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Zupo R, Castellana F, Boero G, Matera E, Colacicco G, Piscitelli P, Clodoveo ML, Rondanelli M, Panza F, Lozupone M, Sardone R. Processed foods and diet quality in pregnancy may affect child neurodevelopment disorders: a narrative review. Nutr Neurosci 2024; 27:361-381. [PMID: 37039128 DOI: 10.1080/1028415x.2023.2197709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To review the evidence on the association between maternal exposure to ultra-processed food (UPF) categories, UPF diet items, and overall diet quality, as assessed by recognized dietary indices, and neurodevelopmental outcomes in offspring. METHODS PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Scholar databases were searched for original articles on female gestational exposure to UPF categories, individual elements of the UPF diet, or indices of diet quality, in relation to outcomes regarding their offspring's neurocognitive development, according to neuropsychometric and behavioral scales, anthropometric/psychomotor indices, and symptoms/diagnosis of neurodevelopmental disorders (NDDs). RESULTS Fourteen articles were selected and underwent the quantitative analysis. Six of these examined diet quality, and eight exposure to UPF categories or specific UPF foods. The maternal population was adult (18+). Child cognitive development was negatively impacted by a diet featuring many processed foods, saturated fats, and sugars. Conversely, a Med-diet led to better neurodevelopment, particularly verbal intelligence and executive functions, in middle childhood. DISCUSSION A maternal diet with many UPFs, saturated fats, and total sugars (especially those added or hidden in packaged carbonated beverages) can adversely affect a child's cognitive development. Knowledge needs to be further extended and managed from a prevention perspective in light of the well-known negative effects of UPFs on human health in all age groups.
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Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni Boero
- Complex Structure of Neurology, SS Annunziata Hospital, Taranto, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University "A. Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | | | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, Department of Public Health, 27100 Pavia, Italy
- IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience (DiBrain), niversity "Aldo Moro," Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Local Healthcare Authority of Taranto, Italy
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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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Godfrey KM, Titcombe P, El-Heis S, Albert BB, Tham EH, Barton SJ, Kenealy T, Chong MFF, Nield H, Chong YS, Chan SY, Cutfield WS. Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLoS Med 2023; 20:e1004260. [PMID: 38051700 PMCID: PMC10697591 DOI: 10.1371/journal.pmed.1004260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Maternal vitamin status preconception and during pregnancy has important consequences for pregnancy outcome and offspring development. Changes in vitamin status from preconception through early and late pregnancy and postpartum have been inferred from cross-sectional data, but longitudinal data on vitamin status from preconception throughout pregnancy and postdelivery are sparse. As such, the influence of vitamin supplementation on vitamin status during pregnancy remains uncertain. This study presents one prespecified outcome from the randomized controlled NiPPeR trial, aiming to identify longitudinal patterns of maternal vitamin status from preconception, through early and late pregnancy, to 6 months postdelivery, and determine the influence of vitamin supplementation. METHODS AND FINDINGS In the NiPPeR trial, 1,729 women (from the United Kingdom, Singapore, and New Zealand) aged 18 to 38 years and planning conception were randomized to receive a standard vitamin supplement (control; n = 859) or an enhanced vitamin supplement (intervention; n = 870) starting in preconception and continued throughout pregnancy, with blinding of participants and research staff. Supplement components common to both treatment groups included folic acid, β-carotene, iron, calcium, and iodine; components additionally included in the intervention group were riboflavin, vitamins B6, B12, and D (in amounts available in over-the-counter supplements), myo-inositol, probiotics, and zinc. The primary outcome of the study was glucose tolerance at 28 weeks' gestation, measured by oral glucose tolerance test. The secondary outcome reported in this study was the reduction in maternal micronutrient insufficiency in riboflavin, vitamin B6, vitamin B12, and vitamin D, before and during pregnancy. We measured maternal plasma concentrations of B-vitamins, vitamin D, and markers of insufficiency/deficiency (homocysteine, hydroxykynurenine-ratio, methylmalonic acid) at recruitment, 1 month after commencing intervention preconception, in early pregnancy (7 to 11 weeks' gestation) and late pregnancy (around 28 weeks' gestation), and postdelivery (6 months after supplement discontinuation). We derived standard deviation scores (SDS) to characterize longitudinal changes among participants in the control group and measured differences between the 2 groups. At recruitment, the proportion of patients with marginal or low plasma status was 29.2% for folate (<13.6 nmol/L), 7.5% and 82.0% for riboflavin (<5 nmol/L and ≤26.5 nmol/L, respectively), 9.1% for vitamin B12 (<221 pmol/L), and 48.7% for vitamin D (<50 nmol/L); these proportions were balanced between the groups. Over 90% of all participants had low or marginal status for one or more of these vitamins at recruitment. Among participants in the control group, plasma concentrations of riboflavin declined through early and late pregnancy, whereas concentrations of 25-hydroxyvitamin D were unchanged in early pregnancy, and concentrations of vitamin B6 and B12 declined throughout pregnancy, becoming >1 SDS lower than baseline by 28 weeks gestation. In the control group, 54.2% of participants developed low late-pregnancy vitamin B6 concentrations (pyridoxal 5-phosphate <20 nmol/L). After 1 month of supplementation, plasma concentrations of supplement components were substantially higher among participants in the intervention group than those in the control group: riboflavin by 0.77 SDS (95% CI 0.68 to 0.87, p < 0.0001), vitamin B6 by 1.07 SDS (0.99 to 1.14, p < 0.0001), vitamin B12 by 0.55 SDS (0.46 to 0.64, p < 0.0001), and vitamin D by 0.51 SDS (0.43 to 0.60, p < 0.0001), with higher levels in the intervention group maintained during pregnancy. Markers of vitamin insufficiency/deficiency were reduced in the intervention group, and the proportion of participants with vitamin D insufficiency (<50 nmol/L) during late pregnancy was lower in the intervention group (35.1% versus 8.5%; p < 0.0001). Plasma vitamin B12 remained higher in the intervention group than in the control group 6 months postdelivery (by 0.30 SDS (0.14, 0.46), p = 0.0003). The main limitation is that generalizability to the global population is limited by the high-resource settings and the lack of African and Amerindian women in particular. CONCLUSIONS Over 90% of the trial participants had marginal or low concentrations of one or more of folate, riboflavin, vitamin B12, or vitamin D during preconception, and many developed markers of vitamin B6 deficiency in late pregnancy. Preconception/pregnancy supplementation in amounts available in over-the-counter supplements substantially reduces the prevalence of vitamin deficiency and depletion markers before and during pregnancy, with higher maternal plasma vitamin B12 maintained during the recommended lactational period. TRIAL REGISTRATION ClinicalTrials.gov NCT02509988; U1111-1171-8056.
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Affiliation(s)
- Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Sarah El-Heis
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom
| | | | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Sheila J. Barton
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Heidi Nield
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Wayne S. Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start, New Zealand National Science Challenge, Auckland, New Zealand
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Grossklaus R, Liesenkötter KP, Doubek K, Völzke H, Gaertner R. Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review. Nutrients 2023; 15:nu15102249. [PMID: 37242131 DOI: 10.3390/nu15102249] [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: 04/11/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
This scoping review critically discusses the publications of the last 30 years on the impact of mild to moderate iodine deficiency and the additional impact of endocrine disrupters during pregnancy on embryonal/fetal brain development. An asymptomatic mild to moderate iodine deficiency and/or isolated maternal hypothyroxinemia might affect the development of the embryonal/fetal brain. There is sufficient evidence underlining the importance of an adequate iodine supply for all women of childbearing age in order to prevent negative mental and social consequences for their children. An additional threat to the thyroid hormone system is the ubiquitous exposure to endocrine disrupters, which might exacerbate the effects of iodine deficiency in pregnant women on the neurocognitive development of their offspring. Ensuring adequate iodine intake is therefore essential not only for healthy fetal and neonatal development in general, but it might also extenuate the effects of endocrine disruptors. Individual iodine supplementation of women of childbearing age living in areas with mild to moderate iodine deficiency is mandatory as long as worldwide universal salt iodization does not guarantee an adequate iodine supply. There is an urgent need for detailed strategies to identify and reduce exposure to endocrine disrupters according to the "precautional principle".
