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Mathews DM, Peart JM, Sim RG, Johnson NP, O’Sullivan S, Derraik JGB, Hofman PL. Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography: a prospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1257888. [PMID: 38974579 PMCID: PMC11224778 DOI: 10.3389/fendo.2024.1257888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 04/29/2024] [Indexed: 07/09/2024] Open
Abstract
Objective To examine factors associated with fertility following hysterosalpingography (HSG) using an oil-soluble contrast medium (OSCM). Design In a prospective cohort study on 196 women undergoing OSCM HSG, we showed that iodine excess was almost universal (98%) and mild subclinical hypothyroidism was frequent (38%). Here, we report the analyses of secondary outcomes examining factors associated with the likelihood of pregnancy following the HSG. Setting Auckland, New Zealand (2019-2021). Sample 196 women with primary or secondary infertility who underwent OSCM HSG. Methods Baseline and serial urine iodine concentrations (UIC) and thyroid function tests were measured over six months following the HSG. Pregnancy and treatment with levothyroxine during the study period were documented. Results Following OSCM HSG, pregnancy rates were 49% in women aged <40 years (77/158) but considerably lower (16%) among those ≥40 years (6/38). Similarly, live birth rates were markedly lower in women ≥40 years (17%; 1/6) versus <40 years (73%; 56/77). 29% of participants were iodine deficient at baseline despite advice recommending iodine fortification. Following HSG, the likelihood of pregnancy in women with moderate iodine deficiency was 64% higher than in women with normal iodine levels (p=0.048). Among women aged <40 years who had subclinical hypothyroidism (n=75), levothyroxine treatment was associated with higher pregnancy rates compared to untreated women [63% (26/48) vs 37% (10/27), respectively; p=0.047]. Conclusion OSCM HSG was associated with higher pregnancy rates in women ≤40 than in those aged >40 years. Iodine deficiency was relatively common in this cohort, and increased iodine levels from OSCM exposure may contribute to the improved fertility observed with this procedure. Trial registration This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12620000738921) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000738921.
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Affiliation(s)
- Divya M. Mathews
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children’s Hospital, Health New Zealand | Te Whatu Ora, Auckland, New Zealand
| | | | | | - Neil P. Johnson
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Repromed Auckland, Auckland, New Zealand
| | - Susannah O’Sullivan
- Endocrinology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - José G B Derraik
- Department of Paediatrics: Child & Youth Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
- Environmental–Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Paul L. Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children’s Hospital, Health New Zealand | Te Whatu Ora, Auckland, New Zealand
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Mutonhodza B, Dembedza MP, Joy EJM, Manzeke-Kangara MG, Njovo H, Nyadzayo TK, Lark RM, Kalimbira AA, Bailey EH, Broadley MR, Matsungo TM, Chopera P. Urine Se concentration poorly predicts plasma Se concentration at sub-district scales in Zimbabwe, limiting its value as a biomarker of population Se status. Front Nutr 2024; 11:1288748. [PMID: 38385014 PMCID: PMC10879291 DOI: 10.3389/fnut.2024.1288748] [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: 09/04/2023] [Accepted: 01/17/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The current study investigated the value of urine selenium (Se) concentration as a biomarker of population Se status in rural sub-Saharan Africa. Method Urine and plasma Se concentrations were measured among children aged 6-59 months (n = 608) and women of reproductive age (WRA, n = 781) living in rural Zimbabwe (Murehwa, Shamva, and Mutasa districts) and participating in a pilot national micronutrient survey. Selenium concentrations were measured by inductively coupled plasma-mass spectrometry (ICP-MS), and urine concentrations were corrected for hydration status. Results The median (Q1, Q3) urine Se concentrations were 8.4 μg/L (5.3, 13.5) and 10.5 μg/L (6.5, 15.2) in children and WRA, respectively. There was moderate evidence for a relationship between urine Se concentration and plasma Se concentration in children (p = 0.0236) and WRA (p = < 0.0001), but the relationship had poor predictive value. Using previously defined thresholds for optimal activity of iodothyronine deiodinase (IDI), there was an association between deficiency when indicated by plasma Se concentrations and urine Se concentrations among WRA, but not among children. Discussion Urine Se concentration poorly predicted plasma Se concentration at sub-district scales in Zimbabwe, limiting its value as a biomarker of population Se status in this context. Further research is warranted at wider spatial scales to determine the value of urine Se as a biomarker when there is greater heterogeneity in Se exposure.
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Affiliation(s)
- Beaula Mutonhodza
- Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mavis P. Dembedza
- Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Edward J. M. Joy
- London School for Hygiene & Tropical Medicine, London, United Kingdom
- Rothamsted Research, West Common, Harpenden, United Kingdom
| | | | - Handrea Njovo
- National Nutrition Unit, Ministry of Health and Child Care of Zimbabwe, Harare, Zimbabwe
| | - Tasiana K. Nyadzayo
- National Nutrition Unit, Ministry of Health and Child Care of Zimbabwe, Harare, Zimbabwe
| | - R. Murray Lark
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom
| | - Alexander A. Kalimbira
- Department of Human Nutrition and Health, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Elizabeth H. Bailey
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom
| | - Martin R. Broadley
- Rothamsted Research, West Common, Harpenden, United Kingdom
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom
| | - Tonderayi M. Matsungo
- Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Prosper Chopera
- Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe
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Wang NX, McLean RM, Cameron C, Skeaff SA. The quantification of sodium intake from discretionary salt intake in New Zealand using the lithium-tagged salt method. Front Nutr 2023; 9:1065710. [PMID: 36741993 PMCID: PMC9893271 DOI: 10.3389/fnut.2022.1065710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Discretionary salt (added in cooking at home or at the table) is a source of sodium and iodine in New Zealand. The amount of discretionary salt consumed in a population has implications on policies regarding sodium and iodine. Sodium intake from discretionary salt intake has not been quantified in New Zealand. The aim of this study was to estimate the proportion of total sodium that comes from discretionary salt in adults using the lithium-tagged salt method. Methods A total of 116 healthy adults, who were not pregnant or breastfeeding, regularly consume home-cooked meals and use salt during cooking or at the table, aged 18-40 years from Dunedin, New Zealand were recruited into the study. The study took place over a 9-day period. On Day 1, participants were asked to collect a baseline 24-h urine to establish their normal lithium output. From Day 2 to Day 8, normal discretionary salt was replaced with lithium-tagged salt. Between Day 6 and Day 8, participants collected another two 24-h urine samples. A 24-h dietary recall was conducted to coincide with each of the final two 24-h urine collections. Urinary sodium was analysed by Ion-Selective Electrode and urinary lithium and urinary iodine were analysed using Inductively Coupled Plasma Mass Spectrometry. The 24-h dietary recall data was entered into Xyris FoodWorks 10. All statistical analysis were conducted using Stata 17.0. Results A total of 109 participants with complete 24-h urine samples were included in the analysis. From the 24-h urine collections, the median urinary excretion of sodium and iodine was 3,222 mg/24 h (25th, 75th percentile: 2516, 3969) and 112 μg/24 h (82, 134). The median estimated sodium intake from discretionary salt was 13% (25th, 75th percentile: 7, 22) of the total sodium intake or 366 mg/24 h (25th, 75th percentile: 186, 705). Conclusion The total sodium intake was higher than the suggested dietary target of 2,000 mg/day. In this sample of healthy adults 18 to 40 years old, 13% of total sodium intake derived from discretionary salt. Discretionary salt is an additional source of iodine if iodised salt is used. Policies to reduce sodium intake is recommended to include a range of strategies to target discretionary and non-discretionary sources of salt and will need to take into account the contribution of iodine from discretionary salt intake.
