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Abel MH, Totland TH, Holvik K, Brantsæter AL, Krokstad S, Åsvold BO, Meyer HE. Iodine status and determinants in adults in Norway - results from a population-based health examination survey (The HUNT Study). Food Nutr Res 2024; 68:9761. [PMID: 38571917 PMCID: PMC10989228 DOI: 10.29219/fnr.v68.9761] [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: 06/13/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 04/05/2024] Open
Abstract
Background In Norway, there is a lack of knowledge about the iodine status in the general and older adult population, and there is no established national monitoring programme for iodine. Several studies have indicated that iodine deficiency is prevalent in subgroups of the population. Salt iodisation is currently being considered as a measure to increase the population iodine status. In this cross-sectional study, the aim was to evaluate iodine status and determinants in the adult and older adult population in Mid-Norway, before salt iodisation is likely to be initiated. Methods The study sample was a subsample of participants in the fourth wave of the population-based Trøndelag Health Study (HUNT4, 2017-2019) with available spot-urine samples. This subsample included participants with 25-64 years (n = 500) and 70-79 years (n = 250). The urine samples were analysed for iodine and creatinine. Information on the habitual intake of milk/yoghurt, fish, supplement use, use of thyroid medication and relevant background factors was collected through a general questionnaire. Multivariable quantile regression was used to model differences in the median urinary iodine concentration (UIC) by determinants. Estimates were weighted to match the age and sex distribution of the Norwegian population aged 25-79 years in 2019. Results Median UIC was 97 µg/L (95% confidence interval [CI]: 92, 103) indicating borderline iodine deficiency at a group level. The median UIC increased with age, and iodine status was insufficient in participants below age 55 years (median 92 µg/L [95% CI: 85, 99]). Important determinants of UIC were habitual milk/yoghurt intake, daily supplement use and current use of thyroid medication, but not intake of lean or fatty fish. Risk of mild-to-moderate iodine deficiency was seen in those with a low intake of milk/yoghurt, no supplement use and who did not use thyroid medication. No group was identified as being at risk of iodine excess. Conclusion Iodine status was adequate in older adults but mildly deficient in adults under 55 years. Milk intake, supplement use and use of thyroid medication are important determinants of iodine intake in Norway.
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Affiliation(s)
- Marianne Hope Abel
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bjørn Olav Åsvold
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Haakon E. Meyer
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Sauder KA, Cohen CC, Mueller NT, Hockett CW, Switkowski KM, Maldonado LE, Lyall K, Kerver JM, Dabelea D, O'Connor TG, Glueck DH, Melough MM, Couzens GL, Catellier DJ, Smith PB, Newby KL, Benjamin DK. Identifying Foods That Optimize Intake of Key Micronutrients During Pregnancy. J Nutr 2023; 153:3012-3022. [PMID: 37604382 PMCID: PMC10613721 DOI: 10.1016/j.tjnut.2023.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/21/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Most pregnant women in the United States are at risk of inadequate intake of vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids from foods alone. Very few United States dietary supplements provide sufficient doses of all 6 nutrients without inducing excess intake. OBJECTIVE We aimed to identify energy-efficient foods that provide sufficient doses of these nutrients and could be consumed in lieu of dietary supplements to achieve the recommended intake in pregnancy. METHODS In a previous analysis of 2,450 pregnant women, we calculated the range of additional intake needed to shift 90% of participants to intake above the estimated average requirement and keep 90% below the tolerable upper level for these 6 nutrients. Here, we identified foods and beverages from the 2019 to 2020 Food and Nutrient Database for Dietary Studies that provide target levels of these nutrients without exceeding the additional energy intake recommended for pregnancy beginning in the second trimester (340 kilocalories). RESULTS We identified 2358 candidate foods meeting the target intake range for at least one nutrient. No candidate foods provided target amounts of all 6 nutrients. Seaweed (raw or cooked without fat) provided sufficient vitamin A, folate, calcium, iron, and omega-3s (5 of 6 nutrients) but would require an intake of >5 cups/d. Twenty-one other foods/beverages (mainly fish, vegetables, and beverages) provided target amounts of 4 of the 6 nutrients. Few foods met targets for vitamin D (n = 54) or iron (n = 93). CONCLUSIONS Results highlight the difficulty in meeting nutritional requirements from diet alone and imply that dietary supplements are likely necessary to meet vitamin D and iron targets in pregnancy, as well as omega-3 fatty acid targets for individuals who do not consume fish products. Other foods could be added in limited amounts to help meet intake targets without exceeding caloric recommendations or nutrient safety limits.