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Affiliation(s)
- Rolf Grossklaus
- Department of Food Safety, Federal Institute for Risk Assessment, D-10589 Berlin, Germany
| | | | - Klaus Doubek
- Professional Association of Gynecologists, D-80337 Munich, Germany
| | - Henry Völzke
- Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, D-17475 Greifswald, Germany
| | - Roland Gaertner
- Medical Clinic IV, University of Munich, D-80336 Munich, Germany
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Dietary Intakes of Folate, Vitamin D and Iodine during the First Trimester of Pregnancy and the Association between Supplement Use and Demographic Characteristics amongst White Caucasian Women Living with Obesity in the UK. Nutrients 2022; 14:nu14235135. [PMID: 36501164 PMCID: PMC9736674 DOI: 10.3390/nu14235135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/11/2022] Open
Abstract
Folate, vitamin D and iodine are key micronutrients in pregnancy, with deficiency associated with poor maternal and infant outcomes. For folate and vitamin D especially, deficiency is more common amongst women with obesity and recommended intakes and guidance on supplementation varies worldwide. The present study aims to investigate dietary and supplementary intakes of these micronutrients amongst a population of pregnant women with obesity in the United Kingdom, alongside key maternal demographic characteristics. Expectant women (n = 75) with a body mass index ≥ 30 kg/m2 at first antenatal appointment were recruited at 12 weeks gestation. Participants were asked about their supplement use preconception and during trimester one in a baseline questionnaire which also asked about demographic characteristics. Women also completed a four day diet diary from which dietary and supplemental intakes of micronutrients intakes were estimated. Folic acid was taken by 96% of women at any point in trimester 1, whilst only 26% of women took the higher 5 mg dose recommended for women with obesity in the UK. For vitamin D and iodine, 56% and 44% of women met the UK RNI, respectively. Maternal age was positively associated with taking supplements of any kind and the 5 mg folic acid supplement, whilst parity was inversely associated with both outcomes. This study strengthens the rationale for further work to be done raising awareness of the need for women with obesity to supplement both with a higher dose of folic acid and vitamin D and to be aware of the role of iodine during pregnancy.
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Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity. Medicina (B Aires) 2022; 58:medicina58081122. [PMID: 36013589 PMCID: PMC9415345 DOI: 10.3390/medicina58081122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022] Open
Abstract
Preconception counseling is an essential tool for preventing adverse pregnancy outcomes associated with thyroid dysfunction. The high prevalence of thyroid disease among women of reproductive age, and the increased risk of adverse pregnancy outcomes associated with thyroid dysfunction, emphasize the necessity for well-established screening and treatment criteria in the preconception period. We therefore conducted a literature review for relevant information on the screening, diagnosis and treatment of subclinical and overt hypothyroidism in women seeking pregnancy. While screening for thyroid disease is recommended only in the presence of risk factors, iodine supplementation should be recommended in most regions, with higher doses in areas with severe deficiency. Known hypothyroid women should be counseled about increasing their levothyroxine dose by 20–30% in the case of suspected or confirmed pregnancy (missed menstrual cycle or positive pregnancy test). Treating subclinical hypothyroidism appears to be beneficial, especially in the presence of autoimmunity or in patients undergoing artificial reproductive techniques. Regarding the management of TPOAb negative SCH women or euthyroid women with positive TPOAb, further research is necessary in order to make evidence-based recommendations.
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O'Hagan AD, Behan S, Peers C, Belton S, O'Connor N, Issartel J. Do our movement skills impact our cognitive skills? Exploring the relationship between cognitive function and fundamental movement skills in primary school children. J Sci Med Sport 2022; 25:871-877. [DOI: 10.1016/j.jsams.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022]
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Lopes CA, Prazeres S, Martinez-de-Oliveira J, Limbert E, Lemos MC. Iodine Supplementation in Pregnancy in an Iodine-Deficient Region: A Cross-Sectional Survey. Nutrients 2022; 14:nu14071393. [PMID: 35406006 PMCID: PMC9002466 DOI: 10.3390/nu14071393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 12/14/2022] Open
Abstract
Iodine deficiency is a common problem in pregnant women and may have implications for maternal and child health. Iodine supplementation during pregnancy has been recommended by several scientific societies. We undertook a cross-sectional survey to assess the efficacy of these recommendations in a European iodine-deficient region. Urinary iodine concentrations (UIC) were determined in pregnant women before (n = 203) and after (n = 136) the implementation of guidelines for iodine supplementation in pregnancy. Iodine supplementation (200 μg/day) reduced the proportion of pregnant women with severe iodine deficiency (37.4% to 18.0%, p = 0.0002). The median UIC increased from 67.6 µg/L to 106.8 µg/L but remained below the recommended target level (>150 µg/L) for pregnant women. In conclusion, iodine supplementation in pregnant women improved iodine status in this iodine-deficient region but was insufficient to achieve recommended iodine levels in pregnancy. Additional measures, such as the adjustment of the dose or timing of supplementation, or universal salt iodization, may be needed.
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Affiliation(s)
- Carla A. Lopes
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal; (C.A.L.); (J.M.-d.-O.)
- Departamento da Saúde da Criança e da Mulher, Centro Hospitalar Universitário Cova da Beira, 6200-251 Covilhã, Portugal
| | - Susana Prazeres
- Laboratório de Endocrinologia, Serviço de Patologia Clínica, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal;
| | - José Martinez-de-Oliveira
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal; (C.A.L.); (J.M.-d.-O.)
- Departamento da Saúde da Criança e da Mulher, Centro Hospitalar Universitário Cova da Beira, 6200-251 Covilhã, Portugal
| | - Edward Limbert
- Serviço de Endocrinologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal;
| | - Manuel C. Lemos
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal; (C.A.L.); (J.M.-d.-O.)
- Correspondence:
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Abstract
PURPOSE Iodine insufficiency during pregnancy may adversely influence fetal growth and development. There is a lack of information on iodine status in pregnant women and infants in many countries including Finland. The aim of this study is to determine dietary intake of iodine and the iodine status in a population of Finnish pregnant women and their infants. METHODS Urine samples were collected from women participating in a mother-child clinical study at early (n = 174) and late pregnancy (n = 186) and at three months of postpartum (n = 197), when infant samples were also collected (n = 123). Urine iodine concentration was measured using inductively coupled plasma mass spectrometry. Cutoffs for iodine insufficiency were < 150 µg/L during pregnancy and < 100 µg/L at postpartum and in infants. Iodine intake was assessed using 3-day food diaries. RESULTS Increased risk of insufficiency, based on urinary iodine concentrations, was observed in the groups investigated in this study. Of the women studied, 66% had urinary iodine concentrations indicating insufficient intakes and iodine insufficiency at early pregnancy, 70% at late pregnancy and 59% at three months of postpartum. This was also the case in 29% of the three-month-old infants. Estimation of iodine intake revealed that iodine insufficient women had lower intakes of iodine from the diet, from food supplements and from diet plus supplements than iodine sufficient women in early pregnancy and at three months of post-partum. In late pregnancy, this difference was seen for iodine intake from supplements. CONCLUSION The majority of the women manifested with low urine iodine concentrations both during and after pregnancy. Similarly, one-third of the infants presented with iodine insufficiency. Maternal iodine intake data support these findings. These observations may have implications for optimal child cognitive development.