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Affiliation(s)
- Nan Xin Wang
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael M. McLean
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Claire Cameron
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Sheila A. Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,*Correspondence: Sheila A. Skeaff,
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Mathews DM, Peart JM, Johnson NP, Sim RG, Heather NL, Webster D, O'Sullivan S, Hofman PL. Hysterosalpingography with Oil-Soluble Contrast Medium Does Not Increase Newborn Hypothyroidism. Int J Endocrinol 2022; 2022:4532714. [PMID: 35242184 PMCID: PMC8888087 DOI: 10.1155/2022/4532714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/29/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates in women with idiopathic infertility. However, OSCM has high iodine content and slow clearance resulting in potential iodine excess. If pregnancy occurs, this could impact fetal thyroid gland development and function. We aim to determine the effect of a preconceptional OSCM HSG on the thyroid function of the neonate. Design and Patients. This was a retrospective analysis of newborn TSH data for a cohort of neonates conceived within six months of an OSCM HSG in the Auckland region, New Zealand, from the years 2000 to 2019. Thyroid-stimulating hormone (TSH) levels of these newborns were obtained from newborn screening, which is routinely performed for all children at 48-72 hours of life. The primary outcome was the incidence of permanent or transient congenital hypothyroidism in this cohort. RESULTS Of 146 babies included, all had normal TSH levels with values ranging from 1 to 7 mIU/L on the whole blood analysis of a capillary heel sample using the Perkin-Elmer AutoDelfia assay. Conception during the first 3 cycles following an OSCM HSG was 76%; however, TSH levels in this group were not higher than those conceived in later cycles. CONCLUSION Preconceptional OSCM HSG did not increase the risk of congenital hypothyroidism in the New Zealand scenario.
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Affiliation(s)
- Divya M. Mathews
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Paediatric Endocrinology, Starship Children's Hospital, Auckland, New Zealand
| | | | - Neil P. Johnson
- Repromed Auckland, Auckland, New Zealand
- University of Auckland, Auckland, New Zealand
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | | | - Natasha L. Heather
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Newborn Metabolic Screening Programme, LabPlus, Auckland District Health Board, Auckland, New Zealand
| | - Dianne Webster
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Newborn Metabolic Screening Programme, LabPlus, Auckland District Health Board, Auckland, New Zealand
| | - Susannah O'Sullivan
- Endocrinology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Paul L. Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Paediatric Endocrinology, Starship Children's Hospital, Auckland, New Zealand
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Jin Y, Coad J, Zhou SJ, Skeaff S, Benn C, Brough L. Use of Iodine Supplements by Breastfeeding Mothers Is Associated with Better Maternal and Infant Iodine Status. Biol Trace Elem Res 2021; 199:2893-2903. [PMID: 33094447 DOI: 10.1007/s12011-020-02438-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/11/2020] [Indexed: 12/21/2022]
Abstract
Adequate iodine status during conception, pregnancy and lactation is essential for supporting infant neurodevelopment. Iodine status in adults and children was improved after two New Zealand government initiatives, but the status of breastfeeding women is unknown. This study aimed to investigate the iodine intake and status of lactating mother-infant pairs at 3 months postpartum and to assess maternal iodine knowledge and practice. Iodine intake was estimated by a weighed 4-day diet diary (4DDD). Maternal urinary iodine concentrations (UIC) in spot urine, breast milk iodine concentrations (BMIC) and infant UIC were measured. Questions about iodine-specific knowledge and practice were asked. In 87 breastfeeding mother-infant pairs, maternal iodine intake was 151 (99, 285) μg/day, and 58% had an intake below the estimated average requirement (EAR) of 190 μg/day. Maternal median UIC (MUIC) was 82 (46, 157) μg/L indicating iodine deficiency (i.e., < 100 μg/L). Women who used iodine-containing supplements had a significantly higher MUIC (111 vs 68 μg/L, P = 0.023) and BMIC (84 vs 62 μg/L, P < 0.001) than non-users. Infants fed by women using iodine-containing supplements had a higher MUIC (150 vs 86 μg/L, P = 0.036) than those of non-users. A total of 66% (57/87) of women had no or low iodine knowledge. The iodine knowledge score was a statistically significant predictor of consuming iodine-containing supplements [(beta = 1.321, P = 0.008)]. Despite a decade of initiatives to increase iodine intakes in New Zealand, iodine knowledge was low; iodine intake and status of these lactating women were suboptimal, but women who used iodine-containing supplement were more likely to achieve adequate status.Study Registration Number (Australia and New Zealand Clinical Trials Registry): ACTRN12615001028594.
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Affiliation(s)
- Ying Jin
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Jane Coad
- Nutrition Science, School of Food and Advance Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North, 4474, New Zealand
| | - Shao J Zhou
- School of Agriculture, Food and Wine, Faculty of Sciences & Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Sheila Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Cheryl Benn
- Mid Central and Whanganui District Health Board, Palmerston North, New Zealand
| | - Louise Brough
- Nutrition Science, School of Food and Advance Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North, 4474, New Zealand.
