1
|
Kelliher L, Kiely ME, Hennessy Á. Development and validation of a food frequency questionnaire to assess habitual iodine intake among women of childbearing age. J Hum Nutr Diet 2024; 37:633-642. [PMID: 38368606 DOI: 10.1111/jhn.13289] [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: 08/30/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Adequate iodine status is critical for thyroid hormone synthesis, which is essential for foetal brain development. Suboptimal iodine status has been reported in young women across Europe. Although urinary iodine concentration (UIC) is a good indicator of recent exposure, it does not reflect habitual iodine intake. This study aimed to develop and validate an iodine-specific food frequency questionnaire (I-FFQ) to assess habitual intake in Irish women aged 18-50 years. METHODS A 47-item interviewer-administered I-FFQ, informed by national food consumption data on Irish women aged 18-35 years, was developed and validated in a study of 100 nonpregnant women using a 4-day weighed food diary (FD) and UIC as the reference methods. Correlation, cross-classification and Bland-Altman analyses were used to assess agreement and bias between the I-FFQ and FD. Validity coefficients were calculated using the method of triads. RESULTS Median (interquartile range [IQR]) UIC was 82 (49, 139) µg/L. Median (IQR) intakes were 161 (106, 217) and 133 (98, 182) µg/day for the I-FFQ and FD, respectively (p = 0.001). Estimates were moderately correlated (r = 0.434), and the I-FFQ classified 89% of participants into the same or adjacent tertile of intake as the FD. Validity coefficients for the I-FFQ, FD and UIC were 0.542, 0.800 and 0.228, respectively. Though repeatability analyses 10 weeks later (n = 69) showed slight differences in estimates of intake (I-FFQ1: 164 (104, 210) µg/day; I-FFQ2: 132 (67, 237) µg/day), intakes were highly correlated between administrations (r = 0.627, p = 0.001). CONCLUSIONS The I-FFQ provides a reasonable estimate of habitual iodine intake in young women.
Collapse
Affiliation(s)
- Lisa Kelliher
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- INFANT Research Centre, University College Cork, Cork, Republic of Ireland
| | - Mairead E Kiely
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- INFANT Research Centre, University College Cork, Cork, Republic of Ireland
| | - Áine Hennessy
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- INFANT Research Centre, University College Cork, Cork, Republic of Ireland
| |
Collapse
|
2
|
Nicol K, Nugent AP, Woodside JV, Hart KH, Bath SC. The impact of replacing milk with plant-based alternatives on iodine intake: a dietary modelling study. Eur J Nutr 2024; 63:599-611. [PMID: 38212424 PMCID: PMC10899362 DOI: 10.1007/s00394-023-03286-7] [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: 07/25/2023] [Accepted: 11/23/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Cow's milk is the primary source of iodine in the UK, but consumption of plant-based milk alternatives (PBMA) is increasing and these products are often not fortified with iodine. We evaluated the impact that replacing current milk consumption with PBMA would have on iodine intake. METHODS We used data from the National Diet and Nutrition Survey (2016-2019) for children (1.5-10 years), girls 11-18 years, and women of reproductive age (WRA). We used a dietary modelling approach with scenarios using brand-level iodine-fortification data (0, 13, 22.5, 27.4 and 45 µg/100 mL). Relative to usual diet, we calculated change in iodine intake, and the proportion with intake below the Lower Reference Nutrient Intake (LRNI) or above the upper limit. RESULTS For all groups, replacement with PBMA, either unfortified or fortified at the lowest concentration, resulted in a meaningful decrease in iodine intake, and increased the proportion with intake < LRNI; compared to usual diet, iodine intake reduced by 58% in children 1.5-3 years (127 vs. 53 µg/day) and the proportion with intake < LRNI increased in girls (11-18 years; 20% to 48%) and WRA (13% to 33%) if an unfortified PBMA was used. Replacement of milk with PBMA fortified at 27.4 µg/100 mL had the lowest impact. CONCLUSION Replacing milk with commercially available PBMAs has potential to reduce population iodine intake, depending on the fortification level. PBMAs fortified with ≥ 22.5 and < 45 µg iodine/100 mL would be required to minimize the impact on iodine intake. Research is needed on the impact of total dairy replacement.