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Lv S, Qin R, Jiang Y, Lv H, Lu Q, Tao S, Huang L, Liu C, Xu X, Wang Q, Li M, Li Z, Ding Y, Song C, Jiang T, Ma H, Jin G, Xia Y, Wang Z, Geng S, Du J, Lin Y, Hu Z. Association of Maternal Dietary Patterns during Gestation and Offspring Neurodevelopment. Nutrients 2022; 14:730. [PMID: 35215380 PMCID: PMC8878236 DOI: 10.3390/nu14040730] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/01/2023] Open
Abstract
The health effects of diet are long term and persistent. Few cohort studies have investigated the influence of maternal dietary patterns during different gestational periods on offspring's health outcomes. This study investigated the associations between maternal dietary patterns in the mid- and late-gestation and infant's neurodevelopment at 1 year of age in the Jiangsu Birth Cohort (JBC) Study. A total of 1178 mother-child pairs were available for analysis. A semiquantitative food frequency questionnaire (FFQ) was used to investigate dietary intake at 22-26 and 30-34 gestational weeks (GWs). Neurodevelopment of children aged 1 year old was assessed using Bayley-Ⅲ Screening Test. Principal component analysis (PCA) and Poisson regression were used to extract dietary patterns and to investigate the association between dietary patterns and infant neurodevelopment. After adjusting for potential confounders, the maternal 'Aquatic products, Fresh vegetables and Homonemeae' pattern in the second trimester was associated with a lower risk of being non-competent in cognitive and gross motor development, respectively (cognition: aRR = 0.84; 95% CI 0.74-0.94; gross motor: aRR = 0.80; 95% CI 0.71-0.91), and the similar pattern, 'Aquatic products and Homonemeae', in the third trimester also showed significant association with decreased risk of failing age-appreciate cognitive and receptive communication development (cognition: aRR = 0.89; 95% CI 0.80-0.98; receptive communication: aRR = 0.91; 95% CI 0.84-0.99). Notably, adherence to the dietary pattern with relatively high aquatic and homonemeae products in both trimesters demonstrated remarkable protective effects on child neurodevelopment with the risk of being non-competent in cognitive and gross motor development decreasing by 59% (95% CI 0.21-0.79) and 63% (95% CI 0.18-0.77), respectively. Our findings suggested that adherence to the 'Aquatic products and Homonemeae' dietary pattern during pregnancy may have optimal effects on offspring's neurodevelopment.
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Affiliation(s)
- Siyuan Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Toxicology and Nutritional Science, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
- Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Shiyao Tao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Lei Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Cong Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Xin Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Qingru Wang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
| | - Mei Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ye Ding
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Ci Song
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
- Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Shanshan Geng
- Department of Toxicology and Nutritional Science, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
- Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.D.); (Z.W.)
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; (S.L.); (R.Q.); (Y.J.); (H.L.); (Q.L.); (S.T.); (L.H.); (C.L.); (X.X.); (Q.W.); (M.L.); (Z.L.); (H.M.); (G.J.); (Y.X.); (Z.H.)
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
- Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China
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11
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Bath SC, Verkaik-Kloosterman J, Sabatier M, ter Borg S, Eilander A, Hora K, Aksoy B, Hristozova N, van Lieshout L, Tanju Besler H, Lazarus JH. OUP accepted manuscript. Nutr Rev 2022; 80:2154-2177. [PMID: 35713524 PMCID: PMC9549594 DOI: 10.1093/nutrit/nuac032] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Context Adequate iodine intake is essential throughout life. Key dietary sources are iodized salt and animal products, but dietary patterns in Europe are changing, for example toward lower salt intake and a more plant-based diet. Objective To review iodine intake (not status) in European populations (adults, children, and pregnant women) to identify at-risk groups and dietary sources. Data sources PubMed, Embase, and Cochrane databases, as well as European national nutrition surveys were searched for data on had iodine intake (from dietary assessment) and sources of iodine, collected after 2006. Data selection In total, 57 studies were included, comprising 22 national surveys and 35 sub-national studies. Iodine intake data were available from national surveys of children aged <10 years (n = 11), 11–17 years (n = 12), and adults (n = 15), but data from pregnancy were only available from sub-national studies. Results Iodine intake data are lacking—only 17 of 45 (38%) European countries had iodine-intake data from national surveys. Iodine intake reported from national surveys was below recommendations for: (1) children aged <10 years in 2 surveys (18%), (2) boys and girls aged 11–17 years in 6 (50%) and 8 (68%) surveys, respectively, and (3) adult men and women in 7 (47%) and 12 (80%) surveys, respectively. In pregnant women, intake was below recommendations except where women were taking iodine-containing supplements. Just 32% of national surveys (n = 7) included iodized salt when estimating iodine intake. Milk, dairy products, fish, and eggs were important contributors to intake in many countries, suggesting limited sources in plant-based diets. Conclusion Results are limited by the challenges of dietary assessment for measuring iodine intake. Future national surveys should include iodine intake. Policy makers should consider dietary sources alongside any iodized salt policies when considering methods for improving population iodine intake. Systematic Review Registration PROSPERO 2017 CRD42017075422.
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Affiliation(s)
- Sarah C Bath
- S.C. Bath, Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. E-mail:
| | | | - Magalie Sabatier
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Sovianne ter Borg
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ans Eilander
- Unilever Foods Innovation Centre, Wageningen, Gelderland, The Netherlands
| | - Katja Hora
- SQM International N.V., Antwerpen, Belgium
| | - Burcu Aksoy
- Department of Nutrition and Dietetics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nevena Hristozova
- International Life Sciences Institute (ILSI) Europe, Brussels, Belgium
| | | | - Halit Tanju Besler
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, İstanbul, Turkey
| | - John H Lazarus
- Department of Endocrinology, Cardiff University, Cardiff, UK
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12
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Morton SU, Leyshon BJ, Tamilia E, Vyas R, Sisitsky M, Ladha I, Lasekan JB, Kuchan MJ, Grant PE, Ou Y. A Role for Data Science in Precision Nutrition and Early Brain Development. Front Psychiatry 2022; 13:892259. [PMID: 35815018 PMCID: PMC9259898 DOI: 10.3389/fpsyt.2022.892259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Multimodal brain magnetic resonance imaging (MRI) can provide biomarkers of early influences on neurodevelopment such as nutrition, environmental and genetic factors. As the exposure to early influences can be separated from neurodevelopmental outcomes by many months or years, MRI markers can serve as an important intermediate outcome in multivariate analyses of neurodevelopmental determinants. Key to the success of such work are recent advances in data science as well as the growth of relevant data resources. Multimodal MRI assessment of neurodevelopment can be supplemented with other biomarkers of neurodevelopment such as electroencephalograms, magnetoencephalogram, and non-imaging biomarkers. This review focuses on how maternal nutrition impacts infant brain development, with three purposes: (1) to summarize the current knowledge about how nutrition in stages of pregnancy and breastfeeding impact infant brain development; (2) to discuss multimodal MRI and other measures of early neurodevelopment; and (3) to discuss potential opportunities for data science and artificial intelligence to advance precision nutrition. We hope this review can facilitate the collaborative march toward precision nutrition during pregnancy and the first year of life.