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Affiliation(s)
- Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
| | - Catherine C Cohen
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Christine W Hockett
- Avera Research Institute and Department of Pediatrics, University of South Dakota, Sioux Falls, SD, United States
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Jean M Kerver
- Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Thomas G O'Connor
- Obstetrics & Gynecology, University of Rochester Medical Center, Rochester, NY, United States
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Melissa M Melough
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - G Lance Couzens
- RTI International, Research Triangle Park, NC, United States
| | | | - P B Smith
- Duke Clinical Research Institute, Durham, North Carolina
| | - K L Newby
- Duke Clinical Research Institute, Durham, North Carolina
| | - D K Benjamin
- Duke Clinical Research Institute, Durham, North Carolina
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3
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Candido AC, Vieira AA, de Souza Ferreira E, Moreira TR, do Carmo Castro Franceschini S, Cotta RMM. Prevalence of Excessive Iodine Intake in Pregnancy and Its Health Consequences: Systematic Review and Meta-analysis. Biol Trace Elem Res 2023; 201:2784-2794. [PMID: 36018544 DOI: 10.1007/s12011-022-03401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/22/2022] [Indexed: 11/02/2022]
Abstract
The objective was to estimate the prevalence of excessive iodine intake in pregnant women and to investigate the consequences for maternal-fetal health. The systematic review was based on PRISMA. The search was conducted in September 2021 in LILACS, PubMed/MEDLINE, Science Direct, and SCOPUS databases. Observational studies that assessed excessive nutritional iodine status in pregnancy diagnosed by urinary iodine concentration and associated it with biomarkers of thyroid health function were included. Study selection, data extraction, and risk of biased evaluation were performed independently. Meta-analysis was calculated using a fixed and random effect model, and heterogeneity was assessed by the chi-square test. Meta-regressions were performed to identify the causes of heterogeneity using the Knapp and Hartung test. Nine studies were included in the systematic review, and eight in the meta-analysis. The prevalence of excessive iodine intake in 10,736 pregnant women in different regions of the world was 52%. The main implications for pregnant women were hypothyroxinemia, hypothyroidism, and hyperthyroidism. For the newborn, macrosomia and thyroid dysfunction. In addition, drinking water with high iodine intake contributed to excessive iodine intake. Therefore, the prevalence of iodine excess was 52%, with high heterogeneity among studies, explained by trimester of gestation and FT4 level; therefore, the farther the trimester of gestation and the lower the FT4, the higher the prevalence of iodine excess. PROSPERO Registration: CRD420206467 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206467 ).
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Affiliation(s)
- Aline Carare Candido
- Department of Nutrition and Health, Ed. Centro de Ciências Biológicas II, Universidade Federal de Viçosa, Peter Henry Rolfs Avenue, w/o. Campus Universitário, Viçosa, Minas Gerais, 36570.900, Brazil.