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Whitbread JS, Murphy KJ, Clifton PM, Keogh JB. Iodine Excretion and Intake in Women of Reproductive Age in South Australia Eating Plant-Based and Omnivore Diets: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073547. [PMID: 33805502 PMCID: PMC8037805 DOI: 10.3390/ijerph18073547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022]
Abstract
Women consuming a strictly vegan/plant-based diet may be at increased risk of low iodine intake due to avoidance of animal products containing iodine. The aim of this pilot study was to determine the iodine excretion and intake in women consuming vegan/plant based diets compared with women consuming omnivore diets. Fifty-seven women (n = 31 plant-based, n = 26 omnivores), provided two spot urine samples to assess urinary iodine concentration (UIC). Two days of dietary intake were also recorded by participants. As the data were not normally distributed results are reported as median (IQR). UIC was significantly different between groups, 44 (26-66) µg/L in the vegan/plant-based group versus 64 (40-88) µg/L in omnivores (p < 0.05). UIC did not meet the >100 µg/L level recommended by the World Health Organization. Iodine intake was also significantly different, 78 (62-91) µg/day in the vegan/plant-based group and 125 (86-175) µg/day in the omnivores (p = 0.000). Iodine intake and bread intake were correlated with iodine excretion (CC 0.410-4.11, p = 0.003). These data indicate iodine insufficiency in both groups of women as the median values were below the minimum WHO recommendation. A larger study assessing iodine excretion in the Australian women of reproductive age who are not pregnant or breastfeeding is needed to confirm these findings.
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Beckford K, Grimes CA, Margerison C, Riddell LJ, Skeaff SA, West ML, Nowson CA. A systematic review and meta-analysis of 24-h urinary output of children and adolescents: impact on the assessment of iodine status using urinary biomarkers. Eur J Nutr 2020; 59:3113-3131. [PMID: 31784814 PMCID: PMC7501103 DOI: 10.1007/s00394-019-02151-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/18/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE Urinary iodine concentration (UIC (μg/ml) from spot urine samples collected from school-aged children is used to determine the iodine status of populations. Some studies further extrapolate UIC to represent daily iodine intake, based on the assumption that children pass approximately 1 L urine over 24-h, but this has never been assessed in population studies. Therefore, the present review aimed to collate and produce an estimate of the average 24-h urine volume of children and adolescents (> 1 year and < 19 years) from published studies. METHODS EBSCOHOST and EMBASE databases were searched to identify studies which reported the mean 24-h urinary volume of healthy children (> 1 year and < 19 years). The overall mean (95% CI) estimate of 24-h urine volume was determined using a random effects model, broken down by age group. RESULTS Of the 44 studies identified, a meta-analysis of 27 studies, with at least one criterion for assessing the completeness of urine collections, indicated that the mean urine volume of 2-19 year olds was 773 (654, 893) (95% CI) mL/24-h. When broken down by age group, mean (95% CI) 24-h urine volume was 531 mL/day (454, 607) for 2-5 year olds, 771 mL/day (734, 808) for 6-12 year olds, and 1067 mL/day (855, 1279) for 13-19 year olds. CONCLUSIONS These results demonstrate that the average urine volume of children aged 2-12 years is less than 1 L, therefore, misclassification of iodine intakes may occur when urine volumes fall below or above 1 L. Future studies utilizing spot urine samples to assess iodine status should consider this when extrapolating UIC to represent iodine intakes of a population.
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Affiliation(s)
- Kelsey Beckford
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia.
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia
| | - Claire Margerison
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia
| | - Lynn J Riddell
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia
| | - Sheila A Skeaff
- Department of Human Nutrition, University of Otago, 362 Leith St, North Dunedin, Dunedin, 9016, New Zealand
| | - Madeline L West
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC, 3220, Australia
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Jin Y, Coad J, Zhou SJ, Skeaff S, Benn C, Kim N, Pond RL, Brough L. Mother and Infant Nutrition Investigation in New Zealand (MINI Project): Protocol for an Observational Longitudinal Cohort Study. JMIR Res Protoc 2020; 9:e18560. [PMID: 32852279 PMCID: PMC7484772 DOI: 10.2196/18560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 12/31/2022] Open
Abstract
Background Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants. Objective This study will determine (1) women’s iodine intake and status among supplement users and nonusers; (2) women’s intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women’s selenium status, thyroid function, and postnatal depression; (4) infants’ iodine and selenium status relating to first year neurodevelopment. Methods Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months. Results Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020. Conclusions This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women’s mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324 International Registered Report Identifier (IRRID) DERR1-10.2196/18560
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Affiliation(s)
- Ying Jin
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Jane Coad
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand
| | - Shao J Zhou
- School of Agriculture, Food and Wine and Robinson Research Institute, Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - Sheila Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Cheryl Benn
- MidCentral District Health Board, Palmerston North, New Zealand
| | - Nicholas Kim
- School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Rachael L Pond
- Institute of Education, College of Humanities and Social Sciences, Massey University, Palmerston North, New Zealand
| | - Louise Brough
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand
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Adequate Iodine Intake among Young Adults in Jiangsu Province, China Despite a Medium Iodine Knowledge Score. Eur J Investig Health Psychol Educ 2020; 10:554-563. [PMID: 34542503 PMCID: PMC8312987 DOI: 10.3390/ejihpe10010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 02/07/2023] Open
Abstract
Lack of iodine knowledge might be a risk factor for inadequate iodine intake in populations. Therefore, we aimed to determine the relationship between iodine knowledge and intake in young Chinese adults. A cross-sectional study was conducted in Suzhou, China. Iodine intake was assessed using a validated 33-item iodine-specific Chinese food frequency questionnaire (FFQ) and iodine knowledge was determined using a Chinese iodine knowledge questionnaire. A total of 150 participants (mean age 20.3 years) completed the study. The median iodine intake plus iodized salt was 260 μg/d, indicating iodine sufficiency (>150 µg/d). The median iodine knowledge score was 16/24, suggesting a medium level of knowledge. The majority of participants correctly recognized fish and seafood (95%) and iodized salt (83%) as the most important dietary iodine sources. After adjusting for age and sex, studying in the science cluster and having received iodine education were the predictors of having a higher iodine knowledge score, with adjusted odd ratios (OR) of 4.33 (1.49, 12.61) and 2.73 (1.21, 6.14), respectively. In conclusion, young Chinese adults had an adequate iodine intake despite a medium iodine knowledge score. This study provides support that iodine fortification in China has been successful, but further research is required to more fully substantiate this finding.
