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Burgard L, Jansen S, Spiegler C, Brettschneider AK, Straßburg A, Alexy U, Storcksdieck genannt Bonsmann S, Ensenauer R, Heuer T. Unfavorable nutrient intakes in children up to school entry age: results from the nationwide German KiESEL study. Front Nutr 2024; 10:1302323. [PMID: 38323223 PMCID: PMC10844530 DOI: 10.3389/fnut.2023.1302323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/13/2023] [Indexed: 02/08/2024] Open
Abstract
Background Nutrition in the first years of life is a cornerstone for child development and long-term health, yet there is a lack of current data on energy and nutrient intake among toddlers and preschoolers in Germany. Objective To analyze energy and nutrient intake in toddlers (1- to 2-year-olds) and preschoolers (3- to 5-year-olds) in Germany and compare the results with the Dietary Reference Values (DRVs) by the European Food Safety Authority. Design Dietary intake was assessed by weighed food record data (3 + 1 day) of 890 children from the representative cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL), carried out in 2014-2017 as a module of the German Health Interview and Examination Survey for Children and Adolescents Wave 2. For the calculation of energy and nutrient intake, the German Nutrient Database BLS 3.02, LEBTAB, and a supplement database were used. Results Median intakes of energy and most nutrients met or exceeded the DRVs in both toddlers and preschoolers. However, low intakes relative to DRVs were found for vitamin D (6-9% of DRV, including supplements) and iodine (57-65% of DRV). Age specific downward deviations were observed for iron intake in toddlers (75% of DRV) and for calcium intake in preschoolers (67-77% of DRV). In contrast, intakes were high for saturated fatty acids (SFA) (14-16 E%), mono-/disaccharides (60-87 g/day), and protein [2.1-2.6 g/(kg body weight*day)]. Conclusion Nutrient imbalances in toddlers and preschoolers in Germany, which are partly age-related, give rise to concern. Research is needed to determine if routine vitamin D supplementation should be extended beyond infancy. Public health efforts to increase the rate of use of iodized salt and to reduce the intake of SFA and mono-/disaccharides in children's diets are to be strengthened.
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Affiliation(s)
- Leonie Burgard
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Sara Jansen
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Clarissa Spiegler
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Anna-Kristin Brettschneider
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Andrea Straßburg
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Ute Alexy
- Department of Nutritional Epidemiology, Institute of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | | | - Regina Ensenauer
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Thorsten Heuer
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
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Li J, Liu JX, Wang YQ, Lu AX, Wang YH, Lin Y, Yan CH. Iodine status and associated dietary factors among preschool children in Shanghai. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:121823-121833. [PMID: 37962761 DOI: 10.1007/s11356-023-30942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
Children aged 3-6 years undergo a critical stage of growth and development and are irreversibly affected by their iodine status. In order to reveal iodine status in preschool children, we detected iodine concentrations in urine samples from 1382 children aged 3-6 years based on a cross-sectional study. The median urinary iodine concentration (UIC) of children was 193.36 μg/L and was 336.96 μg/g·Cr corrected for creatinine. The study developed a link between dietary habits and iodine status, revealing that regular calcium supplement (OR: 1.79, (95% CI: 1.03, 3.12)) increased deficiency risk, while moderate seafood consumption (OR: 0.60, (95% CI: 0.38, 0.95)) decreased it. Additionally, modest intake of shellfish (OR: 0.58, (95% CI: 0.33, 1.00)), vegetables (OR: 0.61, (95% CI: 0.38, 0.97)), and eggs (OR: 0.53, (95% CI: 0.30, 0.95)) was found to protect against excess iodine. The findings underline the importance of balanced diets and various nutrients' roles in preschoolers' iodine status.
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Affiliation(s)
- Jing Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jun-Xia Liu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yu-Qing Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - An-Xin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yi-Hong Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yin Lin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Chong-Huai Yan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China.
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Schulz CA, Weinhold L, Schmid M, Nöthen MM, Nöthlings U. Association between urinary iodine excretion, genetic disposition and fluid intelligence in children, adolescents and young adults: the DONALD study. Eur J Nutr 2023; 62:2375-2385. [PMID: 37103611 PMCID: PMC10421824 DOI: 10.1007/s00394-023-03152-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE Iodine deficiency increases the risk of cognitive impairment and delayed physical development in children. It is also associated with cognitive impairment in adults. Cognitive abilities are among the most inheritable behavioural traits. However, little is known about the consequences of insufficient postnatal iodine intake and whether the individual genetic disposition modifies the association between iodine intake and fluid intelligence in children and young adults. METHODS The cultural fair intelligence test was used to assess fluid intelligence in the participants of the DONALD study (n = 238; mean age, 16.5 [SD = 7.7] years). Urinary iodine excretion, a surrogate iodine intake marker, was measured in 24-h urine. Individual genetic disposition (n = 162) was assessed using a polygenic score, associated with general cognitive function. Linear regression analyses were conducted to determine whether Urinary iodine excretion was associated with fluid intelligence and whether this association was modified by individual genetic disposition. RESULTS Urinary iodine excretion above the age-specific estimated average requirement was associated with a five-point higher fluid intelligence score than that below the estimated average requirement (P = 0.02). The polygenic score was positively associated with the fluid intelligence score (β = 2.3; P = 0.03). Participants with a higher polygenic score had a higher fluid intelligence score. CONCLUSION Urinary iodine excretion above the estimated average requirement in childhood and adolescence is beneficial for fluid intelligence. In adults, fluid intelligence was positively associated with a polygenic score for general cognitive function. No evidence showed that the individual genetic disposition modifies the association between Urinary iodine excretion and fluid intelligence.
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Affiliation(s)
| | - Leonie Weinhold
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, School of Medicine, University of Bonn, University Hospital Bonn, Bonn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany
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Weker H, Friedrich M, Zabłocka-Słowińska K, Sadowska J, Długosz A, Hamułka J, Charzewska J, Socha P, Wądołowska L. Position Statement of the Polish Academy of Sciences' Committee of Human Nutrition Science on the Principles for the Nutrition of Preschool Children (4-6 Years of Age) and Early School-Age Children (7-9 Years of Age). JOURNAL OF MOTHER AND CHILD 2023; 27:222-245. [PMID: 38369720 PMCID: PMC10875211 DOI: 10.34763/jmotherandchild.20232701.d-23-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 02/20/2024]
Affiliation(s)
- Halina Weker
- Department of Nutrition, Institute of Mother and Child, Warsaw, Poland
| | - Mariola Friedrich
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | | | - Joanna Sadowska
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | - Anna Długosz
- Faculty of Chemical Technology and Engineering, University of Science and Technology, Bydgoszcz, Poland
| | - Jadwiga Hamułka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Charzewska
- National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Eating Disorders and Paediatrics, Institute ‘Monument - Children’s Health Center’, Warsaw, Poland
| | - Lidia Wądołowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Poland
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Kognition: Einflüsse von Essen, Trinken und Bewegung. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01539-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Remer T, Hua Y, Esche J, Thamm M. The DONALD study as a longitudinal sensor of nutritional developments: iodine and salt intake over more than 30 years in German children. Eur J Nutr 2022; 61:2143-2151. [PMID: 35043251 PMCID: PMC9106614 DOI: 10.1007/s00394-022-02801-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose Mild-to-moderate iodine deficiency was present in large parts of Germany up to the beginning 1990s and improved from then on. Current epidemiological data on spot urine iodine measurements in German children strongly suggest the re-occurrence of an impaired iodine status. We thus examined whether this re-occurrence is identifiable in more detail, through iodine analyses of 24-h urine samples of a well-characterized cohort of German children in whom samples have been systematically collected from 1985 onward. As iodized salt is a major source for iodine supply, urinary sodium excretion was additionally studied. Methods Daily iodine and sodium excretions were measured in 2600 24-h urine samples collected between 1985 and 2018 by 677 healthy children aged 6–12 years (participants of the DONALD study). These data were compared with 24-h iodine and sodium excretion estimates obtained from spot urine samples collected in the representative German Health Interview and Examination Surveys for Children and Adolescents KiGGS-baseline (2003–2006) and KiGGS-wave-2 (2014–2017). Results Between 1985 and1992, DONALD participants started with a median daily iodine excretion level of 40.1 µg/d. Then, during 1993–2003, iodine excretions mounted up to an approximate plateau (~ 84.8 µg/d). This plateau lasted until 2012. Thereafter, iodine concentrations started to decrease again resulting in a median iodine excretion of only 58.9 µg/d in 2018. Sodium excretion, however, had increased. The marked decrease in iodine status along with an abundant sodium excretion corresponded closely with nationwide KiGGS data. Conclusions As exemplified for the clearly worsening iodine status in German children, longitudinal cohort studies collecting detailed biomarker-based prospective data have the potential to reliably capture health-relevant nutritional changes and trends, applicable on a more comprehensive and even representative population level. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02801-6.
