1
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Bath SC. Thyroid function and iodine intake: global recommendations and relevant dietary trends. Nat Rev Endocrinol 2024; 20:474-486. [PMID: 38693274 DOI: 10.1038/s41574-024-00983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/03/2024]
Abstract
Iodine is a micronutrient that is essential for thyroid hormone production. Adequate iodine intake is especially important during pregnancy and early life, when brain development is dependent on thyroid hormones. Iodine intake recommendations vary around the world, but most recommendations generally reflect the increased requirements during pregnancy and lactation, although adequate iodine intake before pregnancy is also important. Tremendous progress has been made in improving iodine intake across the world over the past 30 years, mainly through salt-iodization programmes. However, in countries without strong iodine fortification programmes, and with shifts in dietary patterns, a need has arisen for health organizations, governments and clinicians to ensure that adequate iodine is consumed by everyone in the population. For example, in countries in which adequate iodine intake depends on individual food choice, particularly of iodine-rich milk and dairy products, intake can be highly variable and is also vulnerable to changing dietary patterns. In this Review, iodine is considered in the wider context of the increasing prevalence of overweight and obesity, the dietary trends for salt restriction for cardiovascular health and the increasing uptake of plant-based diets.
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Affiliation(s)
- Sarah C Bath
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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2
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Tattersall JK, Peiris MS, Arai M, McCully K, Pearce N, Rayman MP, Stergiadis S, Bath SC. Variation in milk‑iodine concentration around the world: a systematic review and meta-analysis of the difference between season and dairy-production system. Food Chem 2024; 459:140388. [PMID: 39033567 DOI: 10.1016/j.foodchem.2024.140388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/30/2024] [Accepted: 07/06/2024] [Indexed: 07/23/2024]
Abstract
Iodine is essential for thyroid hormone production. Milk and dairy products are important sources of iodine in many countries. We aimed to review systematically the variation in milk‑iodine concentration between countries, seasons and farming practice. We searched online food composition tables and published literature for data since 2006. Milk‑iodine concentration was available for 34 countries (from 66 sources) and ranged from 5.5 to 49.9 μg/100 g (median 17.3 μg/100 g). Meta-analyses identified that iodine concentration is significantly higher in: (i) winter than summer milk (mean difference 5.97 μg/100 g; p = 0.001), and (ii) in conventional than in organic milk (mean difference 6.00 μg/100 g; p < 0.0001). Sub-group analysis showed that the difference between organic and conventional milk was only significant in summer (p = 0.0003). The seasonal variation in milk‑iodine concentration may affect iodine intake and status so should be considered in dietary surveys, and when assessing population iodine status.
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Affiliation(s)
- Joanne K Tattersall
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Manishka S Peiris
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Maika Arai
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Katherine McCully
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Neeve Pearce
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Margaret P Rayman
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Sokratis Stergiadis
- School of Agriculture, Policy and Development, Department of Animal Sciences, University of Reading PO Box 237, Earley Gate, Reading RG6 6EU, UK
| | - Sarah C Bath
- Department of Nutrition, Food, and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.
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3
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Lawson I, Wood C, Syam N, Rippin H, Dagless S, Wickramasinghe K, Amoutzopoulos B, Steer T, Key TJ, Papier K. Assessing Performance of Contemporary Plant-Based Diets against the UK Dietary Guidelines: Findings from the Feeding the Future (FEED) Study. Nutrients 2024; 16:1336. [PMID: 38732583 PMCID: PMC11085280 DOI: 10.3390/nu16091336] [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: 03/29/2024] [Revised: 04/12/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
Uncertainty remains about the composition of contemporary plant-based diets and whether they provide recommended nutrient intakes. We established Feeding the Future (FEED), an up-to-date online cohort of UK adults following different plant-based diets and diets containing meat and fish. We recruited 6342 participants aged 18-99 [omnivores (1562), flexitarians (1349), pescatarians (568), vegetarians (1292), and vegans (1571)] between February 2022 and December 2023, and measured diet using a food frequency questionnaire and free text. We compared personal characteristics and dietary intakes between diet groups and assessed compliance with dietary guidelines. Most participants met UK dietary recommendations for fruit and vegetables, sodium, and protein, although protein intakes were lowest among vegetarians and vegans. Omnivores did not meet the fibre recommendation and only vegans met the saturated fat recommendation. All diet groups exceeded the free sugars recommendation. Higher proportions of vegetarians and vegans were below the estimated average requirements (EARs) for zinc, iodine, selenium, and, in vegans, vitamins A and B12, whereas calcium intakes were similar across the diet groups. People following plant-based diets showed good compliance with most dietary targets, and their risk for inadequate intakes of certain nutrients might be mitigated by improved dietary choices and/or food fortification.