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Tamatea JAU, Reid P, Conaglen JV, Elston MS. Thyrotoxicosis in an Indigenous New Zealand Population - a Prospective Observational Study. J Endocr Soc 2020; 4:bvaa002. [PMID: 32161829 PMCID: PMC7060792 DOI: 10.1210/jendso/bvaa002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background Reported international incidence rates of thyrotoxicosis vary markedly, ranging from 6 to 93 cases per 100 000 per annum. Along with population demographics, exposures, and study design factors, ethnicity is increasingly being recognized as a potential factor influencing incidence. This study aimed to document the epidemiology and clinical presentation of thyrotoxicosis for Māori, the indigenous population in New Zealand. Methods A prospective study of adult patients presenting with a first diagnosis of thyrotoxicosis between January 2013 and October 2014 to a single New Zealand center. Demographic data were collected, and detailed clinical assessment performed. Results With 375 patients, an incidence rate of thyrotoxicosis of 73.0 per 100 000 per annum was identified. Of these, 353 (94.1%) participated in the study. The median age of the cohort was 47 years, 81% were female, and 58% had Graves disease. The overall incidence of thyrotoxicosis for Māori, the indigenous people of New Zealand, was higher than non-Māori (123.9 vs 57.3 per 100 000 per annum). Rates of both Graves disease and toxic multinodular goiter were higher in Māori as compared to non-Māori (incidence rate ratios of 1.9 [1.4, 2.6] and 5.3 [3.4, 8.3], respectively), with this increase being maintained after controlling for age, deprivation, and smoking. Conclusions Māori, the indigenous people of New Zealand, have an increased incidence of thyrotoxicosis compared to non-Māori and, in particular, toxic multinodular goiter. A greater understanding of the epidemiology of thyrotoxicosis in other indigenous and marginalized ethnic groups may help to optimize therapeutic pathways, equitable care and outcomes.
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Affiliation(s)
- Jade A U Tamatea
- Department of Medicine, Waikato Clinical Campus, University of Auckland. Hamilton, New Zealand.,Te Kupenga Hauora Māori, Tamaki Campus, University of Auckland Auckland, New Zealand
| | - Papaarangi Reid
- Te Kupenga Hauora Māori, Tamaki Campus, University of Auckland Auckland, New Zealand
| | - John V Conaglen
- Department of Medicine, Waikato Clinical Campus, University of Auckland. Hamilton, New Zealand
| | - Marianne S Elston
- Department of Medicine, Waikato Clinical Campus, University of Auckland. Hamilton, New Zealand
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Conte L, Comina M, Monti E, Sidoti M, Vannozzi O, Di Ciolo L, Lillo F, Giusti M. Urinary Iodine Concentration in a Cohort of Adult Outpatients with Thyroid Diseases in Liguria 14 Years after the Law on Salt Iodization. Nutrients 2019; 12:nu12010011. [PMID: 31861566 PMCID: PMC7019929 DOI: 10.3390/nu12010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Italy is considered a mildly iodine-deficient country. The aim of this study was to evaluate the iodine status of a cohort of adults living in Liguria after the 2005 salt iodization program. We searched all medical records of patients examined in two endocrine outpatient clinics in Genoa and Savona for data on urinary iodine. Subjects were under evaluation for thyroid diseases. Information on the type of salt used was found in few clinical records. Iodized salt use was reported in 29%, 20%, and 13% of records of people living in Genoa districts, the Savona district and nearby districts, respectively. The average urinary iodine concentration was 112.9 ± 62.3 µg/L (n = 415, median 101.0 µg/L). Non-significant differences (p > 0.05) were found between subjects with (median 103.5 µg/L) and without (median 97.5 µg/L) a thyroid gland, between the periods 2009–2013 (median 105.0 µg/L) and 2014–2018 (median 97.5 µg/L), and between Genoa (median 94.0 µg/L), Savona (median 105.0 µg/L) and the other districts (median 114.5 µg/L). No correlation with age, body mass index, creatinine, free thyroxine, thyroglobulin, levo-thyroxine dosage, or thyroid volume was observed. These data suggest a borderline status of iodine sufficiency in this cohort.
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Affiliation(s)
- Lucia Conte
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (L.C.); (M.C.)
- Endocrine Unit, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
| | - Martina Comina
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (L.C.); (M.C.)
- Endocrine Unit, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
| | - Eleonora Monti
- Endocrine Unit, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
| | - Marilena Sidoti
- Endocrine Ambulatory, Centro Diagnostico Priamar, 17100 Savona, Italy;
| | - Ornella Vannozzi
- Laboratory Unit, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
| | - Lucia Di Ciolo
- Nuclear Medicine Unit, Santa Corona Hospital, Pietra Ligure, 17027 Savona, Italy;
| | - Flavia Lillo
- Laboratory Unit, Azienda Sanitaria Locale 2 of Liguria, 17100 Savona, Italy;
| | - Massimo Giusti
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (L.C.); (M.C.)
- Endocrine Unit, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
- Endocrine Ambulatory, Centro Diagnostico Priamar, 17100 Savona, Italy;
- Correspondence:
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12
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Iodine-fortified toddler milk improves dietary iodine intakes and iodine status in toddlers: a randomised controlled trial. Eur J Nutr 2019; 59:909-919. [PMID: 30929067 DOI: 10.1007/s00394-019-01950-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE We aimed to evaluate the effectiveness of consuming iodine-fortified toddler milk for improving dietary iodine intakes and biochemical iodine status in toddlers. METHODS In a 20-week parallel randomised controlled trial, healthy 12-20-month-old children were assigned to: Fortified Milk [n = 45; iodine-fortified (21.1 µg iodine/100 g prepared drink) cow's milk], or Non-Fortified Milk (n = 90; non-fortified cow's milk). Food and nutrient intakes were assessed with 3-day weighed food records at baseline, and weeks 4 and 20. Urinary iodine concentration (UIC) was measured at baseline and 20 weeks. RESULTS At baseline, toddlers' median milk intake was 429 g/day. There was no evidence that milk intakes changed within or between the groups during the intervention. Toddlers' baseline geometric mean iodine intake was 46.9 µg/day, and the median UIC of 43 µg/L in the Fortified Milk group and 55 µg/L in the Non-Fortified Milk group indicated moderate and mild iodine deficiency, respectively, with this difference due to chance. During the intervention, iodine intakes increased by 136% (p < 0.001) and UIC increased by 85 µg/L (p < 0.001) in the Fortified Milk group compared to the Non-Fortified Milk group. The 20-week median UIC was 91 µg/L in the Fortified Milk group and 49 µg/L in the Non-Fortified Milk group. CONCLUSIONS Consumption of ≈ 1.7 cups of iodine-fortified toddler milk per day for 20 weeks can increase dietary iodine intakes and UIC in healthy iodine-deficient toddlers. This strategy alone is unlikely to provide sufficient intake to ensure adequate iodine status in toddlers at risk of mild-to-moderate iodine deficiency.