Collapse
Affiliation(s)
- Katie Nicol
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Anne P Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Jayne V Woodside
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Kathryn H Hart
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Sarah C Bath
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK.
| |
Collapse
|
3
|
Nicol K, Nugent AP, Woodside JV, Hart KH, Bath SC. Iodine and plant-based diets: a narrative review and calculation of iodine content. Br J Nutr 2024; 131:265-275. [PMID: 37622183 PMCID: PMC10751939 DOI: 10.1017/s0007114523001873] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
An increasing number of food-based recommendations promote a plant-based diet to address health concerns and environmental sustainability in global food systems. As the main sources of iodine in many countries are fish, eggs and dairy products, it is unclear whether plant-based diets, such as the EAT-Lancet reference diet, would provide sufficient iodine. This is important as iodine, through the thyroid hormones, is required for growth and brain development; adequate iodine intake is especially important before, and during, pregnancy. In this narrative review, we evaluated the current literature and estimated iodine provision from the EAT-Lancet reference diet. There is evidence that those following a strict plant-based diet, such as vegans, cannot reach the recommended iodine intake from food alone and are reliant on iodine supplements. Using the EAT-Lancet reference diet intake recommendations in combination with iodine values from UK food tables, we calculated that the diet would provide 128 μg/d (85 % of the adult recommendation of 150 μg/d and 51–64 % of the pregnancy recommendation of 200–250 μg/d). However, if milk is replaced with unfortified plant-based alternatives, total iodine provision would be just 54 μg/d (34 % and 22–27 % of the recommendations for adults and pregnancy, respectively). Plant-based dietary recommendations might place consumers at risk of iodine deficiency in countries without a fortification programme and where animal products provide the majority of iodine intake, such as the UK and Norway. It is essential that those following a predominantly plant-based diet are given appropriate dietary advice to ensure adequate iodine intake.
Collapse
Affiliation(s)
- Katie Nicol
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Anne P. Nugent
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Northern Ireland, UK
| | - Jayne V. Woodside
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Northern Ireland, UK
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Kathryn H. Hart
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| |
Collapse
|
4
|
Mustafa M, Ali E, McGowan A, McCabe L, Hegedüs L, Attanasio R, Nagy EV, Papini E, Perros P, Moran C. Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: A THESIS questionnaire survey of members of the Irish Endocrine Society. Ir J Med Sci 2023; 192:2179-2187. [PMID: 36482281 PMCID: PMC10522726 DOI: 10.1007/s11845-022-03235-z] [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: 08/23/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Replacement of thyroid hormones (TH) with Levothyroxine (LT4) is the treatment of choice for hypothyroidism, however, there are aspects of treatment where uncertainties exist and practice varies. Factors influencing initiation and choice of TH replacement may impact patient satisfaction, safety, and health care costs. METHODS The aim of the study was to examine the attitudes of Irish endocrinologists regarding the treatment of hypothyroid and euthyroid patients with TH. Members of the Irish Endocrine Society (IES) were invited to participate in an online survey. RESULTS Forty-eight invitations were sent, and 39 (81.3%) participants responded. All respondents favoured LT4 tablet therapy for treatment of hypothyroidism, but 20.5% prescribed combination therapy (LT4 and liothyronine), and 13% regularly used desiccated thyroid extract. A significant proportion (51%) might prescribe TH in euthyroid patients; 41% for thyroid auto-antibody positive women seeking pregnancy, 18% for goitre and 5% for unexplained fatigue. Many (38%) consider combination therapy in patients with persistent symptoms. Respondents reported seeing LT4 treated patients with persistent symptomatology more frequently and perceive psychosocial factors and comorbidities to be the most common reasons for such symptoms. CONCLUSION LT4 tablets are the treatment of choice for hypothyroidism in Ireland. Approximately a third of Irish endocrinologists either regularly use, or would consider, liothyronine for hypothyroid patients. A significant proportion would give TH to euthyroid individuals in specific circumstances. The prescription of TH amongst Irish endocrinologists was generally in keeping with recommended practice, and areas where practice deviated from guidance were typically where evidence was conflicting or insufficient.