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Affiliation(s)
- Thomas Remer
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
| | - Yifan Hua
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Jonas Esche
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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Bath SC, Verkaik-Kloosterman J, Sabatier M, ter Borg S, Eilander A, Hora K, Aksoy B, Hristozova N, van Lieshout L, Tanju Besler H, Lazarus JH. OUP accepted manuscript. Nutr Rev 2022; 80:2154-2177. [PMID: 35713524 PMCID: PMC9549594 DOI: 10.1093/nutrit/nuac032] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Context Adequate iodine intake is essential throughout life. Key dietary sources are iodized salt and animal products, but dietary patterns in Europe are changing, for example toward lower salt intake and a more plant-based diet. Objective To review iodine intake (not status) in European populations (adults, children, and pregnant women) to identify at-risk groups and dietary sources. Data sources PubMed, Embase, and Cochrane databases, as well as European national nutrition surveys were searched for data on had iodine intake (from dietary assessment) and sources of iodine, collected after 2006. Data selection In total, 57 studies were included, comprising 22 national surveys and 35 sub-national studies. Iodine intake data were available from national surveys of children aged <10 years (n = 11), 11–17 years (n = 12), and adults (n = 15), but data from pregnancy were only available from sub-national studies. Results Iodine intake data are lacking—only 17 of 45 (38%) European countries had iodine-intake data from national surveys. Iodine intake reported from national surveys was below recommendations for: (1) children aged <10 years in 2 surveys (18%), (2) boys and girls aged 11–17 years in 6 (50%) and 8 (68%) surveys, respectively, and (3) adult men and women in 7 (47%) and 12 (80%) surveys, respectively. In pregnant women, intake was below recommendations except where women were taking iodine-containing supplements. Just 32% of national surveys (n = 7) included iodized salt when estimating iodine intake. Milk, dairy products, fish, and eggs were important contributors to intake in many countries, suggesting limited sources in plant-based diets. Conclusion Results are limited by the challenges of dietary assessment for measuring iodine intake. Future national surveys should include iodine intake. Policy makers should consider dietary sources alongside any iodized salt policies when considering methods for improving population iodine intake. Systematic Review Registration PROSPERO 2017 CRD42017075422.
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Affiliation(s)
- Sarah C Bath
- S.C. Bath, Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. E-mail:
| | | | - Magalie Sabatier
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Sovianne ter Borg
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ans Eilander
- Unilever Foods Innovation Centre, Wageningen, Gelderland, The Netherlands
| | - Katja Hora
- SQM International N.V., Antwerpen, Belgium
| | - Burcu Aksoy
- Department of Nutrition and Dietetics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nevena Hristozova
- International Life Sciences Institute (ILSI) Europe, Brussels, Belgium
| | | | - Halit Tanju Besler
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, İstanbul, Turkey
| | - John H Lazarus
- Department of Endocrinology, Cardiff University, Cardiff, UK
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Intake of micronutrients and fatty acids of vegetarian, vegan, and omnivorous children (1-3 years) in Germany (VeChi Diet Study). Eur J Nutr 2021; 61:1507-1520. [PMID: 34855006 PMCID: PMC8921058 DOI: 10.1007/s00394-021-02753-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/20/2021] [Indexed: 01/19/2023]
Abstract
Purpose There is an ongoing debate whether vegetarian (VG) and especially vegan (VN) diets are nutritionally adequate in early childhood. Hence, the Vegetarian and Vegan Children Study (VeChi Diet Study) aimed to assess the food and nutrient intake of VG and VN infants. Methods The study examined the diets of 1–3-year-old VG, VN, and omnivorous (OM) children (n = 430). Dietary intake was assessed via a 3-day weighed dietary record and compared between groups using ANCOVA. Lifestyle data were collected using a questionnaire. Here, the results of micronutrient and fatty acid intakes are presented. Results Most nutrient intakes (with and without supplements) differed significantly between VN children and the two other groups, with a more favourable overall micronutrient intake in VN, followed by VG children, [e.g., the highest intake of vitamin E (8.3 mg/d vs. VG 7.4 mg/d and OM 5.1 mg/d), vitamin B1 (569 µg/d vs. VG 513 µg/d and OM 481 µg/d), folate (143 µg/d vs. VG 116 µg/d and OM 108 µg/d), magnesium (241 mg/d vs. VG 188 mg/d and OM 164 mg/d), and iron (8.9 mg/d vs. VG 7.3 mg/d and OM 6.0 mg/d)] as well as fat quality [highest intake of polyunsaturated fatty acids (8.7 E% vs. VG 6.9 E% and OM 4.5 E%) and lowest intake of saturated fatty acids (9.1 E% vs. VG 11.9 E% and OM 14.0 E%)]. In contrast, OM children had the highest intake of vitamin B2 (639 µg/d vs. VG 461 µg/d and VN 429 µg/d), calcium (445 mg/d vs. VG 399 mg/d and VN 320 mg/d), iodine (47 µg/d vs. VG 33 µg/d and VN 31 µg/d), and DHA (35.4 mg/d vs. VG 16.6 mg/d and VN 18.4 mg/d). Without supplementation, OM children had the highest average vitamin B12 intake (1.5 µg/d vs. VG 0.6 µg/d and VN 0.2 µg/d), whereas VN children had the highest average vitamin B12 intake with supplementation (73.8 µg/d vs. VG 1.3 µg/d and OM 1.7 µg/d). Without supplementation, none of the groups’ median intakes met the harmonised Average Requirement (h-AR) for vitamin D and iodine. Moreover, VG and VN children did not achieve h-ARs for vitamin B2, vitamin B12, and iron—if a low absorption of iron is anticipated; VN children also did not do so for calcium. Conclusion In early childhood, VN and VG diets can provide most micronutrients in desirable amounts and a preferable fat quality compared to an OM diet. Special focus should be paid to (potentially) critical nutrients, particularly vitamin D, iodine, and DHA for all children regardless of diet, as well as vitamin B2, vitamin B12, calcium, and iron for VG and VN children. Trail registration This study was registered with the German Clinical Trials Register (DRKS00010982) on (September 2, 2016). Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02753-3.
