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Li S, Wang C, Cheng Y, Li J, Zhang H, Jin Q, Meng Q, Wu W, Wang T, Liu D, Meng X, Guo W, Zhang W. Iodine Metabolism in Urine and Breast Milk among Lactating Women with Adequate Iodine. J Nutr 2024; 154:2006-2013. [PMID: 38718924 DOI: 10.1016/j.tjnut.2024.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/24/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND In lactating women, iodine metabolism is regulated and maintained by the kidneys and mammary glands. Limited research exists on how iodine absorbed by lactating women is distributed between the kidneys and breasts. OBJECTIVES This study aimed to accurately evaluate the total iodine intake (TII), urinary iodine excretion (UIE), and breast milk iodine excretion (BMIE) in lactating women and explore the relationship between TII and total iodine excretion (TIE). METHODS A 7-d iodine metabolism study was conducted on 41 lactating women with a mean age of 30 y in Yuncheng and Gaoqing, China, from December 2021 to August 2023. TII and TIE were calculated by measuring the iodine content in food, water, 24-h urine, feces, and breast milk. The urinary iodine excretion rate (UIER), breast milk iodine excretion rate (BMIER), and partitioning of iodine excretion between urine and breast milk were determined. RESULTS Iodine metabolism studies were performed for 285 d. The median TII and TIE values were 255 and 263 μg/d, respectively. With an increase in TII, UIER, and BMIER, the UIE and BMIE to TII ratio exhibited a downward trend. The median UIER, BMIER, and proportion of iodine excreted in urine and breast milk were 51.5%, 38.5%, 52%, and 37%, respectively. When the TII was <120 μg/d, the BMIER decreased with the increase of the TII (β: -0.90; 95% confidence interval: -1.08, -0.72). CONCLUSIONS When maternal iodine intake is low, the proportion in breast milk increases, ensuring sufficient iodine nutrition for infants. In addition, the UIE of lactating women with adequate iodine concentrations is higher than their BMIE. This study was registered at clinicaltrials.gov as NCT04492657.
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Affiliation(s)
- Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chunxi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuangui Cheng
- Department of General Surgery, Gaoqing County People's Hospital, Gaoqing, China
| | - Junjing Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hexi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ting Wang
- Department of Obstetrics, Yuncheng County People's Hospital, Yuncheng, China
| | - Denghai Liu
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, China
| | - Xianglu Meng
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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Wang Y, Tian X, Song Q, Wang W, Guo X, Cui T, Pan Z, Chen Y, Chen W, Tan L, Zhang W. Application and Comparison of Different Regression Models in Iodine Balance Experiment on Women of Childbearing Age and Pregnant Women. Biol Trace Elem Res 2024; 202:2474-2487. [PMID: 37807000 DOI: 10.1007/s12011-023-03867-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
The iodine balance experiment is a traditional approach to evaluate the physiological requirement for iodine, while the simple linear regression model (SLM) and the mixed effects model (MEM) are two primary methods used to analyze iodine balance experiments. In the present study, we aimed to compare the effects of these two regression models on the evaluation of iodine balance experiments to investigate appropriate valuation methods. By constructing SLM and MEM, zero iodine balance values (IBV) were determined, and the evaluation effects were compared. No changes were made to the experimental data for women of childbearing age, and cutoff values of 600 µg/day and 1000 µg/day, respectively, were chosen for further processing of the experimental data for pregnant women. Equation combinations 1-3 (EC1-3) were obtained by fitting SLM, and zero IBV were calculated as 110.26 µg/day, 333.06 µg/day, and 434.84 µg/day, respectively. EC4-6 were obtained by fitting MEM, and zero IBV were calculated as 110.44 µg/day, 335.79 µg/day, and 418.06 µg/day, respectively. The inclusion of inter-measurement variation as a random factor in the MEM yielded EC7-8, which reduced the test power of the iodine balance experiment on women of childbearing age. Our study suggested that when experimental conditions were tightly controlled, with fewer uncertainties or significant influences, computationally straightforward and well-understood SLM was preferred. If some uncertain factors might cause large changes in the experimental results, it was advised to use a more "conservative" MEM to calculate the zero IBV. ClinicalTrials.gov Identifier: Registered at Clinicaltrials.gov, NCT03279315 (17th September 2017, retrospectively registered), NCT03710148 (18th October 2018, retrospectively registered).
