Is iodine nutrition in the Spanish pediatric population adequate? Historical review and current situation

Relationship between Thyroid Status during the First Trimester of Pregnancy and Neonatal Well-Being

Iodine is an essential micronutrient for the synthesis of thyroid hormones. The proper functioning of the thyroid axis is essential for the normal development of the nervous system, especially in the first trimester of gestation. The aim of the present study was to analyze the perinatal outcomes, anthropometry, and APGAR test scores of newborns and to relate them to maternal thyroid status. A total of 190 newborns participated in the study. No correlation was found between thyroid stimulating hormone (TSH) and maternal ioduria values in the first trimester of gestation with the weight or length of the newborn, or the APGAR score at one minute after birth. However, we found significant differences between the APGAR scores of children whose mothers had an iodine sufficiency level in the first trimester compared to the children of mothers with iodine deficiency. Similarly, the APGAR scores of children whose mothers had a TSH > 4 have significantly better APGAR scores than the children of mothers with a TSH < 4. Likewise, we found significant differences between the measurements of the newborns depending on whether their mothers smoked. The children of mothers who took iodine supplements or iodized salt obtained the highest APGAR score at one and five minutes after birth. It is essential to focus on recommending adequate consumption of iodine supplements and iodized salt prior to gestation and at least during the first trimester to achieve better fetal well-being.

The association of parents' behaviors related to salt with 24 h urinary sodium excretion of their children: A Spanish cross-sectional study

BACKGROUND

Sodium intake is excessive among Spanish children, but the salt use behaviors of parents and children are unknown. This study aims to determine behaviors related to salt intake in both schoolchildren and parents and the relationship between parental behaviors and 24 h urinary sodium excretion (UNa-24h) in children.

SUBJECTS AND METHODS

A convenience sample was taken from a cross-sectional analysis. Parents completed a self-reported questionnaire about their behaviors related to salt, and their responses were compared with the UNa-24h of their own children. The median test was used to identify differences in UNa-24h according to behaviors. Logistic regression was used to assess the relationship between the behaviors of parents and high sodium excretion in the children and the risk of children's use of table salt, adjusting for age, sex, and BMI. Multinomial logistic regression models, adjusted by the covariates, were used to study the children's salt preferences.

RESULTS

A total of 329 schoolchildren from different Spanish provinces were included in the study (mean age: 9.0 ± 1.2 years, 157 girls). The majority of families (parents mean age: 42.0 ± 5.2 years) reported adding salt to food during cooking (92%), and 59% of them never looked at the sodium content on food labels. However, none of these behaviors were related to UNa-24h (p > 0.05). The use of iodized salt (53%), the presence of a salt shaker on the table (6%), and the use of table salt by fathers (57%), mothers (52%) or children (17%) increased the odds (p < 0.05) of children having a higher UNa-24h. Checking sodium content on food labels and the use of table salt by the children or father was associated with a lower preference for salty foods (p < 0.05).

CONCLUSIONS

It is important to make parents aware of the relationship between their behaviors regarding the use of discretionary salt and their children's sodium intake. Our data suggest that salt-specific education programs on how to reduce salt both in-home and outside the home should be implemented to improve behavior skills related to salt consumption in parents and children.

Nutritional status of iodine in children: When appropriateness relies on milk consumption and not adequate coverage of iodized salt in households

BACKGROUND & AIMS

Iodine deficiency inhibits the normal development of human beings and is the leading cause of preventable mental retardation. Our study aims to update the urinary iodine concentrations and the intake of iodized salt in children in Madrid (Spain).

METHODS

A cross-sectional study was designed where 217 children aged 3-14 years old were studied. A nutritional survey including the intake of iodized salt and other iodine-rich foods was performed. In addition, the urinary concentration of iodine was determined in each patient.

RESULTS

Near 60% of the surveyed households routinely used iodized salt. Significant differences in age, sex, country of birth, or country of birth and parents educational levels and iodized salt consumption were not found. The median of the urinary iodine level (120 μg/L; interquartile range 80-184) was significantly higher in boys than girls and more elevated in younger children. Iodized salt and milk consumption significantly increased the concentration of urinary iodine. Children who drank less than two glasses of milk per day and did not consume iodized salt have four times the risk of iodine deficiency compared to children who daily drank at least two glasses of milk and consumed iodized salt (P < 0.001).

CONCLUSIONS

The nutritional level of iodine in the children studied is appropriate despite the low consumption of iodized salt. This is due to the consumption of dairy products and milk. The younger the child, the better his/her iodine nutritional level. Teenagers studied are at higher risk of iodine deficiency.