Collapse
Affiliation(s)
- Mohamad Mustafa
- Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland
| | - Elsheikh Ali
- Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland
| | - Anne McGowan
- Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland
| | - Laura McCabe
- Pharmacy Department, Tallaght University Hospital, Dublin, Ireland
| | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Roberto Attanasio
- Scientific Committee Associazione Medici Endocrinologi, Milan, Italy
| | - Endre V. Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Opsedale Regina Apostolorum, Rome, Italy
| | - Petros Perros
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - Carla Moran
- Diabetes & Endocrinology Section, Beacon Hospital, Sandyford, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| |
Collapse
|
5
|
Öztürk M. Is there a relationship between the urinary iodine of pregnant and diabetic patients? J Family Med Prim Care 2023; 12:1083-1086. [PMID: 37636175 PMCID: PMC10451571 DOI: 10.4103/jfmpc.jfmpc_270_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/27/2021] [Accepted: 12/05/2022] [Indexed: 08/29/2023] Open
Abstract
Objectives We investigated the iodine status in this study in pregnant women, diabetic women-men, and nondiabetic men-women living in our region. Methods A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (μIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (μg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. Results There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). Conclusions In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy?
Collapse
Affiliation(s)
- Mine Öztürk
- Department of Endocrinology and Metabolism, KTO Karatay University Medicine Faculty Hospital, Konya, Turkey
| |
Collapse
|
6
|
A review of current knowledge about the importance of iodine among women of child-bearing age and healthcare professionals. J Nutr Sci 2022; 11:e56. [PMID: 35836700 PMCID: PMC9274385 DOI: 10.1017/jns.2022.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
Iodine is required for thyroid hormone synthesis and fetal neurogenesis. Recent population studies in the United Kingdom (UK) have found iodine deficiency among schoolgirls, women of child-bearing age and pregnant women. This review explores knowledge and awareness of iodine among women of child-bearing age and healthcare professionals (HCPs) in the UK, set within a global context. We aimed to identify gaps in iodine knowledge in the current UK setting of iodine deficiency without iodine fortification and where iodine is not included in antenatal guidelines. The search terms ‘iodine knowledge’ and ‘iodine awareness’ were used to identify relevant papers. Iodine knowledge is poor among women of child-bearing age in the UK according to four studies using questionnaires and qualitative methods. They were unsure of dietary sources of iodine and were not consistently provided with relevant information from HCPs during clinical care. Midwives have been recognised as the main providers of dietary information during pregnancy and, although they recognised the importance of their role in providing nutrition advice, they did not feel equipped to do so and lacked confidence in addressing nutritional concerns. Globally, there was a similar lack of knowledge, however, this was somewhat improved by the inclusion of iodine in antenatal care guidelines. Midwives’ knowledge of iodine was poor, as was knowledge among women of child-bearing age. Improved HCP knowledge and effective communication of information to pregnant women and women planning to conceive may help to improve iodine status which is of particular concern in pregnancy.
Collapse
|
7
|
Møllehave LT, Eliasen MH, Strēle I, Linneberg A, Moreno-Reyes R, Ivanova LB, Kusić Z, Erlund I, Ittermann T, Nagy EV, Gunnarsdottir I, Arbelle JE, Troen AM, Pīrāgs V, Dahl L, Hubalewska-Dydejczyk A, Trofimiuk-Müldner M, de Castro JJ, Marcelino M, Gaberšček S, Zaltel K, Puig-Domingo M, Vila L, Manousou S, Nyström HF, Zimmermann MB, Mullan KR, Woodside JV, Völzke H, Thuesen BH. Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration. Endocr Connect 2022; 11:e210525. [PMID: 35044931 PMCID: PMC8942317 DOI: 10.1530/ec-21-0525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. DESIGN Register-based cross-sectional study. METHODS National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex- and age-standardized rates were calculated. RESULTS Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. CONCLUSIONS The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper- and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.