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Affiliation(s)
- Izabella Lawson
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
| | - Caroline Wood
- Public Affairs & Communications Directorate, University of Oxford, Oxford OX1 2JD, UK;
| | - Nandana Syam
- Medical Sciences Division, University of Oxford, Oxford OX3 9DU, UK;
| | - Holly Rippin
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Selina Dagless
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Kremlin Wickramasinghe
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Birdem Amoutzopoulos
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SL, UK; (B.A.); (T.S.)
| | - Toni Steer
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SL, UK; (B.A.); (T.S.)
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
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4
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Khalil ZA, Herter-Aeberli I. Contribution of plant-based dairy and fish alternatives to iodine nutrition in the Swiss diet: a Swiss Market Survey. Eur J Nutr 2024:10.1007/s00394-024-03339-5. [PMID: 38451284 DOI: 10.1007/s00394-024-03339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study aimed to assess the iodine content in plant-based dairy and fish alternatives available in the Swiss market and compare them with conventional products. METHODS In 2022, a market survey was conducted in Zurich, Switzerland, to identify the plant-based dairy and fish alternatives available and assess their iodine content. To evaluate the impact of plant-based alternatives on iodine consumption in Switzerland, we modeled dietary scenarios by substituting the intake of dairy and fish items with plant-based alternatives. In addition, we investigated fortification with calcium, vitamins B2, B12, and D. RESULTS Out of 477 identified products, only four milk-alternative products were iodine fortified (median iodine concentration: 22.5 μg/100 ml). The median iodine concentration in unfortified plant-based alternatives was negligible compared to conventional dairy and fish products (milk: 0.21 vs 9.5 μg/100 ml; yogurt 0.36 vs 6.1 μg/100 g; cheese: 0.10 vs 20 μg/100 g; fish 0.50 vs 44 μg/100 g). Three portions of dairy per day as recommended by the Swiss Food Pyramid provide 25% of the RDA for iodine (150 μg/day), whereas substituting those with unfortified alternatives provides only 0.7% of the RDA. CONCLUSION Only four out of 477 plant-based alternative products are iodine fortified in the Swiss market. Thus, the risk for consumers to miss out on the ca. 25% of the RDA for iodine by consuming plant-based alternatives is high, placing them at a risk for inadequate iodine intake.
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Affiliation(s)
- Zulekha Abbas Khalil
- Institute of Food, Nutrition and Health, Laboratory of Nutrition and Metabolic Epigenetics, ETH Zürich, 8092, Zurich, Switzerland
| | - Isabelle Herter-Aeberli
- Institute of Food, Nutrition and Health, Laboratory of Nutrition and Metabolic Epigenetics, ETH Zürich, 8092, Zurich, Switzerland.
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5
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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.
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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.