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Seifert P, Schenke S, Zimny M, Stahl A, Grunert M, Klemenz B, Freesmeyer M, Kreissl MC, Herrmann K, Görges R. Diagnostic Performance of Kwak, EU, ACR, and Korean TIRADS as Well as ATA Guidelines for the Ultrasound Risk Stratification of Non-Autonomously Functioning Thyroid Nodules in a Region with Long History of Iodine Deficiency: A German Multicenter Trial. Cancers (Basel) 2021; 13:cancers13174467. [PMID: 34503277 PMCID: PMC8431215 DOI: 10.3390/cancers13174467] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/22/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023] Open
Abstract
Germany has a long history of insufficient iodine supply and thyroid nodules occur in over 30% of the adult population, the vast majority of which are benign. Non-invasive diagnostics remain challenging, and ultrasound-based risk stratification systems are essential for selecting lesions requiring further clarification. However, no recommendation can yet be made about which system performs the best for iodine deficiency areas. In a German multicenter approach, 1211 thyroid nodules from 849 consecutive patients with cytological or histopathological results were enrolled. Scintigraphically hyperfunctioning lesions were excluded. Ultrasound features were prospectively recorded, and the resulting classifications according to five risk stratification systems were retrospectively determined. Observations determined 1022 benign and 189 malignant lesions. The diagnostic accuracies were 0.79, 0.78, 0.70, 0.82, and 0.79 for Kwak Thyroid Imaging Reporting and Data System (Kwak-TIRADS), American College of Radiology (ACR) TI-RADS, European Thyroid Association (EU)-TIRADS, Korean-TIRADS, and American Thyroid Association (ATA) Guidelines, respectively. Receiver Operating Curves revealed Areas under the Curve of 0.803, 0.795, 0.800, 0.805, and 0.801, respectively. According to the ATA Guidelines, 135 thyroid nodules (11.1%) could not be classified. Kwak-TIRADS, ACR TI-RADS, and Korean-TIRADS outperformed EU-TIRADS and ATA Guidelines and therefore can be primarily recommended for non-autonomously functioning lesions in areas with a history of iodine deficiency.
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Affiliation(s)
- Philipp Seifert
- Clinic of Nuclear Medicine, Jena University Hospital, 07749 Jena, Germany;
- Correspondence: (P.S.); (S.S.)
| | - Simone Schenke
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Magdeburg University Hospital, 39120 Magdeburg, Germany;
- Correspondence: (P.S.); (S.S.)
| | - Michael Zimny
- Institute for Nuclear Medicine Hanau, 63450 Giessen, Germany;
| | - Alexander Stahl
- Institute for Radiology and Nuclear Medicine RIZ, 86150 Augsburg, Germany;
| | - Michael Grunert
- Department of Nuclear Medicine, German Armed Forces Hospital of Ulm, 89081 Ulm, Germany; (M.G.); (B.K.)
| | - Burkhard Klemenz
- Department of Nuclear Medicine, German Armed Forces Hospital of Ulm, 89081 Ulm, Germany; (M.G.); (B.K.)
| | - Martin Freesmeyer
- Clinic of Nuclear Medicine, Jena University Hospital, 07749 Jena, Germany;
| | - Michael C. Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Magdeburg University Hospital, 39120 Magdeburg, Germany;
| | - Ken Herrmann
- Department of Nuclear Medicine, Essen University Hospital, 45147 Essen, Germany; (K.H.); (R.G.)
| | - Rainer Görges
- Department of Nuclear Medicine, Essen University Hospital, 45147 Essen, Germany; (K.H.); (R.G.)
- Joint Practice for Nuclear Medicine, Duisburg (Moers), 47441 Duisburg, Germany
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Food sources of iodine in schoolchildren and relationship with 24-h urinary iodine excretion in Victoria, Australia. Br J Nutr 2021; 127:791-799. [PMID: 33910660 DOI: 10.1017/s0007114521001410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Dietary recalls have been used previously to identify food sources of iodine in Australian schoolchildren. Dietary assessment can provide information on the relative contributions of individual food groups which can be related to a robust objective measure of daily intake (24-h urinary iodine excretion (UIE)). In Australia, the government has mandated the use of iodised salt in breadmaking to address iodine deficiency. The aim of this study was to determine the dietary intake and food sources of iodine to assess their contribution to iodine excretion (UIE) in a sample of Australian schoolchildren. In 2011-2013, UIE was assessed using a single 24-h urine sample and dietary intake was assessed using one 24-h dietary recall in a convenience sample of primary schoolchildren from schools in Victoria, Australia. Of the 454 children with a valid recall and urine sample, 55 % were male (average age 10·1 (1·3 (sd) years). Mean UIE and dietary iodine intake were 108 (sd 54) and 172 (sd 74) μg/d, respectively. Dietary assessment indicated that bread and milk were the main food sources of iodine, contributing 27 and 25 %, respectively, to dietary iodine. Milk but not bread intake was positively associated with UIE. Multiple regression (adjusted for school cluster, age and sex) indicated that for every 100 g increase in milk consumption, there was a 3 μg/d increase in UIE (β = 4·0 (se 0·9), P < 0·001). In conclusion, both bread and milk were important contributors to dietary iodine intake; however, consumption of bread was not associated with daily iodine excretion in this group of Australian schoolchildren.
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Beer RJ, Herrán OF, Villamor E. Median Urinary Iodine Concentration in Colombian Children and Women is High and Related to Sociodemographic and Geographic Characteristics: Results from a Nationally Representative Survey. J Nutr 2021; 151:940-948. [PMID: 33561275 DOI: 10.1093/jn/nxaa392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 11/13/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Salt iodization has been mandatory in Colombia for over half a century. The iodine status of the population has not been recently evaluated using nationally representative data. OBJECTIVE We estimated the median urinary iodine concentration (mUIC) of Colombian women and children overall and by individual and environmental characteristics. METHODS Using data from spot urine samples collected in the 2015 Colombian National Nutrition Survey, we estimated mUIC in 24,248 boys and girls aged 1 to <13 y and 9122 women of reproductive age (WRA). Within each group, we compared mUIC by levels of sociodemographic, anthropometric, and geographic factors by using adjusted median differences with 95% CIs from quantile regression models. RESULTS mUICs were 395 ± 3 μg/L among children and 381 ± 3 μg/L among WRA. Schoolchildren 5 to <13 y old had higher mUIC (407 ± 3 μg/L) than did preschoolers or toddlers. Girls had 21 μg/L (95% CI: -29, -14) lower mUIC than boys after adjustment. In addition, among children, mUIC was positively associated with household wealth and inversely associated with indigenous compared with mestizo ethnicity, living in the southern or Pacific compared with the central regions of Colombia, and altitude. Among WRA, mUIC was positively associated with obesity and inversely with age, indigenous compared with mestizo ethnicity, education, household wealth, living in southern compared with central Colombia, altitude, and alcohol intake frequency. CONCLUSION Colombian children and WRA had mUIC well above conventional cutpoints of iodine excess. Whether excessive iodine affects other subpopulations and its functional consequences warrant urgent investigation.
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Affiliation(s)
- Rachael J Beer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Oscar F Herrán
- Facultad de Salud, Universidad Industrial de Santander (Faculty of Health, Industrial University of Santander), Bucaramanga, Colombia
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Wallborn T, Vogel M, Kneuer A, Thamm M, Dittrich K, Kiess W, Kratzsch J. Spot urine iodine levels below the WHO recommendation are not related to impaired thyroid function in healthy children and adolescents. Eur J Nutr 2021; 60:493-502. [PMID: 32390124 PMCID: PMC7867514 DOI: 10.1007/s00394-020-02268-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 04/28/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Iodine deficiency in childhood and adolescence may lead to later thyroid dysfunction, stunted growth and cognitive impairment. The World Health Organization (WHO) has issued recommended age-dependent urine iodine concentration targets, but a critical threshold beyond which clinical sequelae are to be expected remains undefined. Our study aimed to investigate spot urine iodine concentration in a typical Central European cohort of children and adolescents, and consider the implications of these values in regard to laboratory parameters for evaluating thyroid function. METHODS Using the Sandell-Kolthoff method, spot urine iodine concentration was measured cross-sectionally from 1802 healthy children and adolescent in the age range of 0.25-18 years within the LIFE-Child epidemiological study based in and around the city of Leipzig (Germany). Additionally, serum thyroid biomarkers of these subjects were measured and correlated to urine iodine levels. RESULTS In our cohort, 61.39% of boys and 65.91% of girls had an iodine level of < 100 µg/L (57%, 67%, 65% of the age groups 0-5, 6-12 and 13-18 years), the median iodine excretion was 86 µg/L in boys and 80 µg/L in girls. The iodine levels revealed no significant correlation with the thyroid biomarkers TSH, FT4 and FT3. Moreover, iodine values revealed no correlation with levels of antibodies against thyroid peroxidase or thyroglobulin. CONCLUSION In our cohort of children and adolescents, the relatively high number of iodine levels below the WHO recommendation appears not to be related to clinical or subclinical thyroid diseases in the respective participants.