Collapse
Affiliation(s)
- Line Tang Møllehave
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Correspondence should be addressed to L T Møllehave:
| | - Marie Holm Eliasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ieva Strēle
- The Institute of Occupational Safety and Environmental Health, Riga Stradiņš University, Riga, Latvia
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo Moreno-Reyes
- Nuclear Medicine Department, Erasme Hospital, Brussels, Belgium
- Université Libre de Bruxelles, Bruxelles, Belgium
| | - Ludmila B Ivanova
- Faculty of Medicine, Sofia University St. Kl. Ohridski, Sofia, Bulgaria
| | - Zvonko Kusić
- Croatian Academy of Sciences and Arts, Zagreb, Croatia
- School of Medicine, Zagreb, Croatia
| | - Iris Erlund
- Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Endre V Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Department of Clinical Nutrition, Landspitali-National University Hospital, Reykjavik, Iceland
| | - Jonathan Eli Arbelle
- Division of Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
- Goldman School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Aaron Milton Troen
- The Institute of Biochemistry Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Valdis Pīrāgs
- Internal Medicine, University of Latvia, Riga, Latvia
| | - Lisbeth Dahl
- Seafood, Nutrition and Environmental State, Institute of Marine Research (IMR), Bergen, Norway
| | | | | | | | | | - Simona Gaberšček
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Zaltel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Manuel Puig-Domingo
- Department of Endocrinology and Nutrition, Germans Trias Research Institute and Hospital, Badalona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluis Vila
- Endocrinology and Nutrition Service, Hospital Moisés Broggi, Sant Juan Despi, Barcelona, Spain
| | - Sofia Manousou
- Sahlgrenska Academy, Institute of Medicine, Gothenburg, Sweden
- Frölunda Specialist Hospital, Västra Frölunda, Sweden
| | - Helena Filipsson Nyström
- Department of Endocrinology, Specialist Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre of Molecular and Translational Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Karen R Mullan
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Betina Heinsbæk Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| |
Collapse
|
8
|
Witard OC, Bath SC, Dineva M, Sellem L, Mulet-Cabero AI, van Dongen LH, Zheng JS, Valenzuela C, Smeuninx B. Dairy as a Source of Iodine and Protein in the UK: Implications for Human Health Across the Life Course, and Future Policy and Research. Front Nutr 2022; 9:800559. [PMID: 35223949 PMCID: PMC8866650 DOI: 10.3389/fnut.2022.800559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/11/2022] [Indexed: 12/03/2022] Open
Abstract
This narrative review summarizes key concepts in dairy nutrition for supporting human health throughout the life course. Milk and dairy products have been a staple component of our diet for thousands of years and provide a wide range of important nutrients that are otherwise difficult to obtain from dairy-free diets. In this review, we provide a broad perspective on the nutritional roles of iodine and dairy protein in supporting human health during pregnancy and early life, childhood and adolescence, mid- and later-life. New methodologies to identify biomarkers of dairy intake via high-throughput mass spectrometry are discussed, and new concepts such as the role of the food matrix in dairy nutrition are introduced. Finally, future policy and research related to the consumption of dairy and non-dairy alternatives for health are discussed with a view to improving nutritional status across the lifespan.
Collapse
Affiliation(s)
- Oliver C. Witard
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- *Correspondence: Oliver C. Witard
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Mariana Dineva
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Laury Sellem
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Science, University of Reading, Reading, United Kingdom
| | - Ana-Isabel Mulet-Cabero
- Food Innovation and Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Laura H. van Dongen
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, Netherlands
| | - Ju-Sheng Zheng
- School of Life Sciences, Westlake University, Hangzhou, China
| | - Carina Valenzuela
- Faculty of Medicine, School of Human Development and Health, University of Southampton, Southampton, United Kingdom
| | - Benoit Smeuninx
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| |
Collapse
|
9
|
Rates SPM, Capanema FD, Amaral BD, Secundino CM, Michelli LMDS, Pereira RCM, Ued FDV, Nogueira-de-Almeida CA. Nutritional status of iodine in pregnant and non-pregnant adolescents assisted at the Family Health Strategy in Vespasiano, MG. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the nutritional status of iodine in pregnant adolescents, taking into account the increase in the demand for iodine during pregnancy and the absence of iodization strategies for this population. Methods: cross-sectional study conducted with 62 pregnant and 71 non-pregnant adolescents assisted in primary care. The nutritional status of iodine was determined by urinary samples. The iodine concentration in the consumed culinary salt was also evaluated. For the comparative analyses of categorical variables, the Chi-square test was used and for the continuous variables, the Kruskal-Wallis test, considering a 95% confidence interval (CI) and significance level of 5%. Results: the mean iodine concentration in household salt was 25.1 mg/kg (CI95%= 11.1-67.5 mg/kg), with higher mean content in culinary salt in the group of pregnant women (p<0.028). Regarding the nutritional status of iodine, 71% of pregnant adolescents were deficient and 29% iodine-sufficient, with significant difference when compared to 38% of deficiency and 62% of sufficiency in the control group (p<0.001). Conclusions: there was an iodic deficiency among pregnant adolescents, even in the face of higher concentrations of iode in household salt, exposing a paradox between higher consumption and lower sufficiency in this group. Thus, it is suggested to consider iodine supplementation during pregnancy, seeking to minimize the effects of this deficiency on maternal and child health.