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6
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Embling R, Neilson L, Mellor C, Durodola M, Rouse N, Haselgrove A, Shipley K, Tales A, Wilkinson L. Exploring consumer beliefs about novel fortified foods: A focus group study with UK-based older and younger adult consumers. Appetite 2024; 193:107139. [PMID: 38043697 DOI: 10.1016/j.appet.2023.107139] [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: 09/11/2023] [Revised: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
Consuming 'nutritionally-enhanced' food products (including those that are fortified or enriched to deliver nutritional and functional properties) may help to improve overall diet quality and combat risks associated with malnutrition. However, fortification can negatively impact consumer acceptance, particularly where expected sensory properties of 'delivery' foods are affected by target ingredients. Here, we explored factors influencing consumer acceptability for six novel food products that had been fortified, including both savoury and sweet meal components (e.g., high protein dumplings, probiotic yoghurt drink). In person focus groups (25 consumers aged between 22 and 76 years old) were conducted with two stages; firstly, participants completed a blind taste test of products without awareness of fortification. Secondly, participants discussed products with awareness of additional ingredients and food properties. Reflexive thematic analysis showed that liking of sensory properties differed between foods, but informing participants about the fortification of products highlighted potential trade-offs between taste, health, price, and familiarity. Though taste and texture were generally prioritised by participants, positive perceptions of health benefits increased consumer willingness to buy, whilst both cost and uncertainty about product use were potential barriers. Trust of information was a key concern for labelling and product claims. These results highlight product features that may be optimised to support the success of fortified foods. Greater transparency when building product brands and improving consumer knowledge of fortification may also be important for longer-term consumer acceptance.
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Affiliation(s)
- Rochelle Embling
- School of Psychology, Faculty of Medicine, Health, & Life Science, Swansea University, Swansea, SA2 8PP, UK
| | - Louise Neilson
- BIC Innovation Ltd, One Court Road, Bridgend, CF31 1BE, UK
| | - Chloe Mellor
- School of Psychology, Faculty of Medicine, Health, & Life Science, Swansea University, Swansea, SA2 8PP, UK; BIC Innovation Ltd, One Court Road, Bridgend, CF31 1BE, UK
| | - Mercy Durodola
- School of Psychology, Faculty of Medicine, Health, & Life Science, Swansea University, Swansea, SA2 8PP, UK
| | - Natalie Rouse
- BIC Innovation Ltd, One Court Road, Bridgend, CF31 1BE, UK
| | | | | | - Andrea Tales
- The Awen Institute, Talbot Building, Swansea University, Swansea, SA2 8PP, UK
| | - Laura Wilkinson
- School of Psychology, Faculty of Medicine, Health, & Life Science, Swansea University, Swansea, SA2 8PP, UK.
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7
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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.
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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
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8
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Woodside JV, Lindberg L, Nugent AP. Harnessing the power on our plates: sustainable dietary patterns for public and planetary health. Proc Nutr Soc 2023; 82:437-453. [PMID: 37905409 DOI: 10.1017/s0029665123004809] [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: 11/02/2023]
Abstract
Globally, diet quality is poor, with populations failing to achieve national dietary guidelines. Such failure has been consistently linked with malnutrition and poorer health outcomes. In addition to the impact of diet on health outcomes, it is now accepted that what we eat, and the resulting food system, has significant environmental or planetary health impacts. Changes are required to our food systems to reduce these impacts and mitigate the impact of climate change on our food supply. Given the complexity of the interactions between climate change, food and health, and the different actors and drivers that influence these, a systems-thinking approach to capture such complexity is essential. Such an approach will help address the challenges set by the UN 2030 Agenda for sustainable development in the form of the sustainable development goals (SDG). Progress against SDG has been challenging, with an ultimate target of 2030. While the scientific uncertainties regarding diet and public and planetary health need to be addressed, equal attention needs to be paid to the structures and systems, as there is a need for multi-level, coherent and sustained structural interventions and policies across the full food system/supply chain to effect behaviour change. Such systems-level change must always keep nutritional status, including impact on micronutrient status, in mind. However, benefits to both population and environmental health could be expected from achieving dietary behaviour change towards more sustainable diets.