| | - Almir Antônio Vieira
- Department of Agricultural Engineering, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Emily de Souza Ferreira
- Department of Nutrition and Health, Ed. Centro de Ciências Biológicas II, Universidade Federal de Viçosa, Peter Henry Rolfs Avenue, w/o. Campus Universitário, Viçosa, Minas Gerais, 36570.900, Brazil
| | - Tiago Ricardo Moreira
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Santarossa S, Sitarik AR, Cassidy-Bushrow AE, Comstock SS. Prenatal physical activity and the gut microbiota of pregnant women: results from a preliminary investigation. Phys Act Nutr 2023; 27:1-7. [PMID: 37583065 PMCID: PMC10440177 DOI: 10.20463/pan.2023.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 08/17/2023] Open
Abstract
PURPOSE To determine whether physical activity (PA), specifically meeting the recommended 150 minutes of moderate-intensity PA per week, is associated with gut microbiota composition in pregnant women. METHODS In an ongoing birth cohort study, questions from the Behavioral Risk Factor Surveillance System, which provides data on PA variables, were used to determine whether pregnant women met or exceeded the PA recommendations. To profile the composition of gut bacterial microbiota, 16S rRNA sequencing was performed on stool samples obtained from pregnant women. Differences in alpha diversity metrics (richness, Pielou's evenness, and Shannon's diversity) according to PA were determined using linear regression, whereas beta diversity relationships (Canberra and Bray-Curtis) were assessed using Permutational multivariate analysis of variance (PERMANOVA). Differences in relative taxon abundance were determined using DESeq2. RESULTS The complete analytical sample included 23 women that were evaluated for both PA and 16S rRNA sequencing data (median age [Q1; Q3] = 30.5 [26.6; 34.0] years; 17.4% Black), and 11 (47.8%) met or exceeded the PA recommendations. Meeting or exceeding the PA recommendations during pregnancy was not associated with gut microbiota richness, evenness, or diversity, but it was related to distinct bacterial composition using both Canberra (p = 0.005) and Bray-Curtis (p = 0.022) distances. Significantly lower abundances of Bacteroidales, Bifidobacteriaceae, Lactobacillaceae, and Streptococcaceae were observed in women who met or exceeded the PA recommendations (all false discovery rates adjusted, p < 0.02). CONCLUSION Pregnant women who met or exceeded the PA recommendations showed altered gut microbiota composition. This study forms the basis for future studies on the impact of PA on gut microbiota during pregnancy.
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Affiliation(s)
- Sara Santarossa
- Department of Public Health Sciences, Henry Ford Health System, Michigan, USA
| | | | | | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, Michigan, USA
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A Scoping Review of Iodine and Fluoride in Pregnancy in Relation to Maternal Thyroid Function and Offspring Neurodevelopment. Adv Nutr 2023; 14:317-338. [PMID: 36796438 DOI: 10.1016/j.advnut.2023.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
Iodine (I), an essential nutrient, is important for thyroid function and therefore growth and development. Fluoride (F), also an essential nutrient, strengthens bones and teeth, and prevents childhood dental caries. Both severe and mild-to-moderate I deficiency and high F exposure during development are associated to decreased intelligence quotient with recent reports associating high levels of F exposure during pregnancy and infancy to low intelligence quotient. Both F and I are halogens, and it has been suggested that F may interfere with the role of I in thyroid function. We provide a scoping review of the literature on I and F exposure dur pregnancy and their individual effects on thyroid function and offspring neurodevelopment. We first discuss I intake and status in pregnancy and the relationship to thyroid function and offspring neurodevelopment. We follow with the F in pregnancy and offspring neurodevelopment. We then review the interaction between I and F on thyroid function. We searched for, and found only one study that assessed both I and F in pregnancy. We conclude more studies are needed.
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Krzeczkowski JE, Hall M, McGuckin T, Lanphear B, Bertinato J, Ayotte P, Chevrier J, Goodman C, Green R, Till C. Iodine status in a large Canadian pregnancy cohort. Am J Obstet Gynecol MFM 2023; 5:100784. [PMID: 36280147 PMCID: PMC9972225 DOI: 10.1016/j.ajogmf.2022.100784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022]
Affiliation(s)
- John E Krzeczkowski
- Department of Psychology, York University, 4700 Keele St., Toronto M3J 1P3, Canada.