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13
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Jin Y, Coad J, Weber JL, Thomson JS, Brough L. Selenium Intake in Iodine-Deficient Pregnant and Breastfeeding Women in New Zealand. Nutrients 2019; 11:nu11010069. [PMID: 30609662 PMCID: PMC6356683 DOI: 10.3390/nu11010069] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022] Open
Abstract
Selenium plays a role in antioxidant status and, together with iodine, in thyroid function. Iodine deficiency exists in New Zealand during pregnancy and lactation, and selenium deficiency may further affect thyroid function. This study investigated selenium intakes of pregnant and lactating women, in Palmerston North, in the North Island of New Zealand. Dietary intake was estimated using three repeated 24-h dietary recalls. Dietary intake in pregnancy was also estimated from 24-h urinary excretion of selenium. Selenium concentrations were determined in urine and breastmilk using inductively-coupled plasma mass spectrometry. Median selenium intakes based on dietary data were 51 (39, 65) μg/day in pregnancy and 51 (36, 80) μg/day in lactation, with 61% and 68% below estimated average requirement (EAR). Median daily selenium intake in pregnancy based on urinary excretion was 49 (40, 60) µg/day, with 59% below EAR. Median selenium concentration in breastmilk was 11 (10, 13) µg/L and estimated median selenium intake for infants was 9 (8, 10) µg/day, with 91% below the Adequate Intake of 12 μg/day. These pregnant and breastfeeding women were at risk of dietary selenium inadequacy. Further research is required to assess selenium status in relation to thyroid function and health in this group.
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Affiliation(s)
- Ying Jin
- School of Health Sciences, College of Health, Massey University, Palmerston North 4442, New Zealand.
| | - Jane Coad
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Janet L Weber
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Jasmine S Thomson
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Louise Brough
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
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14
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Serafico ME, Ulanday JRC, Alibayan MV, Gironella GMP, Perlas LA. Iodine Status in Filipino Women of Childbearing Age. Endocrinol Metab (Seoul) 2018; 33:372-379. [PMID: 30229576 PMCID: PMC6145958 DOI: 10.3803/enm.2018.33.3.372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/11/2018] [Accepted: 06/17/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Iodine deficiency (ID) has become a concern not only among pregnant women, but in women of childbearing age as well. In fact, a recent report suggested that women with moderate to severe ID may experience a significantly longer time to conceive. This study aimed to investigate iodine status in Filipino women of childbearing age. METHODS The iodine status of 6,194 Filipino women aged 15 to 45 years old was assessed through urinary iodine analysis. A casual spot urine sample was collected from women in households participating in the eighth National Nutrition Survey conducted by the Food and Nutrition Research Institute. The sample was analyzed using ammonium persulfate digestion followed by the Sandell-Kolthoff colorimetric reaction. A median urinary iodine concentration (UIC) of less than 100 μg/L was used to define ID. RESULTS The median UIC was 123 μg/L, indicative of adequate iodine nutrition; however, 21.5% of participants had a UIC below 50 μg/L. The median UIC of women who lived in urban areas (142 μg/L), belonged to the middle to richest class (>124 μg/L), had reached a college education (136 μg/L), and used iodized salt (15 ppm and above; 148 to 179 μg/L) reflected adequate iodine nutrition. ID was found to have been eliminated in the regions of Central Luzon, Eastern Visayas, Calabarzon, Mimaropa, and the National Capital, while mild ID was identified in Western Visayas, Southern and Western Mindanao, and in the Autonomous Region in Muslim Mindanao. CONCLUSION Pockets of ID among women of childbearing age exist in the Philippines. Proper information through education and the use of adequately iodized salt are key measures for improving the iodine status of the studied population.
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Affiliation(s)
- Michael E Serafico
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines.
| | - Joselita Rosario C Ulanday
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Marites V Alibayan
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Glen Melvin P Gironella
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Leah A Perlas
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
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15
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Grafenauer S, Curtain F. An Audit of Australian Bread with a Focus on Loaf Breads and Whole Grain. Nutrients 2018; 10:E1106. [PMID: 30115880 PMCID: PMC6115933 DOI: 10.3390/nu10081106] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022] Open
Abstract
Bread is a vehicle for a range of nutrients within the Australian diet, but has been the target of negative press. The aim of this study was to examine bread products, particularly white, whole grain and gluten-free loaves, including nutrients, health claims and Health Star Rating (HSR). An audit of four supermarkets and a bakery franchise (2017) was compared with 2014 data. Median and range was calculated for whole grain content, dietary fibre, sodium, protein, carbohydrate and sugar. Of all breads (n = 456), 29% were eligible to make a whole grain claim with 27% very high in whole grain (≥24 g/serve), an 18% increase from 2014. Within loaves (n = 243), 40% were at least a source of whole grain (≥8 g/serve), 79% were at least a source of dietary fibre, 54% met the sodium reformulation target (≤400 mg/100 g), 78% were a 'source' and 20% were a 'good source' of protein (10 g/serve), and 97% were low in sugar. Despite significant differences between loaves for all nutrients assessed, HSR did not differ between white and whole grain varieties. Compared to 2014, there were 20 fewer white loaves and 20 additional whole grain loaves which may assist more Australians achieve the 48g whole grain daily target intake.
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Affiliation(s)
- Sara Grafenauer
- Grains & Legumes Nutrition Council, Sydney, NSW 2060, Australia.
| | - Felicity Curtain
- Grains & Legumes Nutrition Council, Sydney, NSW 2060, Australia.