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Affiliation(s)
- Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Leona Lindberg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
- Institute for Global Food Security, School of Biological 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
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
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9
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Eveleigh E, Coneyworth L, Craigon J, Welham S. Adoption of a Short-Term (4-Week) Vegan Diet as Part of 'Veganuary' Significantly Reduces Saturated Fatty Acid (SFA), Cholesterol, B12, and Iodine Intake in Omnivorous Individuals-An Observational Study. Nutrients 2023; 15:4967. [PMID: 38068825 PMCID: PMC10708059 DOI: 10.3390/nu15234967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Global veganism campaigns like 'Veganuary' have gained popularity. We conducted an observational study to assess the impact of a 4-week vegan diet during 'Veganuary' on nutrient intake, status, knowledge, and motivations for veganism. Data were collected before and after 'Veganuary', using Food Frequency Questionnaires (FFQs) to estimate dietary intake. Micronutrient knowledge and motivation were assessed through questionnaires. A total of 154 UK adults aged 18-60 years (2019: n81; 2020: n73) participated. Groups were vegetarians and omnivores committed to a 4-week vegan diet during 'Veganuary'. Control groups were vegans and omnivores who did not transition. Short-term vegan diets significantly decreased intake of iodine, B12, cholesterol, and saturated fatty acids (SFAs) in omnivores. Micronutrient knowledge was low, and motivation for veganism varied. Short-term vegan diets reduce macro- and micronutrient intake in omnivores. Veganuary participants could benefit from nutritional guidance or supplementation. Attention is required for UK micronutrient intake and knowledge. Motivations for vegan pledges may influence diets, warranting further research.
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Affiliation(s)
- Elizabeth Eveleigh
- Division of Food, Nutrition and Dietetics, School of Biosciences, The University of Nottingham, Sutton Bonington LE12 5RD, UK; (E.E.); (L.C.)
| | - Lisa Coneyworth
- Division of Food, Nutrition and Dietetics, School of Biosciences, The University of Nottingham, Sutton Bonington LE12 5RD, UK; (E.E.); (L.C.)
| | - Jim Craigon
- School of Biosciences, The University of Nottingham, Sutton Bonington LE12 5RD, UK;
| | - Simon Welham
- Division of Food, Nutrition and Dietetics, School of Biosciences, The University of Nottingham, Sutton Bonington LE12 5RD, UK; (E.E.); (L.C.)
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10
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Mariotti F. Nutritional and health benefits and risks of plant-based substitute foods. Proc Nutr Soc 2023:1-14. [PMID: 37881950 DOI: 10.1017/s0029665123004767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Plant-based substitutes (PBS) are seen as a convenient way to transition to a more plant-based diet, but their potential health benefits and nutritional concerns remain debated. Based on a review of the literature, it is concluded here that the primary risk of insufficient nutrient intake with PBS concerns iron and calcium, which are critical to the nutritional value of PBS. Other risks were identified but these would depend on the characteristics of the overall diet, as is the case for iodine in a diet containing no seafood or dairy, and vitamin B12 in a vegetarian/vegan diet. Conversely, the use of PBS is also expected to confer some benefits for long-term health because it would result in higher fibre intakes (in the case of meat PBS) and lower SFA intakes (but higher PUFA/MUFA intakes), but attention should be paid to a potential increase in sodium intake with PBS of meat products. In fact, a recurring finding in this review was that PBS is a very heterogeneous food category involving considerable variations in ingredient and nutrient composition, and whose design could be improved in order to foster nutritional and health benefits. The latter also depend on the animal food that is being replaced and are only deemed likely when PBS replace red meat. The fortification of PBS with key nutrients such as iron and calcium may constitute an actionable public health solution to further shift the balance in favour of PBS in the context of the current dietary transition in western countries.
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Affiliation(s)
- François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120 Palaiseau, France
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11
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Alzahrani A, Ebel R, Norton G, Raab A, Feldmann J. Iodine in plant-based dairy products is not sufficient in the UK: A market survey. J Trace Elem Med Biol 2023; 79:127218. [PMID: 37244048 DOI: 10.1016/j.jtemb.2023.127218] [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: 03/28/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Following a well-balanced diet ensures that a person gets all the essential elements for health sustenance. However, in the United Kingdom an increasing proportion of people are transiting to become vegans who exclude animal-based products in their diets. Consequently, people may have a deficit of essential elements such as iodine which is not present in most plant-based meals, additionally iodide fortified table salt is not commonly used in the UK. Without iodine people consuming a vegan diet risk developing iodine deficiency and diseases like goiter. METHODS The objective of this study is to determine the difference in iodine content and iodine speciation between plant-based and dairy products. More than 100 market samples of plant-based and dairy milk products were collected in Scotland, UK. RESULTS Iodine concentrations in dairy milk is ten times higher compared to plant-based milks. Similar differences were also apparent for butter, yogurt and cheese. A total of 20% of plant-based milk products were fortified with iodine, however these products had lower iodine concentrations compare to the equivalent dairy products. In this study we calculated that people with average diet have an iodine intake of 226 + /- 103 μg day-1 from dairy products which satisfies the WHO recommended intake of adults and 90% of the recommend intake for pregnant and breast-feeding women. A diet from substituted dairy products gives only 21.8 µg day-1 for the respective WHO guideline intake values, which accounts only 15% of the iodine intake for adults and 9% for pregnant and lactating women. Iodine fortified diet could increase the iodine intake to 55% or 33% of the WHO recommended daily intake respectively. CONCLUSION Plant-based dairy consumers are encouraged to use iodine fortified dairy products or use of iodized salt in the UK for home cooking, otherwise there are at risk to get iodine deficient.
