GlcNAc improved sensitivity to 75% at the expense of a specificity of 28%. Estimation of the relative abundance of GlcNH2 (GlcNH2[%]) or the ratio of GlcNH2 to endogenous mannose (Man) improved accuracy. In a further blind experiment, the GlcNH2/Man ratio with a cut-off of 1.5 correctly identified all those receiving "any breast milk," while excluding exclusively formula fed infants. The GlcNH2/Man ratio in infant urine is a promising test to provide biochemical confirmation of any breastfeeding for trials of breastfeeding promotion.
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Affiliation(s)
- Ruth Addison
- NHS Ayrshire & Arran Primary Care Trust, Rainbow House Paediatric UnitAyrshire Central HospitalIrvineUK
| | - Lauren Hill
- General PaediatricsPinderfields General HospitalWakefieldUK
| | - Lars Bode
- Department of Pediatrics and Larsson‐Rosenquist Foundation Mother‐Milk‐Infant Center of Research Excellence (LRF MOMI CORE)University of CaliforniaSan DiegoCalifornia
| | - Bianca Robertson
- Department of Pediatrics and Larsson‐Rosenquist Foundation Mother‐Milk‐Infant Center of Research Excellence (LRF MOMI CORE)University of CaliforniaSan DiegoCalifornia
| | - Biswa Choudhury
- Glycoanalytical Core, Glycobiology Research and Training CenterUniversity of CaliforniaSan DiegoCalifornia
| | - David Young
- Department of Mathematics and StatisticsUniversity of StrathclydeGlasgowUK
| | - Charlotte Wright
- Section of Child Health, School of MedicineGlasgow UniversityGlasgowUK
| | - Clare Relton
- ScHARRUniversity of SheffieldSheffieldUK
- Centre for Primary Care and Public HealthQueen Mary University of LondonLondonUK
| | - Ada L. Garcia
- Human Nutrition, School of Medicine, Dentistry and NursingGlasgow UniversityGlasgowUK
| | - David M. Tappin
- Section of Child Health, School of MedicineGlasgow UniversityGlasgowUK
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Gebreegziabher T, Woltamo T, Thomas DG, Kennedy TS, Stoecker BJ. Iodine supplementation of lactating women and assessment of infant visual information processing and maternal and infant thyroid function: A randomized trial. PLoS One 2019; 14:e0223348. [PMID: 31589645 PMCID: PMC6779247 DOI: 10.1371/journal.pone.0223348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
Iodine deficiency is one of the major causes of brain damage in childhood. However, iodine supplementation during early pregnancy and lactation can prevent the ill effects of iodine deficiency. This study evaluated maternal and infant thyroid function and infant visual information processing (VIP) in the context of maternal iodine supplementation. A community-based, randomized, supplementation trial was conducted. Mother infant dyads (n = 106) were enrolled within the first 10 days after delivery to participate in this study. Mothers were randomly assigned either to receive a potassium iodide capsule (225 μg iodine) daily for 26 weeks or iodized salt weekly for 26 weeks. Maternal thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), thyroglobulin (Tg), urinary iodine concentration (UIC), breast milk iodine concentration (BMIC) and infant T4, TSH, UIC and VIP were measured as outcome variables. At baseline, neither mothers nor infants in the two groups were significantly different in any of the biomarkers or anthropometric measurements. Maternal TSH and goiter prevalence significantly decreased following iodine supplementation. The percentage of infants who preferentially remembered the familiar face was 26% in the capsule and 51% in the I-salt groups. Infant sex, length for age Z score, BMIC, maternal education and household food security were strong predictors of novelty quotient. In conclusion supplementation daily for six months with an iodine capsule or the use of appropriately iodized salt for an equivalent time was sufficient to reduce goiter and TSH in lactating women. Higher BMIC and LAZ as well as better household food security, maternal education, and male sex predicted higher novelty quotient scores in the VIP paradigm.