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Affiliation(s)
- Tillmann Wallborn
- University Hospital for Children and Adolescents, University of Leipzig, 04103, Leipzig, Germany.
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
| | - Mandy Vogel
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Antje Kneuer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13302, Berlin, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13302, Berlin, Germany
| | - Katalin Dittrich
- University Hospital for Children and Adolescents, University of Leipzig, 04103, Leipzig, Germany
| | - Wieland Kiess
- University Hospital for Children and Adolescents, University of Leipzig, 04103, Leipzig, Germany
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital, Leipzig, Germany
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Venance MS, Martin HD, Kimiywe J. Iodine Status and Discretionary Choices Consumption Among Primary School Children, Kinondoni Tanzania. Pediatric Health Med Ther 2020; 11:359-368. [PMID: 33061741 PMCID: PMC7518783 DOI: 10.2147/phmt.s265117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/04/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Tanzania is one of the countries where excessive iodine intake has been reported, to intervene, the identification of possible causes is required. This study aimed to assess iodine status and determine the critical contributors to excessive iodine intakes in schoolchildren aged 8-14 years. MATERIALS AND METHODS A total of 288 school children were randomly selected in this school-based cross-sectional study in Kinondoni municipality, Tanzania. Household salt samples were analyzed using iodine rapid field test kit while that was collected from retailers/wholesalers by iodometric titration. Spot urine samples were collected and analyzed for iodine levels using a modified microplate method following the Sandell-Kolthoff reaction. A lifestyle questionnaire was administered to schoolchildren to assess their eating frequency of discretionary foods and salts. RESULTS The mean salt iodine content was 53.94 ± 13.02, and over 90% of household salt was iodized. Median urinary iodine concentration (UIC) was 401 µg/L indicating excessive iodine intake, and one-third of the children had UIC >500 µg/L. Nearly all school children consume discretionary choices as snacks or part of a meal. Potato chips and fried cassava were the top two discretionary choices consumed with discretionary salt use (67.3%). Potato chips (adjusted odds ratio [AOR=9.04, 95% CI: 3.61-22.63]), fried cassava (AOR=11.08, 95% CI: 3.45-35.54) and groundnuts consumption for 4-7 days/week (AOR = 0.30 95% CI: 0.09-1.0) were significantly associated with iodine intake. CONCLUSION AND RECOMMENDATION The evidence of excessive iodine intakes observed in previous studies and in this study should alert the policymakers to consider adjustment of the amount of iodine added to salt along with the obligation of reducing discretionary foods and salt intake.
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Affiliation(s)
- Mario S Venance
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Department of Health, Social Welfare, and Nutrition, Sikonge District Council, Sikonge, Tanzania
| | - Haikael D Martin
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Judith Kimiywe
- Department of Foods, Nutrition, and Dietetics, Kenyatta University, Nairobi, Kenya
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Rudloff S, Bührer C, Jochum F, Kauth T, Kersting M, Körner A, Koletzko B, Mihatsch W, Prell C, Reinehr T, Zimmer KP. Vegetarian diets in childhood and adolescence : Position paper of the nutrition committee, German Society for Paediatric and Adolescent Medicine (DGKJ). Mol Cell Pediatr 2019; 6:4. [PMID: 31722049 PMCID: PMC6854160 DOI: 10.1186/s40348-019-0091-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022] Open
Abstract
In Western countries, vegetarian diets are associated with lower intakes of energy, saturated fatty acids and animal protein and higher intakes of fibre and phytochemicals, compared to omnivorous diets. Whether the corresponding health benefits in vegetarians outweigh the risks of nutrient deficiencies has not been fully clarified. It should be noted that vegetarians often have a higher socioeconomic status, follow a more health-conscious lifestyle with higher physical activity, and refrain from smoking more often than non-vegetarians. The nutritional needs of growing children and adolescents can generally be met through a balanced, vegetable-based diet; however, due to their higher nutrient requirements per kilogramme of body weight, vegetarian children have a higher risk for developing nutrient deficiencies than adults. With a vegetarian diet, the mean intakes of some nutrients, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are lower than in omnivores or those eating fish. For other nutrients, such as iron and zinc, the bioavailability from vegetable foodstuffs is reduced when the intake of phytates and fibre is high; thus, the prevalence of iron deficiency can be increased despite high vitamin C intake. In addition, vitamin B12 is only found in animal-source foods. Vitamin B12 should be supplemented in people of all age groups who follow a strict vegan diet without consuming animal products. A vegetarian diet in childhood and adolescence requires good information and supervision by a paediatrician, if necessary, in cooperation with an appropriately trained dietary specialist.
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Affiliation(s)
- Silvia Rudloff
- Children’s Hospital, University of Giessen, Giessen, Germany
| | - Christoph Bührer
- Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Jochum
- Evangelisches Waldkrankenhaus Berlin Spandau, Berlin, Germany
| | - Thomas Kauth
- Practice for Paediatrics and Adolescent Medicine/Sports and Nutrition Medicine Ludwigsburg, Committee for Prevention and Early Therapy BVKJ Cologne, Cologne, Germany
| | - Mathilde Kersting
- Research Department of Child Nutrition, Department of Paediatrics, Ruhr-University Bochum, Bochum, Germany
| | - Antje Körner
- Paediatric Research Center, Dept. Womens’ and Childrens’ Medicine, Univ. Leipzig, Leipzig, Germany
| | - Berthold Koletzko
- LMU – Ludwig-Maximilians-Univ. Munich, Dr. von Hauner Children’s Hospital, Munich, Germany
- Nutrition Committee of the German Society for Paediatric and Adolescent Medicine (DGKJ), Chausseestr, 128-129 Berlin, Germany
| | - Walter Mihatsch
- Children’s Hospital, Heliosklinikum Pforzheim, Pforzheim, Germany
| | - Christine Prell
- LMU – Ludwig-Maximilians-Univ. Munich, Dr. von Hauner Children’s Hospital, Munich, Germany
| | - Thomas Reinehr
- Department of Pediatric Endocrinology, Diabetology and Nutritional Medicine, Vestische Children’s Hospital Datteln, University Witten/Herdecke, Witten, Herdecke Germany
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Myszkowska-Ryciak J, Harton A. Eating Healthy, Growing Healthy: Outcome Evaluation of the Nutrition Education Program Optimizing the Nutritional Value of Preschool Menus, Poland. Nutrients 2019; 11:E2438. [PMID: 31614948 PMCID: PMC6835571 DOI: 10.3390/nu11102438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/24/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Staff education can improve the quality of nutrition in childcare centers, but an objective assessment of the change is necessary to assess its effectiveness. This study evaluated the effectiveness of the multicomponent educational program for improving the nutritional value of preschools menus in Poland measured by the change in nutrients content before (baseline) and 3-6 months after education (post-baseline). A sample of 10 daily menus and inventory reports reflecting foods and beverages served in 231 full-board government-sponsored preschools was analyzed twice: at baseline and post-baseline (in total 4620 inventory reports). The changes in 1. the supply of nutrients per 1 child per day; 2. the nutrient-to-energy ratio of menus; 3. the number of preschools serving menus consistent with the healthy diet recommendations, were assessed. Education resulted in favorable changes in the supply of energy, fat and saturated fatty acids. The nutrient-to-energy ratio for vitamins A, B1, B2, B6, C, folate and minerals Calcium, copper, iron, magnesium, phosphorus, potassium and zinc increased significantly. The percentage of preschools implementing the recommendations for energy, share of fat, saturated fatty acids and sucrose as well as calcium, iron and potassium increased significantly. However, no beneficial effects of education on the content of iodine, potassium, vitamin D and folate were observed. This study indicates the potentially beneficial effect of education in optimizing the quality of the menu in preschools. However, the magnitude of change is still not sufficient to meet the nutritional standards for deficient nutrients.