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16
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Henjum S, Brantsæter AL, Kurniasari A, Dahl L, Aadland EK, Gjengedal ELF, Birkeland S, Aakre I. Suboptimal Iodine Status and Low Iodine Knowledge in Young Norwegian Women. Nutrients 2018; 10:nu10070941. [PMID: 30037088 PMCID: PMC6073112 DOI: 10.3390/nu10070941] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 11/18/2022] Open
Abstract
Previous studies have documented mild to moderate iodine deficiency in pregnant and lactating women in Norway. This study focused on non-pregnant young women because their future children may be susceptible to the adverse effects of iodine deficiency. We assessed urinary iodine concentration (UIC), iodine intake from food and supplements, and iodine knowledge in 403 non-pregnant women, mainly students, aged 18–30 years. Iodine concentration was measured in spot urine samples analyzed by inductively coupled plasma mass spectrometry and iodine intake was calculated from a self-reported food frequency questionnaire. Knowledge about iodine was collected through the self-administered, paper-based questionnaire. Median (p25–p75) UIC was 75 (42–130) µg/L and 31% had UIC < 50 µg/L. Habitual iodine intake was 100 (69–136) µg/day. In multiple regression models, supplemental iodine, use of thyroid medication, and iodine intake from food were positively associated with UIC, while vegetarian practice was negatively associated, explaining 16% of the variance. Approximately 40% of the young women had low iodine knowledge score and no differences were found between women in different study programs. Young women in Norway are mild to moderately iodine-deficient, and public health strategies are needed to improve and secure adequate iodine status.
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Affiliation(s)
- Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, 0310 Oslo, Norway.
| | - Anne Lise Brantsæter
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, 0403 Oslo , Norway.
| | - Astrid Kurniasari
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, 0310 Oslo, Norway.
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
| | - Eli Kristin Aadland
- Faculty of Education, Western Norway University of Applied Sciences, 5063 Bergen, Norway, .
| | - Elin Lovise Folven Gjengedal
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Aas 1433, Norway.
| | - Susanne Birkeland
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Aas 1433, Norway.
| | - Inger Aakre
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817 Bergen, Norway.
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17
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Głąbska D, Malowaniec E, Guzek D. Validity and Reproducibility of the Iodine Dietary Intake Questionnaire Assessment Conducted for Young Polish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070700. [PMID: 28661461 PMCID: PMC5551138 DOI: 10.3390/ijerph14070700] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 11/16/2022]
Abstract
The aim of this study was to analyse a designed brief iodine dietary intake questionnaire based on a food frequency assessment (IOdine Dietary INtake Evaluation-Food Frequency Questionnaire—IODINE-FFQ), including the assessment of validity and reproducibility in a group of 90 Polish women aged 20–35 years. Participants collected 3-day dietary records and filled in the IODINE-FFQ twice (FFQ1—directly after the dietary record and FFQ2—6 weeks later). The analysis included an assessment of validity (comparison with the results of the 3-day dietary record) and of reproducibility (comparison of the results obtained twice—FFQ1 and FFQ2). In the analysis of validity, a Bland-Altman index of 5.5% and 4.4% was recorded, respectively for FFQ1 and FFQ2. In the analysis of reproducibility it was 6.7%, but the share of individuals correctly classified into tertiles was over 70% (weighted κ of 0.675). It was stated, that assessment of IODINE-FFQ revealed a satisfactory level of validity and reproducibility in the analysis of Bland-Alman plot. The IODINE-FFQ may be indicated as a tool for the assessment of iodine intake in the young women in Poland, however further studies should be considered in order to obtain the practical tool for public health specialists. Due to the lack of validated iodine-specific food frequency questionnaires for countries of Eastern Europe, the IODINE-FFQ may be adjusted for courtiers other than Poland including iodine-fortified products.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 02-787 Warsaw, Poland.
| | - Ewa Malowaniec
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 02-787 Warsaw, Poland.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 02-787 Warsaw, Poland.
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18
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Waugh DT, Godfrey M, Limeback H, Potter W. Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2017; 2017:5120504. [PMID: 28713433 PMCID: PMC5497633 DOI: 10.1155/2017/5120504] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/25/2017] [Accepted: 05/18/2017] [Indexed: 02/03/2023]
Abstract
In countries with fluoridation of public water, it is imperative to determine other dietary sources of fluoride intake to reduce the public health risk of chronic exposure. New Zealand has one of the highest per capita consumption rates of black tea internationally and is one of the few countries to artificially fluoridate public water; yet no information is available to consumers on the fluoride levels in tea products. In this study, we determined the contribution of black tea as a source of dietary fluoride intake by measuring the fluoride content in 18 brands of commercially available products in New Zealand. Fluoride concentrations were measured by potentiometric method with a fluoride ion-selective electrode and the contribution of black tea to Adequate Intake (AI) and Tolerable Upper Intake Level (UL) was calculated for a range of consumption scenarios. We examined factors that influence the fluoride content in manufactured tea and tea infusions, as well as temporal changes in fluoride exposure from black tea. We review the international evidence regarding chronic fluoride intake and its association with chronic pain, arthritic disease, and musculoskeletal disorders and provide insights into possible association between fluoride intake and the high prevalence of these disorders in New Zealand.
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Affiliation(s)
- Declan T. Waugh
- EnviroManagement Services, 11 Riverview, Dohertys Rd, Bandon, Co. Cork P72 YF10, Ireland
| | - Michael Godfrey
- Bay of Plenty Environmental Health Clinic, 1416A Cameron Road, Tauranga 3012, New Zealand
| | - Hardy Limeback
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, Canada M5G 1G6
| | - William Potter
- Department of Chemistry and Biochemistry, KEH M2225, University of Tulsa, Tulsa, OK, USA
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19
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Ma ZF, Venn BJ, Manning PJ, Cameron CM, Skeaff SA. The sensitivity and specificity of thyroglobulin concentration using repeated measures of urinary iodine excretion. Eur J Nutr 2017; 57:1313-1320. [DOI: 10.1007/s00394-017-1410-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 02/19/2017] [Indexed: 10/20/2022]
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20
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Brough L, Gunn CA, Weber JL, Coad J, Jin Y, Thomson JS, Mauze M, Kruger MC. Iodine and Selenium Intakes of Postmenopausal Women in New Zealand. Nutrients 2017; 9:nu9030254. [PMID: 28282932 PMCID: PMC5372917 DOI: 10.3390/nu9030254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 11/18/2022] Open
Abstract
Iodine and selenium are required for thyroid function. This study investigated iodine and selenium intakes in healthy, women aged 50–70 years (n = 97) from three cities in the North Island of New Zealand, after mandatory fortification of bread with iodised salt. Iodine and selenium concentrations were determined in 24-h urine samples; daily intakes were extrapolated from amounts in urine (90% and 55% of daily intake, respectively). Three day diet diaries (3DDD) also estimated selenium and iodine (excluding iodised salt) intake. Median urinary iodine concentration (UIC) was 57 (41, 78) µg/L, indicating mild iodine deficiency. Estimated median iodine intake based on urine was 138 (100, 172) µg/day, below Recommended Dietary Intake (RDI) (150 µg/day) with 25% below Estimated Average Requirement (EAR) (100 µg/day). Estimated median selenium intake was 50 (36, 71) µg/day based on urine and 45 (36, 68) µg/day using 3DDD, below RDI (60 µg/day) with 49%–55% below EAR (50 µg/day). Median bread intakes were low at 1.8 (1.1, 2.7) serves/day; 25% consumed ≤1 serve/day. Although population iodine intakes improved following mandatory fortification, some had low intakes. Selenium intakes remain low. Further research should investigate thyroid function of low consumers of iodine fortified bread and/or selenium in New Zealand.