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Affiliation(s)
- Tafere Gebreegziabher
- Department of Health Sciences, Central Washington University, Ellensburg, WA, United States of America
| | - Tesfaye Woltamo
- School of Environment, Gender, and Development Studies, Hawassa University, Hawassa, Ethiopia
| | - David G. Thomas
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States of America
| | - Tay S. Kennedy
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | - Barbara J. Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
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Nazeri P, Tahmasebinejad Z, Mehrabi Y, Hedayati M, Mirmiran P, Azizi F. Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial. Thyroid 2018; 28:1547-1558. [PMID: 30272528 DOI: 10.1089/thy.2018.0153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The necessity of iodine supplementation in lactating mothers residing in countries with sustained salt iodization programs for iodine sufficiency of breast-fed infants remains unclear. The aims of this study were to investigate the effect of iodine supplementation on iodine status and growth parameters of lactating mothers and breast-fed infants and to compare these data with that of formula-feeding mothers and their infants during the first year of infancy. METHODS In this multicenter, double-blinded, randomized clinical trial conducted in four healthcare centers in Tehran (Iran), healthy lactating mothers and their term newborns aged 3-5 days were randomly assigned to treatment groups: placebo, 150 μg/day iodine, or 300 μg/day iodine. They were followed up for 12 months. Formula-fed infants aged 30-45 days and their mothers were randomly selected from the same centers. The primary outcomes were maternal and infant urinary iodine concentrations (UICs), breast-milk iodine concentrations (BMICs), and infant growth parameters, measured at 1, 2, 4, 6, 9, and 12 months during routine health visits. The formula-fed group was assessed at 2, 4, 6, 9, and 12 months of age. Analysis was by per protocol principle using mixed-effects models. RESULTS Mother-newborn pairs (n = 180) in treatment groups and partially/exclusively formula-feeding mother-infant pairs (n = 60) participated between October 2014 and January 2016. Median baseline UICs in the treatment groups were 84 μg/L (interquartile range [IQR] 41-143 μg/L) in mothers and 208 μg/L (IQR 91-310 μg/L) in their infants. The values in the formula-fed group were 76 μg/L (IQR 40-144 μg/L) in mothers and 121 μg/L (IQR 66-243 μg/L) in infants. The 300 μg/day iodine group showed significantly higher UICs and BMICs than did the other treatment groups; infant UICs in the 150 μg/day iodine, placebo, and formula-fed groups were similar. Infants in all groups showed iodine sufficiency (median UIC ≥100 μg/L) throughout the study period. Anthropometric measurements were similar between the treatment and formula-fed groups over the study period, except at the last follow-up visit at 12 months. CONCLUSION Supplementation of breast-feeding mothers with either 300 or 150 μg/day iodine improved their iodine status. However, the iodine status of infants in all groups studied indicated iodine sufficiency during the first year of infancy, demonstrating that in countries with effective salt iodization program, iodine supplementation for lactating mothers is unnecessary.
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Affiliation(s)
- Pantea Nazeri
- 1 Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences , Tehran, Iran
- 2 Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Zhale Tahmasebinejad
- 2 Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Yadollah Mehrabi
- 3 Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mehdi Hedayati
- 4 Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Parvin Mirmiran
- 2 Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Fereidoun Azizi
- 5 Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Gebreegziabher T, Stoecker BJ. Comparison of two sources of iodine delivery on breast milk iodine and maternal and infant urinary iodine concentrations in southern Ethiopia: A randomized trial. Food Sci Nutr 2017; 5:921-928. [PMID: 28748081 PMCID: PMC5520864 DOI: 10.1002/fsn3.477] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/30/2016] [Accepted: 02/21/2017] [Indexed: 11/19/2022] Open
Abstract
Iodine deficiency during pregnancy and lactation could expose the infant to severe iodine deficiency disorders. A randomized supplementation trial among rural lactating women was conducted in Sidama zone, southern Ethiopia, to compare the methods of iodine delivery on breast milk iodine, and on maternal and infant urinary iodine concentrations. Women were randomly assigned either to receive 225 μg iodine as potassium iodide capsule daily for 6 months or 450 g of appropriately iodized salt (30-40 μg I as KIO3/g of salt) weekly for household consumption for 6 months. Breast milk iodine concentration (BMIC) and maternal and infant urinary iodine concentration (UIC) were measured at baseline and at 6 months. The women did not differ in BMIC and UIC, and infants did not differ in UIC in a time by treatment interaction. Median (IQR, interquartile range, IQR) BMIC at baseline was 154 [43, 252] μg/L and at 6 months was 105 [36, 198] μg/L, maternal UIC at baseline was 107 [71, 161] μg/L and at 6 months was 130 [80, 208] μg/L; infant UIC at baseline was 218 [108, 356] μg/L and at 6 months was 222 [117, 369] μg/L. Significant correlations among the three variables were obtained in both groups at both times. We conclude that for lactating women an adequate amount of appropriately iodized salt (30-40 μg I/g) had similar effects as a daily supplement of 225 μg I on BMIC and on maternal and infant UIC.
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Affiliation(s)
- Tafere Gebreegziabher
- Hawassa UniversityHawassaEthiopia and Central Washington UniversityEllensburgWashingtonUSA
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