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Affiliation(s)
- Joanna Myszkowska-Ryciak
- Department of Dietetics, Faculty of Human Nutrition, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Anna Harton
- Department of Dietetics, Faculty of Human Nutrition, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str, 02-776 Warsaw, Poland.
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16
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Kalhoff H, Lücke T, Kersting M. Praktische Beratung und Betreuung bei vegetarischer Kinderernährung. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-019-0730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Rudloff S, Bührer C, Jochum F, Kauth T, Kersting M, Körner A, Koletzko B, Mihatsch W, Prell C, Reinehr T, Zimmer KP. Vegetarische Kostformen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-018-0547-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Nerhus I, Odland M, Kjellevold M, Midtbø LK, Markhus MW, Graff IE, Lie Ø, Kvestad I, Frøyland L, Dahl L, Øyen J. Iodine status in Norwegian preschool children and associations with dietary iodine sources: the FINS-KIDS study. Eur J Nutr 2018; 58:2219-2227. [PMID: 29974227 PMCID: PMC6689280 DOI: 10.1007/s00394-018-1768-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/29/2018] [Indexed: 11/24/2022]
Abstract
Purpose Iodine is an essential trace element necessary for thyroid hormone synthesis. Iodine deficiency is a continuing public health problem despite international efforts to eliminate it. Studies on iodine status in preschoolers are scarce. Thus, the aims of the current study were to determine the iodine status and to investigate possible associations between urinary iodine concentration (UIC) and estimated 24 h iodine extraction (UIE) and iodine-rich foods. Methods Data are cross-sectional baseline data, obtained from the two-armed randomized controlled dietary trial “Fish Intervention Studies-KIDS” (FINS-KIDS) conducted in Bergen, Norway. UIC was determined by inductively coupled plasma-mass spectrometry in spot urine samples. Inadequate UIC was defined as median < 100 µg/L, and low estimated 24 h UIE as < 65 µg/day. Habitual dietary intake was assessed by a short food frequency questionnaire. Logistic regression models were used to investigate possible associations between UIC and estimated 24 h UIE and iodine-rich dietary sources including seafood, dairy products and eggs. Iodine/creatinine ratio (I/Cr) was also estimated. Results Urinary spot samples were obtained from 220 children. The median (interquartile range) UIC and estimated 24 h UIE was 132 (96) µg/L, and 65 (55) µg/day, respectively. The majority of children had an estimated I/Cr ratio within 100–199 µg/g. Intake of sweet milk < 2 times/day versus ≥ 2 times/day was associated with UIC < 100 µg/L (OR 2.17, 95% CI 1.07–4.38, p = 0.031). Intake of dairy products (OR 3.59, 95% CI 1.13–11.43, p = 0.031) and sweet milk (OR 2.77, 95% CI 1.37–5.61, p = 0.005) < 2 times/day versus ≥ 2 times day was associated with estimated 24 h UIE < 65 µg/day. Conclusions The preschoolers had adequate iodine status. Low intake of sweet milk and dairy products were associated with low iodine status.
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Affiliation(s)
- Ive Nerhus
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Mathilde Odland
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Clinical Institute 1, University of Bergen, Bergen, Norway
| | - Marian Kjellevold
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Lisa Kolden Midtbø
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Maria Wik Markhus
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Ingvild Eide Graff
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Uni Research Health, Bergen, Norway
| | - Øyvind Lie
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Directorate of Fisheries, Bergen, Norway
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Livar Frøyland
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Jannike Øyen
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway.
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Myszkowska-Ryciak J, Harton A. Implementation of Dietary Reference Intake Standards in Preschool Menus in Poland. Nutrients 2018; 10:nu10050592. [PMID: 29748511 PMCID: PMC5986472 DOI: 10.3390/nu10050592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/28/2022] Open
Abstract
Although the nutritional value of preschool menus largely determines the proper nutrition of attending children, their nutrient composition often does not meet the standards. The purpose of the study was to assess the nutritional value of menus served in preschools throughout Poland. We analyzed a sample of 10 daily menus and inventory reports reflecting foods and beverages served in 270 full-board government-sponsored preschools. Nutrient content was calculated per child per day, and compared with 70% of dietary reference intake (DRI) for children aged 1–3 and 4–6. The content of energy, protein, fat, and carbohydrates generally exceeded 70% of DRI. The amount of vitamins was correct, with the exception of vitamin D (100% of daycare centers (DCCs) were below the recommendations); in ≤3% of preschools vitamin E, folate, and niacin were below DRI. Calcium was too low in 63% of preschools for children aged 1–3 years and in 99% for 4–6-year-olds. A shortage of iodine, iron, and potassium (especially for 4–6-year-olds) was observed in a small number of preschools. Our study highlights the need for uniform legal standards of nutrition in childcare centers, based on the current recommendations for the age group.
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Affiliation(s)
- Joanna Myszkowska-Ryciak
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Anna Harton
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str, 02-776 Warsaw, Poland.
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20
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Variation in iodine food composition data has a major impact on estimates of iodine intake in young children. Eur J Clin Nutr 2017; 72:410-419. [PMID: 29176712 DOI: 10.1038/s41430-017-0030-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/24/2017] [Accepted: 09/29/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES The reliability of an estimate of iodine intake is largely dependent on the quality of the food composition data. We aimed to assess the impact of variations in food composition data for iodine and season on the estimates of iodine intake in young children. SUBJECTS/METHODS Cross-sectional dietary intake study of Irish 2-year-olds participating in the Cork BASELINE Birth Cohort Study (n=468; 30% of the cohort at the 2-year follow-up) were used to assess the impact of variation in iodine food composition data on estimates of iodine intake, dietary adequacy and risk of exceeding the tolerable upper intake level (UL). RESULTS Mean (SD) iodine intakes calculated using UK (147 (71)) and Irish (177 (93)) food composition data were significantly different (P < 0.001) (mean difference (95% confidence interval) = 30 (26-33) µg/day) and largely adequate (7-14% below the estimated average requirement). Intakes at the 95th percentile were 138% and 173% of the UL using UK and Irish food composition data, respectively, of which milk accounted for 106% and 150% of the UL. This translated into 22% and 35% of toddlers exceeding the UL, using UK and Irish composition data, respectively. The mean (SD) daily intake of cow's milk among the 91% of consumers was 309 (208) ml. Intakes of cow's milk at the 75th and 95th percentiles were 452 and 706 ml, respectively. Using Irish composition data for iodine in cows' milk, a daily intake of 450 ml could result in a toddler exceeding the UL from milk alone. CONCLUSIONS Variability in food composition has a large impact on assessments of iodine intake, particularly among young children for whom milk contributes a large proportion of their daily nutrient intake. Although this is unlikely to result in long-term adverse effects, our study highlights the need for development of valid biomarkers of individual iodine status.