Collapse
|
10
|
Woodside JV, Mullan KR. Iodine status in UK-An accidental public health triumph gone sour. Clin Endocrinol (Oxf) 2021; 94:692-699. [PMID: 33249610 DOI: 10.1111/cen.14368] [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: 07/16/2020] [Revised: 09/16/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022]
Abstract
The improvement in iodine status among the UK population from the 1930s onwards has been described as an 'accidental public health triumph' despite the lack of any iodine fortification program. However, iodine deficiency in the UK has re-emerged in vulnerable groups and is likely due to a combination of changing farming practices, dietary preferences and public health priorities. The UK is now among only a minority of European countries with no legislative framework for iodine fortification. The experience of folic acid fortification and the 28-year delay in its implementation lays bare the political difficulties of introducing any fortification program in the UK. If iodine fortification is not an imminent possibility, then it is important to explore other options: how to change farming practice especially on organic farms; encourage dairy intake; protect and expand our public health programs of milk provision for vulnerable groups and embark on education programs for women of childbearing potential and healthcare professionals. This review explores how the UK may have arrived at this juncture and how the iodine status of the nation may be improved at this time of major political and public health upheaval.
Collapse
Affiliation(s)
- Jayne V Woodside
- School of Medicine, Dentistry and Biomedical Sciences, Institute for Global Food Security, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Karen R Mullan
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, BHSCT, Belfast, UK
| |
Collapse
|
11
|
Rahman S, Mathew S, Nair P, Ramadan WS, Vazhappilly CG. Health benefits of cyanidin-3-glucoside as a potent modulator of Nrf2-mediated oxidative stress. Inflammopharmacology 2021; 29:907-923. [PMID: 33740221 DOI: 10.1007/s10787-021-00799-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/06/2021] [Indexed: 02/07/2023]
Abstract
Berries are natural sources of anthocyanins, especially cyanidin-3-glucoside (C3G), and exhibit significant antioxidant, antidiabetic, anti-inflammatory, and cytoprotective effects against various oxidative stress-induced disorders. C3G and its metabolites possess higher absorption and bioavailability, and interaction with gut microbiota may enhance their health benefits. Various in vitro studies have shown the reactive oxygen species (ROS)-mitigating potential of C3G. However, in in vivo models, C3G exerts its cytoprotective properties by regulating the nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant-responsive element (ARE) pathway. Despite existing reports stating various health benefits of C3G, its antioxidant potential by modulating the Nrf2 pathway remains less identified. This review discusses the Nrf2-mediated antioxidant response of C3G in modulating oxidative stress against DNA damage, apoptosis, carcinogen toxicity, and inflammatory conditions. Furthermore, we have reviewed the recent clinical trial data to establish cross talk between a berry-rich diet and disease prevention.
Collapse
Affiliation(s)
- Sofia Rahman
- School of Natural Sciences and Mathematics, The University of Texas at Dallas, Richardson, USA
| | - Shimy Mathew
- Department of Biotechnology, American University of Ras Al Khaimah, Ras Al Khaimah, 10021, UAE
| | - Pooja Nair
- Department of Biotechnology, American University of Ras Al Khaimah, Ras Al Khaimah, 10021, UAE
| | - Wafaa S Ramadan
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE.,College of Medicine, University of Sharjah, Sharjah, UAE
| | - Cijo George Vazhappilly
- Department of Biotechnology, American University of Ras Al Khaimah, Ras Al Khaimah, 10021, UAE.
| |
Collapse
|
12
|
Krela-Kaźmierczak I, Czarnywojtek A, Skoracka K, Rychter AM, Ratajczak AE, Szymczak-Tomczak A, Ruchała M, Dobrowolska A. Is There an Ideal Diet to Protect against Iodine Deficiency? Nutrients 2021; 13:513. [PMID: 33557336 PMCID: PMC7914421 DOI: 10.3390/nu13020513] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/17/2022] Open
Abstract
Iodine deficiency is a global issue and affects around 2 billion people worldwide, with pregnant women as a high-risk group. Iodine-deficiency prevention began in the 20th century and started with global salt iodination programmes, which aimed to improve the iodine intake status globally. Although it resulted in the effective eradication of the endemic goitre, it seems that salt iodination did not resolve all the issues. Currently, it is recommended to limit the consumption of salt, which is the main source of iodine, as a preventive measure of non-communicable diseases, such as hypertension or cancer the prevalence of which is increasing. In spite of the fact that there are other sources of iodine, such as fish, seafood, dairy products, water, and vegetables, the high consumption of processed food with a high content of unionised salt, alternative diets or limited salt intake can still lead to iodine deficiency. Thus, iodine deficiency remains a relevant issue, with new, preventive solutions necessary. However, it appears that there is no diet which would fully cover the iodine requirements, and iodine food supplementation is still required.