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Affiliation(s)
- Yu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Xiaoxiao Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- Tianjin Third Central Hospital Nutrition Department, Tianjin, China
| | - Qiuyi Song
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Wenqiang Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Xiaohui Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
- Tianjin Nankai District Center for Disease Control and Prevention, Tianjin, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
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Chen D, Ye Y, Lan Y, He M, Wu J, Wang L, Chen Z. Adequate iodine nutrition and higher salt intake in Chinese adults aged 18-59 years recommended by international organizations. Sci Rep 2024; 14:6993. [PMID: 38523151 PMCID: PMC10961319 DOI: 10.1038/s41598-024-57892-4] [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: 06/01/2023] [Accepted: 03/22/2024] [Indexed: 03/26/2024] Open
Abstract
Iodine deficiency and excessive salt intake have adverse health effects. This study evaluated the iodine level and salt intake in Chinese adults aged 18-59 years after implementing the salt reduction program and compared with both the World Health Organization (WHO) and Chinese recommendations. Adults aged 18-59 years were randomly selected using multi-stage stratified random sampling in coastal urban area (CUA), non-coastal urban area (Non-CUA), coastal rural area (CRA), and non-coastal rural area (Non-CRA) of Fujian Province, China. Iodine, sodium, and creatinine concentrations in spot urine samples were measured. Knudsen equation was used to determine 24-h urinary iodine and sodium excretion. The median urinary iodine concentration (mUIC) and urinary sodium concentration (mUNaC) among adults (n = 3513) were 132.0 μg/L and 4.0 g/d, respectively. The mUIC and median daily iodine intake in CUA, Non-CUA, CRA and Non-CRA were 112.1, 127.5, 128.5, 167.5 μg/L and 189.6, 182.5, 199.4, 236.0 μg/d, respectively. The mUNaC and median daily salt intake (mDSI) in these four areas were 2.4, 2.8, 2.9, 2.9 g/L and 9.8, 10.4, 10.4, 10.6 g/d, respectively. The mUIC and DII of residents were higher in the Non-CRA than in the other three areas (P < 0.05). The UNaC and DSI of residents were lower in the CUA than in the other three areas (P < 0.05). The logistic regression demonstrated that the people living in CUA and Non-CUA consumed less salt compared with those in Non-CRA. Except for Non-CUA, the DII was lower (< 150 μg/d) among women of childbearing age in the low-salt intake group (< 5 g/d) compared with the high-salt intake group (≥ 5 g/d) (P < 0.05). Iodine nutrition in Chinese adults aged 18-59 years was sufficient, but the salt intake was substantially higher than the WHO and Chinese recommendations. Further policy implementation is needed to reduce salt intake and improve the monitoring of iodine levels in Chinese adults, especially in women of childbearing age.
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Affiliation(s)
- Diqun Chen
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
- School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China
| | - Ying Ye
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
- School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China
| | - Ying Lan
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
| | - Meng He
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
| | - Jiani Wu
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
| | - Lijin Wang
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China
| | - Zhihui Chen
- Institute for Endemic and Chronic Non-Communicable Diseases, Fujian Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China.
- School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China.
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Liu X, Wang J, Li Y, Tan H, Li X, Mao D, Liu Y, Li W, Yu W, Lu J, Yan J, Piao J, Yang L, Guo C, Liu X, Yang X. Re-exploration of dietary iodine intake in Chinese adult males using a modified iodine balance study. Br J Nutr 2023; 130:1308-1315. [PMID: 36876640 DOI: 10.1017/s0007114523000569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
There is still controversy about optimal dietary iodine intake as the Universal Salt Iodization policy enforcement in China. A modified iodine balance study was thus conducted to explore the suitable iodine intake in Chinese adult males using the iodine overflow hypothesis. In this study, thirty-eight apparently healthy males (19·1 (sd 0·6) years) were recruited and provided with designed diets. After the 14-d iodine depletion, daily iodine intake gradually increased in the 30-d iodine supplementation, consisting of six stages and each of 5 d. All foods and excreta (urine, faeces) were collected to examine daily iodine intake, iodine excretion and the changes of iodine increment in relation to those values at stage 1. The dose-response associations of iodine intake increment with excretion increment were fitted by the mixed effects models, as well as with retention increment. Daily iodine intake and excretion were 16·3 and 54·3 μg/d at stage 1, and iodine intake increment increased from 11·2 μg/d at stage 2 to 118·0 μg/d at stage 6, while excretion increment elevated from 21·5 to 95·0 μg/d. A zero iodine balance was dynamically achieved as 48·0 μg/d of iodine intake. The estimated average requirement and recommended nutrient intake were severally 48·0 and 67·2 μg/d, which could be corresponded to a daily iodine intake of 0·74 and 1·04 μg/kg per d. The results of our study indicate that roughly half of current iodine intakes recommendation could be enough in Chinese adult males, which would be beneficial for the revision of dietary reference intakes.