| | - Meaghan Hall
- Department of Psychology, York University, 4700 Keele St., Toronto M3J 1P3, Canada
| | - Taylor McGuckin
- Department of Psychology, York University, 4700 Keele St., Toronto M3J 1P3, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Jesse Bertinato
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada
| | - Pierre Ayotte
- Faculty of Medicine, Department of Social and Preventive Medicine, Université Laval, Québec City, Canada
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada
| | - Carly Goodman
- Department of Psychology, York University, Toronto, Canada
| | - Rivka Green
- Department of Psychology, York University, Toronto, Canada
| | - Christine Till
- Department of Psychology, York University, Toronto, Canada
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Pizzorno J. Common Chemical Pollutants Causing a Lot of Ill Health. Integr Med (Encinitas) 2022; 21:8-12. [PMID: 36643211 PMCID: PMC9831131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Due to industrialization and inadequate controls on release of manufacturing chemicals into the environment and into the products being made, the entire population is constantly being exposed to a wide variety of chemical pollutants. The key question, of course, is their safety. The most acutely damaging ones have been progressively limited. However, virtually all safety research is on single toxins and very little of it looks at the impact of chronic exposure, especially chronic exposure to multiple chemicals simultaneously. This editorial discusses the clinical significance of 4 of the chemicals (acrolein, acrylamide, perchlorate, and phthalates) found most often in samples doctors send to labs for analysis. The research clearly demonstrates that these chemicals in a dose-dependent manner disrupt physiology, impair health, and increase risk for common diseases.
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Association between Elevated Iodine Intake and IQ among School Children in Portugal. Nutrients 2022; 14:nu14214493. [PMID: 36364754 PMCID: PMC9657725 DOI: 10.3390/nu14214493] [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: 09/10/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022] Open
Abstract
The goal of this work was to examine whether elevated iodine intake was associated with adverse effects on IQ among school-age children in Portugal. In a representative sample of children from the north of the country, IQ percentiles by age (assessed with Raven’s Colored Progressive Matrices) were dichotomized to <50 (“below-average” IQs) and ≥50. Morning urine iodine concentrations, corrected for creatinine, were dichotomized to <250 µg/g and ≥250 µg/g, according to the European Commission/Scientific Committee on Food’s tolerable upper level of daily iodine intake for young children. Data were examined with Chi-square tests, logistic regression, and GLM univariate analysis. The sample (N = 1965) was classified as generally iodine-adequate (median urinary iodine concentration = 129 µg/L; median iodine-to-creatinine ratio = 126 µg/g) according to the WHO’s criteria. A greater proportion of children in the ≥250 µg/g group had below-average IQs, compared to children with less than 250 µg/g (p = 0.037), despite a sizable (though non-significant) proportion of children in the less-than-250 µg/g group also presenting below-average IQs, at the bottom of the iodine distribution (<50 µg/g). The proportion of below-average IQs increased with increasingly elevated iodine concentrations (p = 0.047). The association remained significant after the adjustment for confounders, with the elevated iodine group showing increased odds of having below-average IQs when compared with the non-elevated iodine group (OR 1.55; 95% CI 1.11−2.17; p = 0.011). Consistently, the former group presented a lower mean IQ than the latter (p = 0.006). High iodine intake was associated with lower IQs even in a population classified as iodine-adequate. These results bear on child cognition and on initiatives involving iodine supplementation.