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Affiliation(s)
- Sarah U Morton
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | | | - Eleonora Tamilia
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Rutvi Vyas
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States
| | - Michaela Sisitsky
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States
| | - Imran Ladha
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States
| | | | | | - P Ellen Grant
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Boston, MA, United States
| | - Yangming Ou
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Boston, MA, United States
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13
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Young AE, Kemp JF, Uhlson C, Westcott JL, Ali SA, Saleem S, Garcès A, Figueroa L, Somannavar MS, Goudar SS, Hambidge KM, Hendricks AE, Krebs NF. Improved first trimester maternal iodine status with preconception supplementation: The Women First Trial. MATERNAL AND CHILD NUTRITION 2021; 17:e13204. [PMID: 34036728 PMCID: PMC8476419 DOI: 10.1111/mcn.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/31/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
Maternal iodine (I) status is critical in embryonic and foetal development. We examined the effect of preconception iodine supplementation on maternal iodine status and on birth outcomes. Non‐pregnant women in Guatemala, India and Pakistan (n ~ 100 per arm per site) were randomized ≥ 3 months prior to conception to one of three intervention arms: a multimicronutrient‐fortified lipid‐based nutrient supplement containing 250‐μg I per day started immediately after randomization (Arm 1), the same supplement started at ~12 weeks gestation (Arm 2) and no intervention supplement (Arm 3). Urinary I (μg/L) to creatinine (mg/dl) ratios (I/Cr) were determined at 12 weeks for Arm 1 versus Arm 2 (before supplement started) and 34 weeks for all arms. Generalized linear models were used to assess the relationship of I/Cr with arm and with newborn anthropometry. At 12 weeks gestation, adjusted mean I/Cr (μg/g) for all sites combined was significantly higher for Arm 1 versus Arm 2: (203 [95% CI: 189, 217] vs. 163 [95% CI: 152, 175], p < 0.0001). Overall adjusted prevalence of I/Cr < 150 μg/g was also lower in Arm 1 versus Arm 2: 32% (95% CI: 26%, 38%) versus 43% (95% CI: 37%, 49%) (p = 0.0052). At 34 weeks, adjusted mean I/Cr for Arm 1 (235, 95% CI: 220, 252) and Arm 2 (254, 95% CI: 238, 272) did not differ significantly but were significantly higher than Arm 3 (200, 95% CI: 184, 218) (p < 0.0001). Nominally significant positive associations were observed between I/Cr at 12 weeks and birth length and head circumference z‐scores (p = 0.028 and p = 0.005, respectively). These findings support the importance of first trimester iodine status and suggest need for preconception supplementation beyond salt iodization alone.
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Affiliation(s)
- Amy E Young
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jennifer F Kemp
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Charis Uhlson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jamie L Westcott
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sumera A Ali
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Ana Garcès
- Maternal Infant Health Center, Instituto de Nutrición de Centro América y Panamá (INCAP), Guatemala City, Guatemala
| | - Lester Figueroa
- Maternal Infant Health Center, Instituto de Nutrición de Centro América y Panamá (INCAP), Guatemala City, Guatemala
| | - Manjunath S Somannavar
- Women's and Children's Health Research Unit, KLE Academy of Higher Education & Research's JN Medical College, Belagavi, India
| | - Shivaprasad S Goudar
- Women's and Children's Health Research Unit, KLE Academy of Higher Education & Research's JN Medical College, Belagavi, India
| | - K Michael Hambidge
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Audrey E Hendricks
- Department of Mathematical & Statistical Sciences, University of Colorado Denver, Denver, Colorado, USA
| | - Nancy F Krebs
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, Colorado, USA
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14
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Wenger MJ, DellaValle DM, Todd LE, Barnett AL, Haas JD. Limited Shared Variance among Measures of Cognitive Performance Used in Nutrition Research: The Need to Prioritize Construct Validity and Biological Mechanisms in Choice of Measures. Curr Dev Nutr 2021; 5:nzab070. [PMID: 34056512 PMCID: PMC8141094 DOI: 10.1093/cdn/nzab070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The literature on correlates of nutrition has seen an increase in studies focused on functional consequences at the levels of neural, perceptual, and cognitive functioning. A range of measurement methodologies have been used in these studies, and investigators and funding agencies have raised the questions of how and if these various methodologies are at all comparable. OBJECTIVE The aim was to determine the extent to which 3 different sets of cognitive measures provide comparable information across 2 subsamples that shared culture and language but differed in terms of socioeconomic status (SES) and academic preparation. METHODS A total of 216 participants were recruited at 2 US universities. Each participant completed 3 sets of cognitive measures: 1 custom-designed set based on well-understood laboratory measures of cognition [cognitive task battery (COGTASKS)] and 2 normed batteries [Cambridge Neuropsychological Test Automated Battery (CANTAB), Weschler Adult Intelligence Scale, fourth edition (WAIS-IV)] designed for assessing general cognitive function. RESULTS The 3 sets differed with respect to the extent to which SES and educational preparation affected the results, with COGTASKS showing no differences due to testing location and WAIS-IV showing substantial differences. There were, at best, weak correlations among tasks sharing the same name or claiming to measure the same construct. CONCLUSIONS Comparability of measures of cognition cannot be assumed, even if measures have the same name or claim to assess the same construct. In selecting and evaluating different measures, construct validity and underlying biological mechanisms need to be at least as important as population norms and the ability to connect with existing literatures.
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Affiliation(s)
- Michael J Wenger
- Department of Psychology, Cellular, and Behavioral Neurobiology, The University of Oklahoma, Norman, OK, USA
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Diane M DellaValle
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- Nutrition Science, King's College, Wilkes-Barre, PA, USA
| | - Lauren E Todd
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Amy L Barnett
- Department of Psychology, Cellular, and Behavioral Neurobiology, The University of Oklahoma, Norman, OK, USA
| | - Jere D Haas
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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15
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Threapleton DE, Snart CJP, Keeble C, Waterman AH, Taylor E, Mason D, Reid S, Azad R, Hill LJB, Meadows S, McKillion A, Alwan NA, Cade JE, Simpson NAB, Stewart PM, Zimmermann M, Wright J, Waiblinger D, Mon-Williams M, Hardie LJ, Greenwood DC. Maternal iodine status in a multi-ethnic UK birth cohort: Associations with child cognitive and educational development. Paediatr Perinat Epidemiol 2021; 35:236-246. [PMID: 32870514 DOI: 10.1111/ppe.12719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/17/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal iodine requirements increase during pregnancy to supply thyroid hormones critical for fetal neurodevelopment. Iodine insufficiency may result in poorer cognitive or child educational outcomes but current evidence is sparse and inconsistent. OBJECTIVES To quantify the association between maternal iodine status and child educational outcomes. METHODS Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6971 mothers at 26-28 weeks' gestation participating in the Born in Bradford cohort. Maternal iodine status was examined in relation to child school achievement (early years foundation stage (EYFS), phonics, and Key Stage 1 (KS1)), other learning outcomes, social and behavioural difficulties, and sensorimotor control in 5745 children aged 4-7 years. RESULTS Median (interquartile range) UIC was 76 µg/L (46, 120), and I:Cr was 83 µg/g (59, 121). Overall, there was no strong or consistent evidence to support associations between UIC or I:Cr and neurodevelopmental outcomes. For instance, predicted EYFS and phonics scores (primary outcomes) at the 25th vs 75th I:Cr percentiles (99% confidence intervals) were similar, with no evidence of associations: EYFS scores were 32 (99% CI 31, 33) and 33 (99% CI 32, 34), and phonics scores were 34 (99% CI 33, 35) and 35 (99% CI 34, 36), respectively. CONCLUSIONS In the largest single study of its kind, there was little evidence of detrimental neurodevelopmental outcomes in children born to pregnant women with iodine insufficiency as defined by World Health Organization-outlined thresholds. Alternative functional biomarkers for iodine status in pregnancy and focused assessment of other health outcomes may provide additional insight.