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Affiliation(s)
- Xiaobing Liu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Jun Wang
- Shenzhen Polytechnic, School of Food and Drug, Shenzhen, Guangdong518055, People's Republic of China
| | - Yajie Li
- Changzhi Medical College, Changzhi, Shanxi046000, People's Republic of China
| | - Hongxing Tan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Xiuwei Li
- Chinese Center for Disease Control and Prevention, National Reference Laboratory for Iodine Deficiency Disorders, Beijing100050, People's Republic of China
| | - Deqian Mao
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
| | - Yanyan Liu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Weidong Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
| | - Wei Yu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Jiaxi Lu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
| | - Junan Yan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Jianhua Piao
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
| | - Lichen Yang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
| | - Chongzheng Guo
- Changzhi Medical College, Changzhi, Shanxi046000, People's Republic of China
| | - Xiaoli Liu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
| | - Xiaoguang Yang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing100050, People's Republic of China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong518020, People's Republic of China
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Guo W, Yang Y, Jiang W, Cheng Y, Wu W, Pan Z, Zhang D, Li S, Ren Z, Zhang N, Zhang K, Pearce EN, Chen W, Zhang W. An Iodine Balance Study in Chinese School-age Children. J Clin Endocrinol Metab 2023; 108:e949-e955. [PMID: 37146180 DOI: 10.1210/clinem/dgad244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023]
Abstract
CONTEXT Few iodine balance studies have been conducted in school-age children. OBJECTIVE This study aimed to conduct an iodine balance study in school-age children. METHODS We measured daily iodine intake, excretion, and retention for 3 consecutive days without any dietary interventions in school-age children. Linear mixed-effects models were used to fit the relationship between total iodine intake and iodine retention. RESULTS 29 children aged 7-12 years (mean age 10.2 ± 1.4 years) with normal thyroid function and thyroid volume were recruited. The 0 balance value (iodine intake = iodine excretion, iodine retention = 0 μg/day) shifted with iodine intake in an iodine sufficient population. The 0 balance value for school-age children with an iodine intake of 235 (133, 401) μg/day is 164 μg/day. Children aged 7-12 years with iodine intake >400 μg/day were almost all in a positive iodine state. CONCLUSION An iodine intake of 235 (133, 401) μg/day for children aged 7-10 years achieved a 0 balance value of 164 μg/day. Long-term iodine intake of >400 μg/day is not recommended.
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Affiliation(s)
- Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ying Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wen Jiang
- Department of Iodine Deficiency Disorders, Shandong Provincial Institute for Endemic Disease Control, Jinan, Shandong Province 250014, China
| | - Yuangui Cheng
- Department of General Surgery, People's Hospital of Gaoqing County, Zibo, Shandong Province 256399, China
| | - Wen Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Dingyan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Zhiyuan Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Naifan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Kexin Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA 02118, USA
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin 300052, China
- The Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
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Chen W, Wang W, Gao M, Chen Y, Guo W, Dong S, Sun H, Pan Z, Pearce EN, Tan L, Shen J, Zhang W. Iodine Intakes of <150 μg/day or >550 μg/day are Not Recommended during Pregnancy: A Balance Study. J Nutr 2023; 153:2041-2050. [PMID: 37100687 DOI: 10.1016/j.tjnut.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/25/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adequate iodine intake during pregnancy is critical for maintaining maternal and fetal thyroid function and development. There are only limited data from iodine-balance studies to inform iodine requirements during pregnancy. OBJECTIVES This is an iodine-balance study conducted to explore the associations among iodine intake, excretion, and retention to provide information regarding iodine requirements during pregnancy. METHODS A 7-d iodine-balance experiment enrolled 93 healthy pregnant Chinese women from Hebei, Tanjin, and Shandong. Duplicates of all foods and beverages consumed were systematically collected and measured for iodine content. Iodine excretion was measured by collecting 24-h urine and feces samples. Simple linear regression models were used to assess relationships between total iodine intake and iodine retention, whereas mixed effect models were used to assess the relationship between daily iodine intake and iodine retention. RESULTS The mean ± SD age of participating pregnant women was 29 ± 2 y at a median 22 (IQR: 13-30) wk of gestation. The mean 7-d iodine retention was 43.0 ± 1060 μg/7 d. A negative iodine balance was present in 56% of women whereas 44% had a positive balance. Pregnant women with iodine intakes <150 μg/d were in negative balance whereas those with intakes >550 μg/d were in positive balance. The daily iodine intake at zero balance was 343 μg/d, which was higher in women from Shandong (492 μg/d) than in those from Hebei and Tianjin (202 μg/d). CONCLUSIONS Iodine intake at zero balance determined in pregnant women with adequate iodine nutrition is 202 μg/d, and the calculated recommended nutrient intake (RNI) is 280 μg/d. Iodine intakes of <150 μg/d and >550 μg/d are not recommended during pregnancy. This trial was registered at clinicaltrials.gov as NCT03710148.