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Affiliation(s)
- Louise Brough
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Caroline A Gunn
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- Fonterra Research & Development Centre, Private Bag 11029, Dairy Farm Road, Palmerston North 4442, New Zealand.
| | - Janet L Weber
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Jane Coad
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Ying Jin
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Jasmine S Thomson
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Mathilde Mauze
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - Marlena C Kruger
- Massey Institute of Food Science and Technology, School of Food and Nutrition, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
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21
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Liang Z, Xu C, Luo YJ. Association of iodized salt with goiter prevalence in Chinese populations: a continuity analysis over time. Mil Med Res 2017; 4:8. [PMID: 28331628 PMCID: PMC5359876 DOI: 10.1186/s40779-017-0118-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 03/08/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Iodine deficiency disorders (IDD) refer to diseases that are caused by insufficient iodine intake, and the best strategy to prevent IDD is the addition of iodine to dietary salt. Because iodine deficiency is a common cause of goiter, the prevalence as effectively controlled after the implementation of universal salt iodization (USI) in China. However, there is substantial controversy as to whether the incidence of thyroid disorders is related to iodized salt intake. Therefore, we aimed to clarify whether the risk of goiter can be promoted by USI. METHODS A longitudinal continuous study based on the national monitoring results of IDD in China was performed for 3 consecutive years. We recorded the following indicators of IDD from 31 provinces: goiter number, two degrees of goiter (the degree of goiter severity) and cretinism (three endemic diseases), iodized salt intake, median urinary iodine concentration (UIC), soil iodine content and coverage rates of iodized salt. One-way Analysis of Variance (ANOVA) and linear regression analyses examined the differences between the three groups and correlations, respectively. Data were collected from the Chinese national IDD surveillance data in 2011-2013, and the background values of Chinese soil elements were published in 1990. RESULTS A reference male's daily intake of maximum iodine was 378.9 μg, 379.2 μg and 366.9 μg in 2011, 2012, and 2013, respectively. No statistical association between daily iodized salt intake and the three endemic diseases was observed in 2011-2013 (P > 0.05). No association was observed between daily iodized salt intake and the UIC of children in 2011 (P > 0.05). Linear regression revealed no significant correlation between the soil iodine content and three endemic diseases. The present study indicated no difference in the daily iodized salt intake in each province during three years (F = 0.886, P = 0.647). The coverage rate of iodized salt remained above 98.7%, and goiter rates were stable in 2011-2013. CONCLUSION There was no significant association between iodized salt intake and the three endemic diseases, suggesting that the current nutrition level of iodized salt did not cause the high goiter prevalence.
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Affiliation(s)
- Zhen Liang
- Department of Military Medical Geography, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, 400038 China.,Battalion 5 of Cadet Brigade, Third Military Medical University, Chongqing, 400038 China.,Key Laboratory of High Altitude Medicine (PLA), Third Military Medical University, Chongqing, 400038 China
| | - Chen Xu
- Battalion 5 of Cadet Brigade, Third Military Medical University, Chongqing, 400038 China
| | - Yong-Jun Luo
- Department of Military Medical Geography, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, 400038 China.,Key Laboratory of High Altitude Medicine (PLA), Third Military Medical University, Chongqing, 400038 China
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22
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Huang CJ, Tseng CL, Chen HS, Garabwan C, Korovo S, Tang KT, Won JGS, Hsieh CH, Wang FF. Iodine Nutritional Status of School Children in Nauru 2015. Nutrients 2016; 8:nu8090520. [PMID: 27563920 PMCID: PMC5037507 DOI: 10.3390/nu8090520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/16/2016] [Accepted: 08/18/2016] [Indexed: 11/16/2022] Open
Abstract
Little is known about iodine nutritional status in island countries in the Pacific Ocean. The primary objective of this study was to report for the first time the iodine nutritional status of people in Nauru. In addition, sources of iodine nutrition (i.e., water and salt) were investigated. A school-based cross-sectional survey of children aged 6–12 years was conducted in three primary schools of Nauru. Urinary iodine concentration (UIC) was determined by spot urine samples. Available water and salt samples in Nauru were collected for the measurement of iodine content. A food frequency questionnaire was conducted. The median UIC was 142 μg/L, and 25.2% and 7.4% of the population had median UIC below 100 μg/L and 50 μg/L, respectively. Natural iodine-containing foods such as seaweeds and agar were rare. Iodine was undetectable in Nauruan tank water, filtered tap water, and raindrops. Of the analyzed salt products, five kinds were non-iodized, and three were iodized (iodine content: 15 ppm, 65 ppm, and 68 ppm, respectively). The results indicate that the iodine status in Nauruan school children is adequate. Iodized salt may serve as an important source of iodine nutrition in Nauru.
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Affiliation(s)
- Chun-Jui Huang
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
- Institute of Public Health, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Chi-Lung Tseng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Division of Gastroenterology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan.
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Harn-Shen Chen
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | | | | | - Kam-Tsun Tang
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
| | - Justin Ging-Shing Won
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
| | - Fan-Fen Wang
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- Department of Medicine, Yangming Branch, Taipei City Hospital, Taipei 11146, Taiwan.