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Affiliation(s)
- Diane E Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Charles J P Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Claire Keeble
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | | | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Liam J B Hill
- School of Psychology, University of Leeds, Leeds, UK
| | - Sarah Meadows
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Amanda McKillion
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nisreen A Alwan
- Faculty of Medicine, School of Primary Care and Population Sciences, Southampton General Hospital, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Nigel A B Simpson
- Division of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, UK
| | - Paul M Stewart
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zürich, Switzerland
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Laura J Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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16
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Cohen Kadosh K, Muhardi L, Parikh P, Basso M, Jan Mohamed HJ, Prawitasari T, Samuel F, Ma G, Geurts JMW. Nutritional Support of Neurodevelopment and Cognitive Function in Infants and Young Children-An Update and Novel Insights. Nutrients 2021; 13:nu13010199. [PMID: 33435231 PMCID: PMC7828103 DOI: 10.3390/nu13010199] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022] Open
Abstract
Proper nutrition is crucial for normal brain and neurocognitive development. Failure to optimize neurodevelopment early in life can have profound long-term implications for both mental health and quality of life. Although the first 1000 days of life represent the most critical period of neurodevelopment, the central and peripheral nervous systems continue to develop and change throughout life. All this time, development and functioning depend on many factors, including adequate nutrition. In this review, we outline the role of nutrients in cognitive, emotional, and neural development in infants and young children with special attention to the emerging roles of polar lipids and high quality (available) protein. Furthermore, we discuss the dynamic nature of the gut-brain axis and the importance of microbial diversity in relation to a variety of outcomes, including brain maturation/function and behavior are discussed. Finally, the promising therapeutic potential of psychobiotics to modify gut microbial ecology in order to improve mental well-being is presented. Here, we show that the individual contribution of nutrients, their interaction with other micro- and macronutrients and the way in which they are organized in the food matrix are of crucial importance for normal neurocognitive development.
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Affiliation(s)
- Kathrin Cohen Kadosh
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK; (K.C.K.); (M.B.)
| | - Leilani Muhardi
- FrieslandCampina AMEA, Singapore 039190, Singapore; (L.M.); (P.P.)
| | - Panam Parikh
- FrieslandCampina AMEA, Singapore 039190, Singapore; (L.M.); (P.P.)
| | - Melissa Basso
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK; (K.C.K.); (M.B.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | - Titis Prawitasari
- Nutrition and Metabolic Diseases Working Group, Indonesian Pediatric Society, Jakarta 10310, Indonesia;
- Department of Pediatrics, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusomo National Referral Hospital Jakarta, Jakarta 10430, Indonesia
| | - Folake Samuel
- Department of Human Nutrition, University of Ibadan, Ibadan 200284, Nigeria;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China;
- Laboratory of Toxicological Research and Risk assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Jan M. W. Geurts
- FrieslandCampina, 3818 LE Amersfoort, The Netherlands
- Correspondence: ; Tel.: +31-6-53310499
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17
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Cromie KJ, Threapleton DE, Snart CJP, Taylor E, Mason D, Wright B, Kelly B, Reid S, Azad R, Keeble C, Waterman AH, Meadows S, McKillion A, Alwan NA, Cade JE, Simpson NAB, Stewart PM, Zimmermann M, Wright J, Waiblinger D, Mon-Williams M, Hardie LJ, Greenwood DC. Maternal iodine status in a multi-ethnic UK birth cohort: associations with autism spectrum disorder. BMC Pediatr 2020; 20:544. [PMID: 33276760 PMCID: PMC7718710 DOI: 10.1186/s12887-020-02440-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/22/2020] [Indexed: 11/27/2022] Open
Abstract
Background Maternal iodine requirements increase during pregnancy to supply thyroid hormones essential for fetal brain development. Maternal iodine deficiency can lead to hypothyroxinemia, a reduced fetal supply of thyroid hormones which, in the first trimester, has been linked to an increased risk of autism spectrum disorder (ASD) in the child. No study to date has explored the direct link between maternal iodine deficiency and diagnosis of ASD in offspring. Methods Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6955 mothers at 26–28 weeks gestation participating in the Born in Bradford (BiB) cohort. Maternal iodine status was examined in relation to the probability of a Read (CTV3) code for autism being present in a child’s primary care records through a series of logistic regression models with restricted cubic splines. Results Median (inter-quartile range) UIC was 76 μg/L (46, 120) and I:Cr was 83 μg/g (59, 121) indicating a deficient population according to WHO guidelines. Ninety two children (1·3%) in our cohort had received a diagnosis of ASD by the census date. Overall, there was no evidence to support an association between I:Cr or UIC and ASD risk in children aged 8–12 years (p = 0·3). Conclusions There was no evidence of an increased clinical ASD risk in children born to mothers with mild-to-moderate iodine deficiency at 26 weeks gestation. Alternative functional biomarkers of exposure and a wider range of conditions may provide further insight.
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Affiliation(s)
- Kirsten Jade Cromie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Diane Erin Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Charles Jonathan Peter Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Barry Wright
- The Hull York Medical School, University of York, Heslington, York, YO10 5DD, UK
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Claire Keeble
- Leeds Institute for Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Sarah Meadows
- Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Amanda McKillion
- Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janet Elizabeth Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Nigel A B Simpson
- Division of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Paul M Stewart
- Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, 8092, Zürich, Switzerland
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Laura J Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Darren Charles Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK. .,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
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18
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Iodine status of pregnant women with obesity from inner city populations in the United Kingdom. Eur J Clin Nutr 2020; 75:801-808. [PMID: 33184453 DOI: 10.1038/s41430-020-00796-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/14/2020] [Accepted: 10/26/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Iodine is essential for foetal neurodevelopment and growth. Requirements increase in pregnancy to support increased thyroid hormone synthesis for maternal and foetal requirements, and for foetal transfer. Iodine deficiency in pregnancy is widely reported, and obesity has been associated with sub-optimal thyroid function. We evaluated iodine status and its relation with birthweight in a secondary analysis of pregnant women with obesity from multi-ethnic inner-city settings who participated in the UK Pregnancies Better Eating and Activity trial (UPBEAT). SUBJECTS/METHODS Iodine and creatinine concentrations were evaluated in spot urine samples in the second (15+0-18+6 weeks, n = 954) trimester of pregnancy. We assessed iodine status as urinary iodine concentration (UIC) and urinary iodine-to-creatinine ratio (UI/Cr) and applied WHO/UNICEF/IGN population threshold of median UIC > 150 µg/L for iodine sufficiency. Relationships between iodine status and birthweight were determined using linear and logistic regression with appropriate adjustment, including for maternal BMI and gestational age. RESULTS Median (IQR) UIC and UI/Cr in the second trimester of pregnancy were 147 µg/L (99-257) and 97 µg/g (59-165), respectively. An UI/Cr <150 μg/g was observed in 70% of women. Compared to women with UI/Cr >150 µg/g, there was a trend for women with UI/Cr <150 µg/g to deliver infants with a lower birthweight (β = -60.0 g; 95% CI -120.9 to -1.01, P = 0.05). CONCLUSIONS Iodine status of pregnant women with obesity from this cohort of UK women was suboptimal. Lower iodine status was associated with lower birthweight.
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19
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Dolean D, Cãlugãr A. How Reliably Can We Measure a Child's True IQ? Socio-Economic Status Can Explain Most of the Inter-Ethnic Differences in General Non-verbal Abilities. Front Psychol 2020; 11:2000. [PMID: 32903767 PMCID: PMC7438872 DOI: 10.3389/fpsyg.2020.02000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/20/2020] [Indexed: 11/28/2022] Open
Abstract
Roma children have been discriminated against for many years as they are denied access to high-quality education based on their scores on general non-verbal IQ tests. Rushton et al. (2007) showed that Roma perform more poorly than non-Roma on one such test (i.e., Raven Progressive Matrices), but suggest that this underperformance could be explained by Roma’s low socio-economic status. In this paper, we tested the non-verbal abilities of Roma children and expanded on the research of Rushton et al. (2007) by investigating empirically the potential mediating effects of socio-economic status on children’s performance on Raven Progressive Matrices. Results showed that the performance of Roma children was, on average, significantly lower than the performance of their non-Roma peers; however, the effect of ethnicity was partially mediated by the parents’ education and living conditions (while the parents’ income had no significant effect). As hypothesized by Rushton et al. (2007) some socio-economic factors can explain important variability in the performance of Roma children on general non-verbal tests, and their poor performance on such tests may lead to an underestimation of the true population mean.