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Affiliation(s)
- Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Department of Endocrinology and Metabolism, Health care and Prevention, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; The Department of Health Services and Management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shuyao Dong
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Shen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Endocrinology and Metabolism, Health care and Prevention, Tianjin Medical University General Hospital, Tianjin, China.
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Li Y, Wang J, Liu X, Li W, Mao D, Lu J, Li X, Tan H, Liu Y, Yan J, Yu W, Guo C, Liu X, Yang X. Re-exploring the requirement of dietary iodine intake in Chinese female adults based on 'iodine overflow theory'. Eur J Nutr 2023; 62:1467-1478. [PMID: 36651989 PMCID: PMC10030447 DOI: 10.1007/s00394-022-03065-w] [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: 02/21/2022] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE We re-explored the basal iodine requirement based on healthy Chinese female and a new iodine overflow theory was proposed for iodine balance study. METHODS Thirty-six Chinese healthy female adults (age 20.7 ± 1.1) were recruited for this study, which included 40 days low iodine depletion period and six stages of 30 days supplementation period. Uniform diets with low iodine were provided and the content of iodine in the diet was regulated by dairy products. The total iodine intake from food and the total iodine excretion through 24-h urine and staged feces were completely gathered and monitored. The incremental (Δ) intake and excretion over the range were calculated. RESULTS The iodine intake and excretion were 13.6 μg/day and 48.6 μg/day at the first stage, respectively. The incremental iodine intakes and excretions were 21.1 μg/day to 120.3 μg/day and 25.8 μg/day to 105.4 μg/day for the supplementation stages, respectively. According to the 'iodine overflow theory', the zero iodine balance (Δ iodine intake = Δ iodine excretion) derived from a mixed effect model indicated a mean iodine intake of 52.2 μg/d (1.0 μg/d kg). The RNI for iodine to healthy Chinese female adult was 73.1 μg/d (1.4 μg/d kg). CONCLUSION A daily iodine intake of 52.2 μg/d may meet the basal iodine requirement for healthy Chinese female adults, and Chinese female may need more than 20% iodine intake than male based on the 'iodine overflow theory'. The trial was registered at the Chinese Clinical Trial Registry in May 2018 (No: ChiCTR1800016184).
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Affiliation(s)
- Yajie Li
- Changzhi Medical College, No. 360, Jiefang East Street, Changzhi, 046000, Shanxi, People's Republic of China
| | - Jun Wang
- School of Food and Drug, Shenzhen Polytechnic, Shenzhen, 518055, Guangdong, People's Republic of China
| | - Xiaobing Liu
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Weidong Li
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Deqian Mao
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Jiaxi Lu
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Xiuwei Li
- National Reference Laboratory for iodine deficiency disorders, Chinese Center for Disease Control and Prevention, Beijing, 100050, People's Republic of China
| | - Hongxing Tan
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Yanyan Liu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Junan Yan
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Wei Yu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Chongzheng Guo
- Changzhi Medical College, No. 360, Jiefang East Street, Changzhi, 046000, Shanxi, People's Republic of China
| | - Xiaoli Liu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Xiaoguang Yang
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China.
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China.