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Folgenahrungen für Kleinkinder im Alter von einem bis 3 Jahren (sog. Kindermilchgetränke). Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Costa Leite J, Keating E, Pestana D, Cruz Fernandes V, Maia ML, Norberto S, Pinto E, Moreira-Rosário A, Sintra D, Moreira B, Costa A, Silva S, Costa V, Martins I, Castro Mendes F, Queirós P, Peixoto B, Carlos Caldas J, Guerra A, Fontoura M, Leal S, Moreira R, Palmares Carvalho I, Matias Lima R, Martins C, Delerue-Matos C, Almeida A, Azevedo L, Calhau C. Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study. Nutrients 2017; 9:E458. [PMID: 28475154 PMCID: PMC5452188 DOI: 10.3390/nu9050458] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 11/17/2022] Open
Abstract
The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6-12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children's urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children's eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 µg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake.
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Affiliation(s)
- João Costa Leite
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
| | - Elisa Keating
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
| | - Diogo Pestana
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
- Nutrition & Metabolism, NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.
| | - Virgínia Cruz Fernandes
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
- LAQV/REQUIMTE-Instituto Superior de Engenharia, Instituto Politécnico do Porto, 4249-015 Porto, Portugal.
| | - Maria Luz Maia
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
| | - Sónia Norberto
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
| | - Edgar Pinto
- LAQV/REQUIMTE-Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4249-015 Porto, Portugal.
| | - André Moreira-Rosário
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Diana Sintra
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Bárbara Moreira
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Ana Costa
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Sofia Silva
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Vera Costa
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Inês Martins
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | | | - Pedro Queirós
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
| | - Bruno Peixoto
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, 4585-116 Gandra, Portugal.
| | - José Carlos Caldas
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, 4585-116 Gandra, Portugal.
| | - António Guerra
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Division of Paediatric Nutrition, Department of Paediatrics, Integrated Paediatric Hospital, Centro Hospitalar São João, Porto. Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Manuel Fontoura
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Division of Paediatric Endocrinology, Department of Paediatrics, Integrated Paediatric Hospital, Centro Hospitalar São João, Porto. Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Sandra Leal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, 4585-116 Gandra, Portugal.
- Department of Biomedicine-Anatomy Unit, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Roxana Moreira
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, 4585-116 Gandra, Portugal.
| | - Irene Palmares Carvalho
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Rui Matias Lima
- Directorate-General of Education, 1049-005 Lisbon, Portugal.
| | - Catia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), NO-7491 Trondheim, Norway.
| | - Cristina Delerue-Matos
- LAQV/REQUIMTE-Instituto Superior de Engenharia, Instituto Politécnico do Porto, 4249-015 Porto, Portugal.
| | - Agostinho Almeida
- LAQV/REQUIMTE-Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4249-015 Porto, Portugal.
| | - Luís Azevedo
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
| | - Conceição Calhau
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.
- Department of Biomedicine-Biochemistry Unit, Faculty of Medicine of the University of Porto, 4200-450 Porto, Portugal.
- Nutrition & Metabolism, NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.
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Schürmann S, Kersting M, Alexy U. Vegetarian diets in children: a systematic review. Eur J Nutr 2017; 56:1797-1817. [PMID: 28299420 DOI: 10.1007/s00394-017-1416-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/19/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE While the prevalence of children on vegetarian diets is assumed to be on the rise in industrialized countries, there are hardly any representative data available. In general, vegetarian diets are presumed to be healthy; nevertheless, there are concerns as to whether the dietary specifications required during infancy, childhood, and adolescence can be met. Therefore, the objective of this systematic review was to evaluate studies on the dietary intake and the nutritional or health status of vegetarian infants, children, and adolescents. METHODS The database MEDLINE was used for literature search. In addition, references of reviews and expert opinions were considered. Inclusion criteria were (1) sufficient dietary information to define vegetarian type diet and (2) characteristics of nutritional or health status. Case reports and studies from non-industrialized countries were excluded. RESULTS 24 publications from 16 studies published from 1988 to 2013 met our criteria. Study samples covered the age range from 0 to 18 years, and median sample size was 35. Five studies did not include a control group. With regard to biomarkers, anthropometry, and dietary or nutritional intake, the outcomes were diverse. Growth and body weight were generally found within the lower reference range. The intakes of folate, vitamin C, and dietary fiber were relatively high compared to reference values and/or control groups. Low status of vitamin B12 was reported in one study and low status of vitamin D in two studies. CONCLUSIONS Due to the study heterogeneity, the small samples, the bias towards upper social classes, and the scarcity of recent studies, the existing data do not allow us to draw firm conclusions on health benefits or risks of present-day vegetarian type diets on the nutritional or health status of children and adolescents in industrialized countries.
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Affiliation(s)
- S Schürmann
- Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - M Kersting
- Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - U Alexy
- IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
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Nazeri P, Mirmiran P, Tahmasebinejad Z, Hedayati M, Delshad H, Azizi F. The Effects of Iodine Fortified Milk on the Iodine Status of Lactating Mothers and Infants in an Area with a Successful Salt Iodization Program: A Randomized Controlled Trial. Nutrients 2017; 9:nu9020180. [PMID: 28241419 PMCID: PMC5331611 DOI: 10.3390/nu9020180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/06/2017] [Accepted: 02/17/2017] [Indexed: 11/20/2022] Open
Abstract
Iodine deficiency during the first two years of life may cause irreversible brain damage and mental retardation. The aim of the present study was to investigate, for the first time, the effect of iodine fortified milk on the iodine status of lactating mothers and their infants. In this multicenter randomized controlled trial, 84 lactating mother-infant pairs from health care centers were randomly selected. After meeting the inclusion criteria, lactating mothers were randomly assigned to two groups: the iodine fortified milk group and the control group (n = 42 each). Maternal and infant urine and breast milk samples were collected at 3–5 (baseline), 7, 10, 14 days, and 1 month postpartum, for a measurement of the iodine concentration. A total of 84 lactating mothers, with a mean age of 28.2 ± 4.5 years, and 84 infants, with a mean age of 4.2 ± 0.7 days, were included in the study. Compared to mothers of the control group, mothers receiving iodine fortified milk had higher urinary (p < 0.001) and breast milk (p < 0.001) iodine concentrations. Urinary iodine levels in infants revealed no significant differences between the two groups. The findings of this study indicate that supplementation with daily iodine fortified milk provides iodine nutrition adequacy among lactating mothers. However, it had no effect on the iodine status of infants, who were previously iodine sufficient.
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Affiliation(s)
- Pantea Nazeri
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
- Department of Nutrition and Clinical Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, 19395-4741 Tehran, Iran.
| | - Zhale Tahmasebinejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
| | - Hossein Delshad
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 19395-4763 Tehran, Iran.
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Abstract
AbstractI is an important mineral for health, required for the production of key thyroid hormones, which are essential for cellular metabolism, growth and physical development. Hence, adequate I is crucial at all stages of life, but imperative during pregnancy for fetal brain development and during a child’s early life for neurodevelopment. Within Ireland, limited information exists on population I intakes and status. Therefore, the purposes of the present analysis were to estimate dietary I intakes and to analyse urinary iodine (UI) status using the cross-sectional National Adult Nutrition Survey 2008–2010 and the most recent Irish Total Diet Study. Median I intakes in the total population (n1106) were adequate with only 26 % of the population being classified as below the estimated average requirement (EAR). Milk consumption was the major source of I in the diet, contributing 45 % to total intake. Likewise, median UI concentrations (107 µg/l) indicated ‘optimal’ I nutrition according to the WHO cut-off points. In our cohort, 77 % of women of childbearing age (18–50 years) did not meet the EAR recommendation set for pregnant women. Although I is deemed to be sufficient in the majority of adult populations resident in Ireland, any changes to the current dairy practices could significantly impact intake and status. Continued monitoring should be of priority to ensure that all subgroups of the population are I sufficient.