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Affiliation(s)
- Dacian Dolean
- Faculty of Psychology and Educational Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
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20
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The association of urine markers of iodine intake with development and growth among children in rural Uganda: a secondary analysis of a randomised education trial. Public Health Nutr 2020; 24:3730-3739. [PMID: 32654677 PMCID: PMC8369454 DOI: 10.1017/s1368980020001603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We examined associations of urine iodide excretion, proxy for iodine intake, with child development and growth. DESIGN This is a secondary analysis of a 1:1 cluster-randomised trial with a 6-month nutrition/stimulation/hygiene education intervention among mothers of children aged 6-8 months to improve child development and growth. Development was assessed using Bayley Scales of Infant and Toddler Development-III (BSID-III) and Ages and Stages Questionnaire (ASQ), whereas anthropometry was used to assess growth. Urine iodide concentration (UIC) and urine iodide/creatinine ratio (ICR) were measured. SETTING The current study was conducted in southern Uganda. PARTICIPANTS We randomly selected 155 children from the 511 enrolled into the original trial and analysed data when they were aged 20-24 and 36 months. RESULTS Median UIC for both study groups at 20-24 and 36 months were similar (P > 0·05) and within the normal range of 100-199 µg/l (0·79-1·60 µmol/l), whereas the intervention group had significantly higher ICR at 20-24 months. The BSID-III cognitive score was positively associated (P = 0·028) with ICR at 20-24 months in the intervention group. The ASQ gross motor score was negatively associated (P = 0·020) with ICR at 20-24 months among the controls. ICR was not significantly associated with anthropometry in the two study groups at either time-point. CONCLUSIONS Following the intervention, a positive association was noted between ICR and child's cognitive score at 20-24 months, whereas no positive association with ICR and growth was detected. Iodine sufficiency may be important for child's cognitive development in this setting.
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21
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Levie D, Bath SC, Guxens M, Korevaar TIM, Dineva M, Fano E, Ibarluzea JM, Llop S, Murcia M, Rayman MP, Sunyer J, Peeters RP, Tiemeier H. Maternal Iodine Status During Pregnancy Is Not Consistently Associated with Attention-Deficit Hyperactivity Disorder or Autistic Traits in Children. J Nutr 2020; 150:1516-1528. [PMID: 32171006 PMCID: PMC7269752 DOI: 10.1093/jn/nxaa051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/19/2019] [Accepted: 02/13/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Severe iodine deficiency during pregnancy can cause intellectual disability, presumably through inadequate placental transfer of maternal thyroid hormone to the fetus. The association between mild-to-moderate iodine deficiency and child neurodevelopmental problems is not well understood. OBJECTIVES We investigated the association of maternal iodine status during pregnancy with child attention-deficit hyperactivity disorder (ADHD) and autistic traits. METHODS This was a collaborative study of 3 population-based birth cohorts: Generation R (n = 1634), INfancia y Medio Ambiente (n = 1293), and the Avon Longitudinal Study of Parents and Children (n = 2619). Exclusion criteria were multiple fetuses, fertility treatment, thyroid-interfering medication use, and pre-existing thyroid disease. The mean age of assessment in the cohorts was between 4.4 and 7.7 y for ADHD symptoms and 4.5 and 7.6 y for autistic traits. We studied the association of the urinary iodine-to-creatinine ratio (UI/Creat) <150 μg/g-in all mother-child pairs, and in those with a urinary-iodine measurement at ≤18 weeks and ≤14 weeks of gestation-with the risk of ADHD or a high autistic-trait score (≥93rd percentile cutoff), using logistic regression. The cohort-specific effect estimates were combined by random-effects meta-analyses. We also investigated whether UI/Creat modified the associations of maternal free thyroxine (FT4) or thyroid-stimulating hormone concentrations with ADHD or autistic traits. RESULTS UI/Creat <150 μg/g was not associated with ADHD (OR: 1.2; 95% CI: 0.7, 2.2; P = 0.56) or with a high autistic-trait score (OR: 0.8; 95% CI: 0.6, 1.1; P = 0.22). UI/Creat <150 μg/g in early pregnancy (i.e., ≤18 weeks or ≤14 weeks of gestation) was not associated with a higher risk of behavioral problems. The association between a higher FT4 and a greater risk of ADHD (OR: 1.3; 95% CI: 1.0, 1.6; P = 0.017) was not modified by iodine status. CONCLUSIONS There is no consistent evidence to support an association of mild-to-moderate iodine deficiency during pregnancy with child ADHD or autistic traits.
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Affiliation(s)
- Deborah Levie
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands,Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children's Hospital, Rotterdam, Netherlands,ISGlobal, Barcelona, Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Sarah C Bath
- Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children's Hospital, Rotterdam, Netherlands,ISGlobal, Barcelona, Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Tim I M Korevaar
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands,Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Mariana Dineva
- Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom
| | - Eduardo Fano
- BIODONOSTIA, Health Research Institute, Donostia—San Sebastián, Spain,Faculty of Psychology, University of the Basque Country (UPV/EHU), Donostia—San Sebastián, Spain
| | - Jesús M Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain,BIODONOSTIA, Health Research Institute, Donostia—San Sebastián, Spain,Faculty of Psychology, University of the Basque Country (UPV/EHU), Donostia—San Sebastián, Spain,Basque Government Department of Health, Deputy Directorate of Public Health of Gipuzkoa, Donostia—San Sebastián, Spain
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain,Epidemiology and Environmental Health Joint Research Unit, FISABIO–Jaume I University–University of València, Valencia, Spain
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain,Epidemiology and Environmental Health Joint Research Unit, FISABIO–Jaume I University–University of València, Valencia, Spain
| | - Margaret P Rayman
- Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children's Hospital, Rotterdam, Netherlands,Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA,Address correspondence to HT (e-mail: )
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22
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Ellsworth L, McCaffery H, Harman E, Abbott J, Gregg B. Breast Milk Iodine Concentration Is Associated with Infant Growth, Independent of Maternal Weight. Nutrients 2020; 12:E358. [PMID: 32019065 PMCID: PMC7071233 DOI: 10.3390/nu12020358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
In breastfed infants, human milk provides the primary source of iodine to meet demands during this vulnerable period of growth and development. Iodine is a key micronutrient that plays an essential role in hormone synthesis. Despite the importance of iodine, there is limited understanding of the maternal factors that influence milk iodine content and how milk iodine intake during infancy is related to postnatal growth. We examined breast milk samples from near 2 weeks and 2 months post-partum in a mother-infant dyad cohort of mothers with pre-pregnancy weight status defined by body mass index (BMI). Normal (NW, BMI < 25.0 kg/m2) is compared to overweight/obesity (OW/OB, BMI ≥ 25.0 kg/m2). The milk iodine concentration was determined by inductively coupled plasma mass spectrometry. We evaluated the associations between iodine content at 2 weeks and infant anthropometrics over the first year of life using multivariable linear mixed modeling. Iodine concentrations generally decreased from 2 weeks to 2 months. We observed no significant difference in iodine based on maternal weight. A higher iodine concentration at 2 weeks was associated with a larger increase in infant weight-for-age and weight-for-length Z-score change per month from 2 weeks to 1 year. This pilot study shows that early iodine intake may influence infant growth trajectory independent of maternal pre-pregnancy weight status.