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Silva DLF, Crispim SP, Almeida CCB, Schrubbe V, Azevedo FM, de Faria FR, Pizato N, Pereira RJ, Macedo MDS, Franceschini SDCC. Improving Pregnant Women's Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates. Nutrients 2023; 15:nu15040846. [PMID: 36839203 PMCID: PMC9966772 DOI: 10.3390/nu15040846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
(1) Measuring usual iodine intake is a complex task due to the food consumption variability and its natural concentration in food. Therefore, the use of covariates to adjust statistical methods to estimate usual intake could improve the estimates obtained through dietary surveys. This study aims to evaluate the influence of salt and seasoning usage covariates on the estimates of usual iodine intake and the prevalence of its inadequacy. (2) A cross-sectional study was conducted with Brazilian pregnant women's food consumption data obtained with 24-h recall (n = 2247). The usual iodine intake was adjusted for intraindividual variability, supplement use, temporal effects, data collection methods, and sociodemographic characteristics with the tool UCD/NCI SIMPLE in the SAS software. Then, salt and seasoning usage covariates were used to adjust the distribution. The harmonized intake reference values for populations were used to assess intake adequacy. (3) The adjustments for salt and seasoning usage yielded a higher mean of usual iodine intakes. The only exception was the adjustment for the "habit of adding salt to meals after preparing/cooking", which produced a lower mean of usual intake and increased the prevalence of insufficient intake. (4) Salt and seasoning usage covariates affect the estimates evaluated. However, more studies are necessary to evaluate the influence observed.
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Affiliation(s)
- Débora L. F. Silva
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
- Correspondence: ; Tel.: +55-41-9-9845-9490
| | - Sandra P. Crispim
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Claudia C. B. Almeida
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Vanessa Schrubbe
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Francilene M. Azevedo
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
| | - Franciane R. de Faria
- Faculdade de Ciências da Saúde, Universidade Federal de Rondonópolis, Rondonópolis 78736-900, Mato Grosso, Brazil
| | - Nathalia Pizato
- Departamento de Nutrição, Universidade de Brasília, Brasília 70970-000, Distrito Federal, Brazil
| | - Renata J. Pereira
- Curso de Graduação em Nutrição, Universidade Federal do Tocantins, Palmas 77001-090, Tocantins, Brazil
| | - Mariana de S. Macedo
- Departamento de Nutrição, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina 39100-000, Minas Gerais, Brazil
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An iodine balance study to explore the recommended nutrient intake of iodine in Chinese young adults. Br J Nutr 2020; 124:1156-1165. [PMID: 32624007 DOI: 10.1017/s0007114520002196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Data on average iodine requirements for the Chinese population are limited following implementation of long-term universal salt iodisation. We explored the minimum iodine requirements of young adults in China using a balance experiment and the 'iodine overflow' hypothesis proposed by our team. Sixty healthy young adults were enrolled to consume a sequential experimental diet containing low, medium and high levels of iodine (about 20, 40 and 60 μg/d, respectively). Each dose was consumed for 4 d, and daily iodine intake, excretion and retention were assessed. All participants were in negative iodine balance throughout the study. Iodine intake, excretion and retention differed among the three iodine levels (P < 0·01 for all groups). The zero-iodine balance derived from a random effect model indicated a mean iodine intake of 102 μg/d, but poor correlation coefficients between observed and predicted iodine excretion (r 0·538 for μg/d data) and retention (r 0·304 for μg/d data). As iodine intake increased from medium to high, all of the increased iodine was excreted ('overflow') through urine and faeces by males, and 89·5 % was excreted by females. Although the high iodine level (63·4 μg/d) might be adequate in males, the corresponding level of 61·6 μg/d in females did not meet optimal requirements. Our findings indicate that a daily iodine intake of approximately half the current recommended nutrient intake (120 μg/d) may satisfy the minimum iodine requirements of young male adults in China, while a similar level is insufficient for females based on the 'iodine overflow' hypothesis.
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Intra-individual and inter-individual variations in iodine intake and excretion in adult women: implications for sampling. Br J Nutr 2020; 123:987-993. [PMID: 31771664 DOI: 10.1017/s0007114519003015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Iodine intake and excretion vary widely; however, these variations remain a large source of geometric uncertainty. The present study aims to analyse variations in iodine intake and excretion and provide implications for sampling in studies of individuals or populations. Twenty-four healthy women volunteers were recruited for a 12-d sampling period during the 4-week experiment. The duplicate-portion technique was used to measure iodine intake, while 24-h urine was collected to estimate iodine excretion. The mean intra-individual variations in iodine intake, 24-h UIE (24-h urinary iodine excretion) and 24-h UIC (24-h urinary iodine concentration) were 63, 48 and 55 %, respectively, while the inter-individual variations for these parameters were 14, 24 and 32 %, respectively. For 95 % confidence, approximately 500 diet samples or 24-h urine samples should be taken from an individual to estimate their iodine intake or iodine status at a precision range of ±5%. Obtaining a precision range of ±5% in a population would require twenty-five diet samples or 150 24-h urine samples. The intra-individual variations in iodine intake and excretion were higher than the inter-individual variations, which indicates the need for more samples in a study on individual participants.
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