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23
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Miller JC, MacDonell SO, Gray AR, Reid MR, Barr DJ, Thomson CD, Houghton LA. Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care. Nutrients 2016; 8:nu8080445. [PMID: 27455319 PMCID: PMC4997360 DOI: 10.3390/nu8080445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/10/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022] Open
Abstract
In response to the re-emergence of iodine deficiency in New Zealand, in 2009 the government mandated that all commercially made breads be fortified with iodized salt. There has been no evaluation of the impact of the program on iodine status of the elderly, despite this population group being vulnerable to iodine deficiency or excess. The aim of this study was to describe the iodine status of elderly New Zealanders in residential aged-care homes following the implementation of the bread fortification program. A cross-sectional survey was conducted, involving 309 residents (median age 85 years) from 16 aged-care homes throughout NZ. Information on socio-demographic, anthropometric, dietary and health characteristics were collected. Casual spot urine samples were analysed for urinary iodine concentration (UIC). Blood samples were analysed for serum thyroglobulin, thyroglobulin antibodies, and other biochemical indices. The median UIC (MUIC) of the residents was 72 μg/L, indicating mild iodine deficiency, and 29% had a UIC < 50 μg/L. Median thyroglobulin concentration was 18 ng/mL and 26% had elevated thyroglobulin concentration (>40 ng/mL), suggesting iodine insufficiency. Diuretic use was associated with lower MUIC (p = 0.043). Synthetic thyroxine use was associated with lower odds of having a UIC < 50 μg/L (OR 0.32, p = 0.030)) and lower median thyroglobulin (−15.2 ng/mL, p = 0.001), compared with untreated participants. Frailty was associated with elevated thyroglobulin (p = 0.029), whereas anemia was associated with lower thyroglobulin (p = 0.016). Iodine insufficiency persists in New Zealanders residing in residential aged-care homes despite increasing iodine intake from fortified bread. Research is required to establish optimal iodine intake and status in the elderly.
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Affiliation(s)
- Jody C Miller
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Sue O MacDonell
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Andrew R Gray
- Department of Preventive and Social Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Malcolm R Reid
- Trace Element Centre, Department of Chemistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - David J Barr
- Trace Element Centre, Department of Chemistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Christine D Thomson
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Lisa A Houghton
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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24
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Nyström HF, Brantsæter AL, Erlund I, Gunnarsdottir I, Hulthén L, Laurberg P, Mattisson I, Rasmussen LB, Virtanen S, Meltzer HM. Iodine status in the Nordic countries - past and present. Food Nutr Res 2016; 60:31969. [PMID: 27283870 PMCID: PMC4901513 DOI: 10.3402/fnr.v60.31969] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/08/2016] [Accepted: 05/09/2016] [Indexed: 11/19/2022] Open
Abstract
Background Adequate iodine nutrition is dependent on ground water content, seafood, and, as many countries use iodized cow fodder, dairy products. In most countries, salt fortification programs are needed to assure adequate iodine intake. Objectives The objectives are threefold: 1) to describe the past and present iodine situation in the Nordic countries, 2) to identify important gaps of knowledge, and 3) to highlight differences among the Nordic countries’ iodine biomonitoring and fortification policies. Design Historical data are compared with the current situation. The Nordic countries’ strategies to achieve recommended intake and urine iodine levels and their respective success rates are evaluated. Results In the past, the iodine situation ranged from excellent in Iceland to widespread goiter and cretinism in large areas of Sweden. The situation was less severe in Norway and Finland. According to a 1960 World Health Organization (WHO) report, there were then no observations of iodine deficiency in Denmark. In Sweden and Finland, the fortification of table salt was introduced 50–75 years ago, and in Norway and Finland, the fortification of cow fodder starting in the 1950s helped improve the population's iodine status due to the high intake of milk. In Denmark, iodine has been added to household salt and salt in bread for the past 15 years. The Nordic countries differ with regard to regulations and degree of governmental involvement. There are indications that pregnant and lactating women, the two most vulnerable groups, are mildly deficient in iodine in several of the Nordic countries. Conclusion The Nordic countries employ different strategies to attain adequate iodine nutrition. The situation is not optimal and is in need of re-evaluation. Iodine researchers, Nordic national food administrations, and Nordic governmental institutions would benefit from collaboration to attain a broader approach and guarantee good iodine health for all.
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Affiliation(s)
- Helena Filipsson Nyström
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden;
| | | | - Iris Erlund
- National Institute for Health and Welfare, Helsinki, Finland
| | - Ingibjörg Gunnarsdottir
- Unit for Nutrition Research, University of Iceland and Landspitali National University Hospital, Reykjavik, Iceland
| | - Lena Hulthén
- Department of Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Laurberg
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Lone Banke Rasmussen
- Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Suvi Virtanen
- National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Finland
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25
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Adequate Iodine Status in New Zealand School Children Post-Fortification of Bread with Iodised Salt. Nutrients 2016; 8:nu8050298. [PMID: 27196925 PMCID: PMC4882711 DOI: 10.3390/nu8050298] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/09/2016] [Accepted: 05/11/2016] [Indexed: 11/16/2022] Open
Abstract
Iodine deficiency re-emerged in New Zealand in the 1990s, prompting the mandatory fortification of bread with iodised salt from 2009. This study aimed to determine the iodine status of New Zealand children when the fortification of bread was well established. A cross-sectional survey of children aged 8–10 years was conducted in the cities of Auckland and Christchurch, New Zealand, from March to May 2015. Children provided a spot urine sample for the determination of urinary iodine concentration (UIC), a fingerpick blood sample for Thyroglobulin (Tg) concentration, and completed a questionnaire ascertaining socio-demographic information that also included an iodine-specific food frequency questionnaire (FFQ). The FFQ was used to estimate iodine intake from all main food sources including bread and iodised salt. The median UIC for all children (n = 415) was 116 μg/L (females 106 μg/L, males 131 μg/L) indicative of adequate iodine status according to the World Health Organisation (WHO, i.e., median UIC of 100–199 μg/L). The median Tg concentration was 8.7 μg/L, which was <10 μg/L confirming adequate iodine status. There was a significant difference in UIC by sex (p = 0.001) and ethnicity (p = 0.006). The mean iodine intake from the food-only model was 65 μg/day. Bread contributed 51% of total iodine intake in the food-only model, providing a mean iodine intake of 35 μg/day. The mean iodine intake from the food-plus-iodised salt model was 101 μg/day. In conclusion, the results of this study confirm that the iodine status in New Zealand school children is now adequate.
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