Collapse
Affiliation(s)
- Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Agata Czarnywojtek
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.C.); (M.R.)
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Kinga Skoracka
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.C.); (M.R.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| |
Collapse
|
13
|
Givens DI. MILK Symposium review: The importance of milk and dairy foods in the diets of infants, adolescents, pregnant women, adults, and the elderly. J Dairy Sci 2021; 103:9681-9699. [PMID: 33076181 DOI: 10.3168/jds.2020-18296] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022]
Abstract
The ongoing increase in life expectancy is not always accompanied by an increase in healthy life span. There is increasing evidence that dietary exposure in early life can substantially affect chronic disease risk in later life. Milk and dairy foods are important suppliers of a range of key nutrients, with some being particularly important at certain life stages. It is now recognized that milk protein can stimulate insulin-like growth factor-1 (IGF-1), essential for longitudinal bone growth and bone mass acquisition in young children, thus reducing the risk of stunting. Low milk consumption during adolescence, particularly by girls, may contribute to suboptimal intake of calcium, magnesium, iodine, and other important nutrients. Given the generally low vitamin D status of European populations, this may have already affected bone development, and any resulting reduced bone strength may become a big issue when the populations are much older. Suboptimal iodine status of many young women has already been reported together with several observational studies showing an association between suboptimal iodine status during pregnancy and reduced cognitive development in the offspring. There is now good evidence that consumption of milk and dairy foods does not lead to an increased risk of cardiovascular diseases and type 2 diabetes. Indeed, some negative associations are seen, notably between yogurt consumption and type 2 diabetes, which should be researched with urgency. Greater emphasis should be placed on reducing malnutrition in the elderly and on dietary approaches to reduce their loss of muscle mass, muscle functionality, and bone strength. Whey protein has been shown to be particularly effective for reducing muscle loss; this needs to be developed to provide simple dietary regimens for the elderly to follow. There is an ongoing, often too simplistic debate about the relative value of animal versus plant food sources for protein in particular. It is important that judgments on the replacement of dairy products with those from plants also include the evidence on relative functionality, which is not expressed in simple nutrient content (e.g., hypotensive and muscle synthesis stimulation effects). Only by considering such functionality will a true comparison be achieved.
Collapse
Affiliation(s)
- D I Givens
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, UK.
| |
Collapse
|
14
|
Shaw M, Nugent AP, McNulty BA, Walton J, McHugh M, Kane A, Moore Heslin A, Morrissey E, Mullan K, Woodside JV. What is the availability of iodised salt in supermarkets on the Island of Ireland? Eur J Clin Nutr 2019; 73:1636-1638. [PMID: 31624363 DOI: 10.1038/s41430-019-0518-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 11/10/2022]
Abstract
Iodine deficiency remains a global nutritional public health challenge, with evidence suggesting borderline adequate or even deficient status for UK and Irish subpopulations such as schoolgirls and pregnant women. The solution, according to the WHO, is salt iodisation, but it is not known how widely available iodised salt is in supermarkets. Iodised salt availability was determined by a shelf survey of 89 supermarket stores on the island of Ireland (n = 30 in Northern Ireland and n = 59 in the Republic of Ireland) from September 2018 to January 2019, to take into account factors such as store type, location, population density, socioeconomic status and ethnicity. Availability was calculated as the number of stores selling iodised salt as a percentage of the total. Iodised salt was only available in 11 stores (12%), of which 10 were ethnic stores. This indicates a lack of access for the majority of the Irish and Northern Irish populations.
Collapse
Affiliation(s)
- Mark Shaw
- Institute for Global Food Security, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Anne P Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Breige A McNulty
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Dublin 4, Ireland
| | - Janette Walton
- Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Michaela McHugh
- Institute for Global Food Security, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ashley Kane
- Institute for Global Food Security, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Aoibhin Moore Heslin
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Dublin 4, Ireland
| | - Eoin Morrissey
- Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Karen Mullan
- Regional Centre for Endocrinology & Diabetes, Belfast Health & Social Care Trust, Belfast, UK
| | - Jayne V Woodside
- Institute for Global Food Security, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
| |
Collapse
|