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Affiliation(s)
- Lindsay Ellsworth
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Harlan McCaffery
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Emma Harman
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Jillian Abbott
- Metals Laboratory, Division of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Brigid Gregg
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
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23
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Toloza FJK, Motahari H, Maraka S. Consequences of Severe Iodine Deficiency in Pregnancy: Evidence in Humans. Front Endocrinol (Lausanne) 2020; 11:409. [PMID: 32636808 PMCID: PMC7318882 DOI: 10.3389/fendo.2020.00409] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/21/2020] [Indexed: 11/13/2022] Open
Abstract
Iodine is a necessary micronutrient for the production of thyroid hormones and normal human development. Despite the significant worldwide strategies for the prevention and control of iodine deficiency, it is still a prevalent public health issue, especially in pregnant women. Severe iodine deficiency during pregnancy and neonatal period is associated with many major and irreversible adverse effects, including an increased risk of pregnancy loss and infant mortality, neonatal hypothyroidism, cretinism, and neuropsychomotor retardation. We will review the impact of severe iodine deficiency on maternofetal, neonatal, and offspring outcomes. We will also discuss its epidemiology, classification of iodine deficiency severity, and current recommendations to prevent iodine deficiency in childbearing age and pregnant women.
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Affiliation(s)
- Freddy J. K. Toloza
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Knowledge and Evaluation Research Unit in Endocrinology (KER-Endo), Rochester, MN, United States
| | - Hooman Motahari
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Knowledge and Evaluation Research Unit in Endocrinology (KER-Endo), Rochester, MN, United States
- Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
- *Correspondence: Spyridoula Maraka
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24
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Crozier SR, Godfrey KM, Calder PC, Robinson SM, Inskip HM, Baird J, Gale CR, Cooper C, Sibbons CM, Fisk HL, Burdge GC. Vegetarian Diet during Pregnancy Is Not Associated with Poorer Cognitive Performance in Children at Age 6-7 Years. Nutrients 2019; 11:nu11123029. [PMID: 31835868 PMCID: PMC6949927 DOI: 10.3390/nu11123029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022] Open
Abstract
Compared with omnivorous mothers, vegetarian mothers have lower intakes of some nutrients required for neurological development. However, there is a lack of information about the impact of vegetarianism during pregnancy on subsequent cognitive function in children. The aim of this study was to investigate whether vegetarianism during pregnancy is associated with altered maternal nutritional status and with cognitive function in children at six to seven years of age. Women aged 20–34 years participating in a prospective observational study who provided dietary data and blood samples in early pregnancy (11 weeks; 78 vegetarians and 2144 omnivores) or late pregnancy (34 weeks; 91 vegetarians and 2552 omnivores). Compared with omnivorous women, vegetarian women had lower blood concentrations of arachidonic acid, docosahexaenoic acid, and cobalamin in early and late pregnancy. Vegetarianism in pregnancy was linked to higher maternal educational attainment, longer breastfeeding duration, lower incidence of smoking during pregnancy and a tendency towards higher IQ in the mothers. Concentrations of some nutrients required for neurodevelopment were lower in maternal blood during gestation; however, after controlling for confounders consuming a vegetarian diet during pregnancy was not associated with poorer neurocognitive development of the children in this study.
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Affiliation(s)
- Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Philip C. Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sian M. Robinson
- AGE Research Group, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Catharine R. Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- Centre for Cognitive Ageing & Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh EH8 9AZ, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Charlene M. Sibbons
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Helena L. Fisk
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Graham C. Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Correspondence: ; Tel.: +44-(0)23-812-05259
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25
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Levie D, Korevaar TIM, Bath SC, Murcia M, Dineva M, Llop S, Espada M, van Herwaarden AE, de Rijke YB, Ibarluzea JM, Sunyer J, Tiemeier H, Rayman MP, Guxens M, Peeters RP. Association of Maternal Iodine Status With Child IQ: A Meta-Analysis of Individual Participant Data. J Clin Endocrinol Metab 2019; 104:5957-5967. [PMID: 30920622 PMCID: PMC6804415 DOI: 10.1210/jc.2018-02559] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/22/2019] [Indexed: 12/16/2022]
Abstract
CONTEXT Although the consequences of severe iodine deficiency are beyond doubt, the effects of mild to moderate iodine deficiency in pregnancy on child neurodevelopment are less well established. OBJECTIVE To study the association between maternal iodine status during pregnancy and child IQ and identify vulnerable time windows of exposure to suboptimal iodine availability. DESIGN Meta-analysis of individual participant data from three prospective population-based birth cohorts: Generation R (Netherlands), INMA (Spain), and ALSPAC (United Kingdom); pregnant women were enrolled between 2002 and 2006, 2003 and 2008, and 1990 and 1992, respectively. SETTING General community. PARTICIPANTS 6180 mother-child pairs with measures of urinary iodine and creatinine concentrations in pregnancy and child IQ. Exclusion criteria were multiple pregnancies, fertility treatment, medication affecting the thyroid, and preexisting thyroid disease. MAIN OUTCOME MEASURE Child nonverbal and verbal IQ assessed at 1.5 to 8 years of age. RESULTS There was a positive curvilinear association of urinary iodine/creatinine ratio (UI/Creat) with mean verbal IQ only. UI/Creat <150 µg/g was not associated with lower nonverbal IQ (-0.6 point; 95% CI: -1.7 to 0.4 points; P = 0.246) or lower verbal IQ (-0.6 point; 95% CI: -1.3 to 0.1 points; P = 0.082). Stratified analyses showed that the association of UI/Creat with verbal IQ was only present up to 14 weeks of gestation. CONCLUSIONS Fetal brain development is vulnerable to mild to moderate iodine deficiency, particularly in the first trimester. Our results show that potential randomized controlled trials investigating the effect of iodine supplementation in women with mild to moderate iodine deficiency on child neurodevelopment should begin supplementation not later than the first trimester.
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Affiliation(s)
- Deborah Levie
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, Netherlands
- Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, CA Rotterdam, Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, CB Rotterdam, Netherlands
- ISGlobal, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Tim I M Korevaar
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, Netherlands
- Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, CA Rotterdam, Netherlands
| | - Sarah C Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Mariana Dineva
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Mercedes Espada
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Basque Government, Parque Tecnológico de Bizkaia, Derio, Spain
| | - Antonius E van Herwaarden
- Department of Laboratory Medicine, Radboud University Nijmegen Medical Centre, GA Nijmegen, Netherlands
| | - Yolanda B de Rijke
- Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, CA Rotterdam, Netherlands
- Department of Clinical Chemistry, Erasmus University Medical Centre, CN Rotterdam, Netherlands
| | - Jesús M Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Sanidad Gobierno Vasco, Subdirección de Salud Pública de Guipúzcoa, Donostia – San Sebastián, Spain
- BIODONOSTIA Health Research Institute, Donostia – San Sebastián, Spain
- Faculty of Psychology, University of the Basque Country UPV/EHU, Donostia – San Sebastián, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, CB Rotterdam, Netherlands
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Margaret P Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, CB Rotterdam, Netherlands
- ISGlobal, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, CA Rotterdam, Netherlands
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26
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Gebreegziabher T, Woltamo T, Thomas DG, Kennedy TS, Stoecker BJ. Iodine supplementation of lactating women and assessment of infant visual information processing and maternal and infant thyroid function: A randomized trial. PLoS One 2019; 14:e0223348. [PMID: 31589645 PMCID: PMC6779247 DOI: 10.1371/journal.pone.0223348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
Iodine deficiency is one of the major causes of brain damage in childhood. However, iodine supplementation during early pregnancy and lactation can prevent the ill effects of iodine deficiency. This study evaluated maternal and infant thyroid function and infant visual information processing (VIP) in the context of maternal iodine supplementation. A community-based, randomized, supplementation trial was conducted. Mother infant dyads (n = 106) were enrolled within the first 10 days after delivery to participate in this study. Mothers were randomly assigned either to receive a potassium iodide capsule (225 μg iodine) daily for 26 weeks or iodized salt weekly for 26 weeks. Maternal thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), thyroglobulin (Tg), urinary iodine concentration (UIC), breast milk iodine concentration (BMIC) and infant T4, TSH, UIC and VIP were measured as outcome variables. At baseline, neither mothers nor infants in the two groups were significantly different in any of the biomarkers or anthropometric measurements. Maternal TSH and goiter prevalence significantly decreased following iodine supplementation. The percentage of infants who preferentially remembered the familiar face was 26% in the capsule and 51% in the I-salt groups. Infant sex, length for age Z score, BMIC, maternal education and household food security were strong predictors of novelty quotient. In conclusion supplementation daily for six months with an iodine capsule or the use of appropriately iodized salt for an equivalent time was sufficient to reduce goiter and TSH in lactating women. Higher BMIC and LAZ as well as better household food security, maternal education, and male sex predicted higher novelty quotient scores in the VIP paradigm.