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Hao Y, Xu Y, Ban Y, Li J, Wu B, Ouyang Q, Sun Z, Zhang M, Cai Y, Wang M, Wang W. Efficacy evaluation of probiotics combined with prebiotics in patients with clinical hypothyroidism complicated with small intestinal bacterial overgrowth during the second trimester of pregnancy. Front Cell Infect Microbiol 2022; 12:983027. [PMID: 36275023 PMCID: PMC9583945 DOI: 10.3389/fcimb.2022.983027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To explore the effect of probiotics combined with prebiotics on clinical hypothyroidism during pregnancy combined with small intestinal bacterial overgrowth. Methods (1) In total, 441 pregnant women were included in this study. A total of 231 patients with clinical hypothyroidism during the second trimester of pregnancy and 210 normal pregnant women were enrolled in the lactulose methane-hydrogen breath test. The positive rate of intestinal bacterial overgrowth (SIBO), gastrointestinal symptoms, thyroid function and inflammatory factors were compared between the two groups by chi-square test and two independent sample t-test. (2) SIBO-positive patients in the clinical hypothyroidism group during pregnancy (n=112) were treated with probiotics combined with prebiotics based on conventional levothyroxine sodium tablets treatment. The changes in the methane-hydrogen breath test, gastrointestinal symptoms, thyroid function and inflammatory factors were compared before treatment (G0) and 21 days after treatment (G21) by chi-square test and paired sample t test. Results (1) The positive rates of SIBO in pregnant women in the clinical hypothyroidism group and control group were 48.5% and 24.8%, respectively. (2) The incidence of abdominal distention and constipation in the clinical hypothyroidism group was significantly higher than that in the control group, and the risk of abdominal distention and constipation in SIBO-positive pregnant women was higher than that in SIBO-negative pregnant women. (3) The serum levels of hypersensitive C-reactive protein (hsCRP), IL-10, IL-6, TNF-α, low-density lipoprotein (LDL), total cholesterol (TC), free fatty acids (FFAs) and apolipoprotein B (ApoB) in the hypothyroidism group during pregnancy were higher than those in the control group. (4) After 21 days of probiotics combined with prebiotics, the incidence of pure methane positivity in the methane-hydrogen breath test in the G21 group was significantly reduced, and the average abundance of hydrogen and methane at each time point in the G21 group was lower than that in the G0 group. (5) The incidence of constipation in the G21 group was significantly lower than before treatment. (6) The levels of serum TSH, hsCRP, IL-6, TNF-α, TC and LDL in pregnant women after probiotics combined with prebiotics were lower than those before treatment. Conclusion Probiotics combined with prebiotics are effective in the treatment of pregnant patients with clinical hypothyroidism complicated with SIBO, providing a new idea to treat pregnant patients with clinical hypothyroidism complicated with SIBO.
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Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue. Nutrients 2022; 14:nu14173474. [PMID: 36079737 PMCID: PMC9459956 DOI: 10.3390/nu14173474] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Iodine is a mineral nutrient essential for the regulation of a variety of key physiological functions including metabolism and brain development and function in children and adults. As such, iodine intake and status within populations is an area of concern and research focus. This paper will review recently published studies that focus on the re-emerging issue of iodine deficiency as a global concern and declining intake among populations in developed countries. Historically, the implementation of salt-iodization programs worldwide has reduced the incidence of iodine deficiency, but 30% of the world’s population is still at risk. Iodine nutrition is a growing issue within industrialized countries including the U.S. as a result of declining iodine intake, in part due to changing dietary patterns and food manufacturing practices. Few countries mandate universal salt iodization policies, and differing agriculture and industry practices and regulations among countries have resulted in inconsistencies in supplementation practices. In the U.S., in spite of salt-iodization policies, mild-to-moderate iodine deficiency is common and appears to be increasing. European countries with the highest incidence of deficiency lack iodization programs. Monitoring the iodine status of at-risk populations and, when appropriate, public health initiatives, appear to be warranted.
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Zhang X, Yuan N, Sun J, Zhao X, Du J, Nan M, Zhang Q, Ji L. Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study. Biol Trace Elem Res 2022; 200:2620-2628. [PMID: 34570342 PMCID: PMC9132840 DOI: 10.1007/s12011-021-02887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/12/2021] [Indexed: 12/03/2022]
Abstract
Iodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658-8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465-6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539-5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (Pnon-linear < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405.
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Affiliation(s)
- Xiaomei Zhang
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Ning Yuan
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Jianbin Sun
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Xin Zhao
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Jing Du
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Min Nan
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - QiaoLing Zhang
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, China
| | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, China.