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Abebe Z, Gebeye E, Tariku A. Poor dietary diversity, wealth status and use of un-iodized salt are associated with goiter among school children: a cross-sectional study in Ethiopia. BMC Public Health 2017; 17:44. [PMID: 28061776 PMCID: PMC5219792 DOI: 10.1186/s12889-016-3914-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Globally, more than two billion people are at risk of iodine deficiency disorders, 32% of which are school children. Iodine deficiency has been recognized as a severe public health concern in Ethiopia, however little is known about the problem. Therefore, this study aimed to assess the prevalence of goiter and associated factors among school children (6 to 12 years) in Dabat District, northwest Ethiopia. Methods A school-based cross-sectional study was conducted from February 21 to March 31, 2016. A total of 735 school children were included in the study. A stratified multistage sampling followed by systematic sampling technique was employed to select the study participants. Thyroid physical examination was done and classified according to the World Health Organization recommendations as grade 0, grade 1, and grade 2. The level of salt iodine content was determined using the rapid field test kit. The value 0 parts per million (PPM), <15 PPM and ≥15 PPM with the corresponding color chart on the rapid test kit were used to classify the level of iodine in the sampled salt. A multivariable logistic regression analysis was employed to identify factors associated with goiter. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was calculated to show the strength of association. In multivariable analysis, variables with a P-value of <0.05 were considered statistically significant. Results In this community, the overall prevalence of goiter was 29.1% [95% CI: 25.9, 32.6], in which about 22.4 and 6.7% had goiter grade 1 and grade 2, respectively. The age of children (AOR = 1.13; 95% CI: 1.01, 1.26), being housewife mother (AOR = 1.49; 95% CI: 1.08, 2.15), use of unprotected well water source for drinking (AOR = 6.25; 95% CI: 2.50, 15.66), medium household wealth status (AOR = 1.78; 95% CI: 1.18, 2.92), use of inadequately iodized salt (AOR = 2.79; 95% CI: 1.86, 4.19), poor dietary diversity score of the child (AOR = 1.92;95% CI: 1.06, 3.48) and medium maternal knowledge (AOR = 0.65; 95% CI: 0.42, 0.94) were significantly associated with goiter. Conclusions The prevalence of goiter is higher in Dabat District, which confirmed a moderate public health problem. Therefore, regular monitoring of household salt iodine content, improving access to safe water, promoting the importance of diversified food for children is recommended to address the higher burden of iodine deficiency.
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Affiliation(s)
- Zegeye Abebe
- Department of Public Health Officer, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ejigu Gebeye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
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Bath SC, Combet E, Scully P, Zimmermann MB, Hampshire-Jones KHC, Rayman MP. A multi-centre pilot study of iodine status in UK schoolchildren, aged 8-10 years. Eur J Nutr 2016; 55:2001-9. [PMID: 26276556 PMCID: PMC5009164 DOI: 10.1007/s00394-015-1014-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/05/2015] [Indexed: 11/04/2022]
Abstract
PURPOSE Iodine, as an essential constituent of thyroid hormones, is required for brain development. Iodine status is low in some UK population groups, notably in teenage girls, women of childbearing age and pregnant women. We aimed to assess iodine status of UK schoolchildren as there are no data on children below 14 years of age. METHODS Children (boys and girls) aged 8-10 years were recruited to a cross-sectional study from schools in three areas of the UK (Omagh, Northern Ireland; Glasgow, Scotland, and Guildford, South-East England). Spot urine samples, for measurement of urinary iodine concentration, were collected in the winter months (November 2012 to March 2013) and in the summer, in Omagh only (September 2013). A food frequency questionnaire was completed. RESULTS A total of 168 schoolchildren provided 165 urine samples. The median urinary iodine concentration was 161 µg/L in winter samples (n = 134) and 127 µg/L in summer samples (n = 31). The median urinary iodine concentration for the whole group was 144 µg/L, weighted to account for the unequal proportion of samples from the two seasons. The children are classified as iodine-sufficient by WHO criteria (100-199 µg/L), even in the summer. Milk intake was positively associated with iodine status. CONCLUSIONS This pilot study suggests that iodine deficiency is unlikely to be a problem in UK children aged 8-10 years. This could be a result of higher intake of milk, the principal UK dietary iodine source, in this age group than in teenagers and adults. Further assessment of iodine status in a representative sample of UK schoolchildren is required.
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Affiliation(s)
- Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH UK
| | - Emilie Combet
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G31 2ER UK
| | - Patrick Scully
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH UK
| | - Michael B. Zimmermann
- Human Nutrition Laboratory, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Katharine H. C. Hampshire-Jones
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH UK
| | - Margaret P. Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH UK
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Samidurai AJ, Ware RS, Davies PSW. The Iodine Status of Queensland Preschool Children After the Introduction of Mandatory Iodine Fortification in Bread: An Exploratory Study Using a Convenience Sample. Matern Child Health J 2016; 21:215-221. [DOI: 10.1007/s10995-016-2111-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nazeri P, Norouzian MA, Mirmiran P, Hedayati M, Azizi F. Heating Process in Pasteurization and not in Sterilization Decreases the Iodine Concentration of Milk. Int J Endocrinol Metab 2015; 13:e27995. [PMID: 26587031 PMCID: PMC4648127 DOI: 10.5812/ijem.27995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/23/2015] [Accepted: 06/19/2015] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Iodine is a vital component of the thyroid hormones and is required for normal growth, development, and tissue metabolism in humans and animals. OBJECTIVES This study for the first time compares the effects of heating during pasteurization and sterilization on the iodine concentration of milk for an adequate provision of dietary iodine. MATERIALS AND METHODS This study was carried out on multiparous Holstein Friesian lactating cows. Thirty Holstein dairy cows were fed with a diet containing 10 mg of potassium iodide (KI) per kilogram dry matter of diet. Milk samples were obtained on days 4 and 2 before and again on days 2, 4, 6, and 8 after the inclusion of KI into the total mixed ration diet of the dairy cows. The milk samples were sterilized using ultra-high temperature, following which the effect of the heating process during sterilization on the cows' iodine concentration was compared to that in the only previous documented study from Iran in which milk supplementation with KI was the same as ours. Milk in that study was pasteurized via the high-temperature short-time method, a method which involves temperatures in excess of 73°C for durations longer than 15 seconds. RESULTS The inclusion of KI in the diet of the dairy cows in these 2 separate experiments increased their milk iodine levels. Pasteurization decreased the iodine content of the milk (P < 0.05), while no significant difference was observed in the iodine concentration of the sterilized milk. CONCLUSIONS The present study showed that the iodine concentration is not decreased during the heating process in sterilization, indicating that supplemented sterilized milk could be a good alternative vehicle for dietary iodine in the prevention of iodine deficiency.
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Affiliation(s)
- Pantea Nazeri
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Ali Norouzian
- Department of Animal Science, College of Abouraihan, University of Tehran, Tehran, IR Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR 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, Tehran, IR Iran
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Dietary ratio of animal:plant protein is associated with 24-h urinary iodine excretion in healthy school children. Br J Nutr 2015; 114:24-33. [PMID: 26059089 DOI: 10.1017/s0007114515001567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Adequate dietary iodine intake in children is essential for optimal physical and neurological development. Whether lower dietary animal food and salt intake may adversely affect iodine status is under discussion. We examined the association between dietary animal:plant protein ratio with 24-h urinary iodine excretion (24-h UI, μg/d), and whether this is modified by salt intake. A 24-h UI was measured in 1959 24-h urine samples from 516 6- to 12-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Parallel 3 d weighed food records were used to estimate dietary intakes. Protein sources were classified as dairy, animal and plant. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of animal:plant protein ratios on 24-h UI. ANIMAL plant protein ratios ranged from 0.5 (95 % CI 0.4, 0.6) to 1.6 (95 % CI 1.4, 1.9) (lowest and highest quartile). After adjustment for total energy intake, main dietary iodine sources (dairy and salt intake), and further covariates, the inter-individual variation in animal:plant protein ratio was significantly associated with variation in 24-h UI. One unit higher animal:plant protein ratio predicted 6 μg/d higher 24-h UI (P= 0.002) in boys and 5 μg/d (P= 0.03) in girls. This relationship was partially mediated by a higher salt intake at higher animal:plant protein ratios. These results suggest that lower consumption of animal protein is associated with a small decline in iodine excretion, partially mediated by decreased salt intake. Because limited salt and increased intake of plant-based foods are part of a preferable healthy food pattern, effective nutrition political strategies will be required in the future to ensure appropriate iodine nutrition in adherent populations.