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Affiliation(s)
- Tafere Gebreegziabher
- Department of Health Sciences, Central Washington University, Ellensburg, WA, United States of America
| | - Tesfaye Woltamo
- School of Environment, Gender, and Development Studies, Hawassa University, Hawassa, Ethiopia
| | - David G. Thomas
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States of America
| | - Tay S. Kennedy
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | - Barbara J. Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
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27
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Hay I, Hynes KL, Burgess JR. Mild-to-Moderate Gestational Iodine Deficiency Processing Disorder. Nutrients 2019; 11:E1974. [PMID: 31443337 PMCID: PMC6770179 DOI: 10.3390/nu11091974] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 12/28/2022] Open
Abstract
This synopsis paper aims to identify if a common pattern of learning and social difficulties can be conceptualized across recent longitudinal studies investigating the influence of mild-to-moderate gestational iodine deficiency (GID) on offspring's optimal cognitive and psycho-social development. The main studies investigated are: The Southampton Women's Study (SWS)-United Kingdom; the Avon Longitudinal Study of Parents and Children (ALSPAC)-United Kingdom; the Gestational Iodine Cohort Longitudinal Study-Tasmania, Australia, and the Danish National Birth Cohort Case-Control Study-Denmark. In contrast to severe GID where there is a global negative impact on neurodevelopment, mild-to-moderate intrauterine iodine deficiency has subtler, but nonetheless important, permanent cognitive and psycho-social consequences on the offspring. This paper links the results from each study and maintains that mild-to-moderate GID is associated with a disorder that is characterized by speed of neural transmitting difficulties that are typically associated with working memory capacity difficulties and attention and response inhibition. The authors maintain that this disorder is better identified as Gestational Iodine Deficiency Processing Disorder (GIDPD), rather than, what to date has often been identified as 'suboptimal development'. The Autistic Spectrum Disorder (ASD), Attention Deficit, Hyperactivity Disorder (ADHD), language and literacy disorders (learning disabilities and dyslexia) are the main manifestations associated with GIDPD. GIDPD is identified on IQ measures, but selectively and mainly on verbal reasoning IQ subtests, with individuals with GIDPD still operating within the 'normal' full-scale IQ range. Greater consideration needs to be given by public health professionals, policy makers and educators about the important and preventable consequences of GID. Specifically, more emphasis should be placed on adequate iodine intake in women prior to pregnancy, as well as during pregnancy and when lactating. Secondly, researchers and others need to further extend, refine and clarify whether GIDPD, as a nosological (medical classification) entity, is a valid disorder and concept for consideration.
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Affiliation(s)
- Ian Hay
- Faculty of Education, University of Tasmania, Launceston 7250, Australia.
| | - Kristen L Hynes
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7001, Australia
| | - John R Burgess
- Department of Endocrinology, Royal Hobart Hospital, Hobart 7001, Australia
- School of Medicine, University of Tasmania, Hobart 7000, Australia
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28
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Women Remain at Risk of Iodine Deficiency during Pregnancy: The Importance of Iodine Supplementation before Conception and Throughout Gestation. Nutrients 2019; 11:nu11010172. [PMID: 30650544 PMCID: PMC6356319 DOI: 10.3390/nu11010172] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/22/2018] [Accepted: 01/01/2019] [Indexed: 12/17/2022] Open
Abstract
In Australia, pregnant women are advised to take an iodine supplement (I-supp) (150 µg/day) to reduce risks to the foetus associated with iodine deficiency (ID). To examine the impact of this recommendation on iodine status, and to identify factors that contribute to adequacy during gestation, supplement use and Urinary Iodine Concentration (UIC) was measured in 255 pregnant women (gestation range 6 to 41 weeks) in Tasmania. The median UIC (MUIC) of 133 µg/L (Inter-quartile range 82–233) was indicative of ID, being below the 150–249 µg/L range for adequacy during pregnancy. Women taking an iodine-containing-supplement (I-supp) had a significantly higher MUIC (155 µg/L) (n = 171) compared to the combined MUIC (112.5 µg/L) (n = 84) of those who had never (120 µg/L) (n = 61) or were no longer taking an I-supp (90 µg/L) (n = 23) (p = 0.017). Among women reporting I-supp use, the MUIC of those commencing the recommended 150 µg/day prior to conception was significantly higher than those starting supplementation following pregnancy confirmation: 196 (98–315) µg/L (n = 45) versus 137.5 (82.5–233.5) µg/L (n = 124), p = 0.032. Despite recommendations for iodine supplementation pregnant Tasmanian women remain at risk of ID. Commencing an I-supp of 150 µg/day prior to conception and continuing throughout pregnancy is required to ensure adequacy. Timely advice regarding the importance of adequate iodine nutrition, including supplementation is needed to reduce the risk of irreversible in utero neurocognitive damage to the foetus.
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Abstract
It is well known that severe iodine deficiency during pregnancy may cause impaired brain development in the child, with effects on cognitive and motor function, hearing and speech. Whether mild-to-moderate deficiency also affects neurological development is less well known, but in the past decade a number of observational studies have been conducted to answer this question and these studies are reviewed in this article. The picture is now emerging that even mild-to-moderate iodine deficiency during pregnancy may be associated with subtle impairments in cognition and school performance, although the evidence from randomised controlled trials is still lacking. As global efforts to eradicate iodine deficiency in populations continue, it is more likely that mild-to-moderate, rather than severe, iodine deficiency will be the issue of concern in pregnancy, and therefore further research in regions of mild-to-moderate deficiency is required to strengthen the research base and to inform public-health policy.
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Maternal Iodine Status is Associated with Offspring Language Skills in Infancy and Toddlerhood. Nutrients 2018; 10:nu10091270. [PMID: 30205599 PMCID: PMC6163597 DOI: 10.3390/nu10091270] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 01/01/2023] Open
Abstract
Inadequate iodine status affects the synthesis of the thyroid hormones and may impair brain development in fetal life. The aim of this study was to explore the association between maternal iodine status in pregnancy measured by urinary iodine concentration (UIC) and child neurodevelopment at age 6, 12 and 18 months in a population-based cohort. In total, 1036 families from nine locations in Norway were enrolled in the little in Norway cohort. The present study includes n = 851 mother-child pairs with singleton pregnancies, no use of thyroid medication in pregnancy, no severe genetic disorder, data on exposure (UIC) in pregnancy and developmental outcomes (Bayley Scales of Infant and Toddler Development, third edition). Data collection also included general information from questionnaires. We examined associations between UIC (and use of iodine-containing supplements) and repeated measures of developmental outcomes using multivariable mixed models. The median UIC in pregnancy was 78 µg/L (IQR 46⁻130), classified as insufficient iodine intake according to the WHO. Eighteen percent reported use of iodine-containing multisupplements. A UIC below ~100 was associated with reduced receptive (p = 0.025) and expressive language skills (p = 0.002), but not with reduced cognitive or fine- and gross motor skills. Maternal use of iodine-containing supplements was associated with lower gross motor skills (b = -0.18, 95% CI = -0.33, -0.03, p = 0.02), but not with the other outcome measures. In conclusion, an insufficient iodine intake in pregnancy, reflected in a UIC below ~100 µg/L, was associated with lower infant language skills up to 18 months. The use of iodine-containing supplements was not associated with beneficial effects.
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