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Affiliation(s)
- Ali Alzahrani
- Department of Chemistry, University of Aberdeen, Aberdeen AB24 3UE, Scotland, UK; Department of Chemistry, Faculty of Science and Arts, University of Albaha, Albaha, Qilwah 65565, Saudi Arabia
| | - Rainer Ebel
- Department of Chemistry, University of Aberdeen, Aberdeen AB24 3UE, Scotland, UK
| | - Gareth Norton
- School of Biosciences, University of Aberdeen, Aberdeen AB24 3UE, Scotland, UK
| | - Andrea Raab
- TESLA-Analytical Chemistry, University of Graz, 8010 Graz, Austria
| | - Joerg Feldmann
- Department of Chemistry, University of Aberdeen, Aberdeen AB24 3UE, Scotland, UK; TESLA-Analytical Chemistry, University of Graz, 8010 Graz, Austria.
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12
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Aarsland TE, Kaldenbach S, Bakken KS, Solvik BS, Holten-Andersen M, Strand TA. Inadequate Iodine Intake in Mothers of Young Children in Innlandet County, Norway. Curr Dev Nutr 2023; 7:100047. [PMID: 37181930 PMCID: PMC10111588 DOI: 10.1016/j.cdnut.2023.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Background Iodine has an essential role in child growth and brain development. Thus, sufficient iodine intake is particularly important in women of childbearing age and lactating women. Objectives This cross-sectional study aimed to describe iodine intake in a large random sample of mothers of young children (aged ≤2 y) living in Innlandet County, Norway. Methods From November 2020 to October 2021, 355 mother-child pairs were recruited from public health care centers. Dietary data were obtained using two 24-h dietary recalls (24-HRs) per woman and an electronic FFQ. The Multiple Source Method was used to estimate the usual iodine intake from the 24-HR assessment. Results Based on the 24-HRs, the median (P25, P75) usual iodine intake from food was 117 μg/d (88, 153) in nonlactating women and 129 μg/d (95, 176) in lactating women. The median (P25, P75) total usual iodine intake (from food combined with supplements) was 141 μg/d (97, 185) in nonlactating women and 153 μg/d (107, 227) in lactating women. Based on the 24-HRs, 62% of the women had a total iodine intake below the recommendations (150 μg/d in nonlactating women and 200 μg/d in lactating women), and 23% of them had an iodine intake below the average requirement (100 μg/d). The reported use of iodine-containing supplements was 21.4% in nonlactating women and 28.9% in lactating women. In regular users of iodine-containing supplements (n = 63), supplements contributed to an average of 172 μg/d of iodine. Among regular iodine supplement users, 81% reached the recommendations compared with 26% of nonsupplement users (n = 237). The iodine intake estimated by FFQ was substantially higher than that estimated by 24-HRs. Conclusions Maternal iodine intake in Innlandet County was inadequate. This study confirms the need for action to improve iodine intake in Norway, particularly among women of childbearing age.
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Affiliation(s)
- Tonje E. Aarsland
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Women’s Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Siri Kaldenbach
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway
- Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Kjersti S. Bakken
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Women’s Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Beate S. Solvik
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Women’s Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Mads Holten-Andersen
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway
- Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Tor A. Strand
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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