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Johner SA, Thamm M, Schmitz R, Remer T. Examination of iodine status in the German population: an example for methodological pitfalls of the current approach of iodine status assessment. Eur J Nutr 2015; 55:1275-82. [PMID: 26031434 DOI: 10.1007/s00394-015-0941-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/22/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Preliminary iodine concentration (UIC) measurements in spot urines of the representative German adult study DEGS indicated a severe worsening of iodine status compared to previous results in German children (KiGGS study). Therefore, we aimed to evaluate adult iodine status in detail and to investigate the impact of hydration status on UIC. METHODS UIC and creatinine concentrations were measured in 6978 spot urines from the German nationwide DEGS study (2008-2011). Twenty-four-hour iodine excretions (24-h UIE) were estimated by relating iodine/creatinine ratios to age- and sex-specific 24-h creatinine reference values. Urine osmolality was measured in two subsamples of spot urines (n = 100 each) to determine the impact of hydration status on UIC. RESULTS In DEGS, median UIC was 69 µg/L in men and 54 µg/L in women, lying clearly below the WHO cutoff for iodine sufficiency (100 µg/L). Estimated median 24-h UIE was 113 µg/day, accompanied by 32 % of DEGS adults, lying below the estimated average requirement (EAR) for iodine. Comparative analysis with the KiGGS data (>14,000 spot urines of children; median UIC 117 µg/L) revealed a comparable percentage <EAR (33 %). In two DEGS subsamples with significantly different UIC but similar median 24-h UIE, osmolality was twofold higher in the high- versus the low-UIC group. CONCLUSION Over 30 % of participants in the two German surveys had an estimated iodine intake less than the respective age-group-specific EAR. Our data strongly suggest that even in large surveys, hydration status can considerably interfere with the epidemiological iodine assessment parameter UIC. The present data can serve as an example how to evaluate population-based spot urine data on a 24-h basis, independent of hydration status.
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Affiliation(s)
- S A Johner
- IEL-Nutritional Epidemiology, DONALD Study Centre at the Research Institute of Child Nutrition, University of Bonn, Dortmund, Germany
| | - M Thamm
- Central Epidemiology Laboratory, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - R Schmitz
- Health of Children and Adolescents, Prevention Concepts, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - T Remer
- IEL-Nutritional Epidemiology, DONALD Study Centre at the Research Institute of Child Nutrition, University of Bonn, Dortmund, Germany.
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Iodine deficiency in pregnant women in Austria. Eur J Clin Nutr 2014; 69:349-54. [PMID: 25491497 DOI: 10.1038/ejcn.2014.253] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 09/09/2014] [Accepted: 09/19/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES In Austria, iodine deficiency has been considered to be eliminated owing to table salt fortification with iodine, but whether this also applies to pregnant women is unclear. Even mild iodine deficiency during gestation may lead to neurocognitive sequelae in the offspring. SUBJECTS/METHODS This is a cross-sectional investigation of urinary iodine excretion in 246 pregnant women (first trimester n=2, second trimester n=53, third trimester n=191, gestational diabetes mellitus n=115, no gestational diabetes mellitus n=131). The iodine content of morning spot urine samples was determined using inductively coupled plasma mass spectrometry. RESULTS Pregnant women in the Vienna area had a median urinary iodine concentration (UIC) of 87 μg/l. Only 13.8% of the cohort were in the recommended range of 150-249 μg/l, whereas 21.5% had a UIC of 0-49 μg/l, 40.2% had a UIC of 50-99 μg/l and 19.5% had a UIC of 100-149 μg/l. In all, 4.9% had a UIC over 250 μg/l. A total of 137 women of foreign origin had a significantly higher iodine excretion compared with Austrian-born women. Maternal or gestational age had no influence on UIC. Although 79 women on iodine supplementation had a significantly higher iodine concentration compared with women without iodine supplementation (97.3 vs 80.1 μg/l, P=0,006), their UIC was below the recommended range, indicating that doses of 100-150 μg per day are not sufficient to normalize iodine excretion. Sodium and iodine concentrations in the urine were tightly correlated (R=0.539, n=61), suggesting that low intake of iodized salt might contribute to insufficient iodine supply. CONCLUSIONS This study shows that pregnant women in the Vienna area have a potentially clinically significant iodine deficiency and that currently recommended doses of iodine supplementation may not be sufficient.
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Bath SC, Sleeth ML, McKenna M, Walter A, Taylor A, Rayman MP. Iodine intake and status of UK women of childbearing age recruited at the University of Surrey in the winter. Br J Nutr 2014; 112:1715-23. [PMID: 25274294 PMCID: PMC4340577 DOI: 10.1017/s0007114514002797] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As intra-thyroidal iodine stores should be maximised before conception to facilitate the increased thyroid hormone production during pregnancy, women who are planning to become pregnant should ideally consume 150 μg iodine/d (US RDA). As few UK data exist for this population group, a cross-sectional study was carried out at the University of Surrey to assess the iodine intake and status of women of childbearing age. Total iodine excretion was measured from 24 h urine samples in fifty-seven women; iodine intake was estimated by assuming that 90 % of ingested iodine was excreted. The average iodine intake was also estimated from 48 h food diaries that the participants completed. The median urinary iodine concentration value (63·1 μg/l) indicated the group to be mildly iodine deficient by WHO criteria. By contrast, the median 24 h urinary iodine excretion value (149·8 μg/24 h) indicated a relatively low risk of iodine deficiency. The median estimated iodine intake, extrapolated from urinary excretion, was 167 μg/d, whereas it was lower, at 123 μg/d, when estimated from the 48 h food diaries. Iodine intake estimated from the food diaries and 24 h urinary iodine excretion were strongly correlated (r 0·75, P< 0·001). The intake of milk, eggs and dairy products was positively associated with iodine status. The iodine status of this UK cohort is probably a best-case scenario as the women were mostly nutrition students and were recruited in the winter when milk-iodine content is at its highest; further study in more representative cohorts of UK women is required. The present study highlights the need for revised cut-off values for iodine deficiency that are method- and age group-specific.
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Affiliation(s)
- Sarah C Bath
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
| | - Michelle L Sleeth
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
| | - Marianne McKenna
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
| | - Alan Walter
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
| | - Andrew Taylor
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
| | - Margaret P Rayman
- Department of Nutritional Sciences,Faculty of Health and Medical Sciences, University of Surrey,Guildford,SurreyGU2 7XH,UK
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Remer T, Johner S. Kritischer Nährstoff Jod. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Iannotti LL, Lutter CK, Bunn DA, Stewart CP. Eggs: the uncracked potential for improving maternal and young child nutrition among the world's poor. Nutr Rev 2014; 72:355-68. [DOI: 10.1111/nure.12107] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Lora L Iannotti
- Institute for Public Health; Brown School; Washington University; St. Louis Missouri USA
| | - Chessa K Lutter
- Pan American Health Organization/World Health Organization; Washington, DC USA
| | - David A Bunn
- College of Agricultural and Environmental Sciences; University of California, Davis; Davis California USA
| | - Christine P Stewart
- Program in International and Community Nutrition; University of California, Davis; Davis California USA
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Flachowsky G, Franke K, Meyer U, Leiterer M, Schöne F. Influencing factors on iodine content of cow milk. Eur J Nutr 2013; 53:351-65. [DOI: 10.1007/s00394-013-0597-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 10/07/2013] [Indexed: 10/26/2022]
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