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Ershow AG, Haggans CJ, Roseland JM, Patterson KY, Spungen JH, Gahche JJ, Merkel JM, Pehrsson PR. Databases of Iodine Content of Foods and Dietary Supplements––Availability of New and Updated Resources. J Acad Nutr Diet 2022; 122:1229-1231. [DOI: 10.1016/j.jand.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/06/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022]
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Haddad EN, Comstock SS. Archive for Research in Child Health (ARCH) and Baby Gut: Study Protocol for a Remote, Prospective, Longitudinal Pregnancy and Birth Cohort to Address Microbiota Development and Child Health. Methods Protoc 2021; 4:mps4030052. [PMID: 34449678 PMCID: PMC8395764 DOI: 10.3390/mps4030052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/16/2021] [Accepted: 07/24/2021] [Indexed: 02/05/2023] Open
Abstract
The infant gut microbiome is shaped by numerous factors such as diet and the maternal microbiota and is also associated with later atopy and obesity. The Archive for Research in Child Health and Baby Gut (ARCHBG) cohort was established in 2015 to (1) understand how the development of the infant gut microbiota is associated with atopy, obesity, and gastrointestinal disease and (2) characterize the associations of maternal pre-pregnancy BMI and infant diet with the development of the gut microbiota. Study participants for ARCHBG are convenience samples recruited through two pipelines in Lansing and Traverse City, Michigan: (1) Archive for Research in Child Health (ARCHGUT) and (2) BABYGUT. A total of (n = 51) mother–infant dyads have been enrolled to date. This prospective cohort study collects maternal pre-pregnancy fecal samples, maternal data, child fecal samples at four timepoints (one week, six months, 12 months, and 24 months), and child data up to five years of age. All samples and data are collected remotely by mail, phone, or drop-off at select locations. Of all participants enrolled, 76.5% (n = 39) of infants have a complete record of stool samples. At least 88.2% (n = 45) of fecal samples were submitted at each timepoint. ARCHBG will allow for a nuanced understanding of the temporal development of the infant gut microbiome and numerous child health outcomes.
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Verkaik-Kloosterman J, de Jong M, Ocké M. Assessing prevalence of inadequacy and excessive iodine intake: misinterpretation is lying in ambush. Am J Obstet Gynecol 2021; 224:418. [PMID: 33221291 DOI: 10.1016/j.ajog.2020.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022]
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Sekhon I, Pearce EN, He X, Lee SY. Iodine Content in Meal Replacements in the United States. Endocr Pract 2021; 27:668-672. [PMID: 33705969 DOI: 10.1016/j.eprac.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Iodine is essential for thyroid hormone production. The recommended dietary allowance for iodine in nonpregnant adults is 150 μg/d. However, most product labels do not list the iodine content. Meal replacements are not required to contain specific vitamins and minerals. Nevertheless, they are often marketed as good and convenient sources of a balanced nutrition. In this study, we aimed to assess the iodine content in meal replacements to determine how they may contribute to iodine deficiency or excess. METHODS Twenty seven meal replacements from supermarkets in the Boston area were collected. The iodine concentration of each meal replacement was measured spectrophotometrically. Iodine content in meal replacements were compared according to form (liquid, bar, and powder) and type (vegan and nonvegan). RESULTS The overall mean ± SD iodine content was 49.7 ± 125.4 μg/serving. However, 1 meal replacement was an outlier and had 671.9 μg iodine per serving. Mean iodine content differed between forms and was highest for liquids (mean ± SD: 37.4 ± 6.5 μg/serving). Nonvegan meal replacements had a higher mean iodine content than vegan meal replacements (mean ± SD: 31.6 ± 15.78 μg/serving). CONCLUSION All of the meal replacements contained detectible amounts of iodine regardless of whether it was listed on their labels (41% did not list iodine). Overall, the meal replacements in this study were found to be good sources of iodine. However, consumers should be aware that packaging labels may not accurately reflect the amount of iodine present.
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Affiliation(s)
- Isha Sekhon
- Nutrition and Metabolism, Graduate Medical Sciences, Boston University School of Medicine, Boston
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston
| | - Xuemei He
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston
| | - Sun Y Lee
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston.
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