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Glover A, Hayes HE, Ni H, Raikos V. A comparison of the nutritional content and price between dairy and non-dairy milks and cheeses in UK supermarkets: A cross sectional analysis. Nutr Health 2024; 30:157-165. [PMID: 35695231 PMCID: PMC10924701 DOI: 10.1177/02601060221105744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Non-Dairy (ND) food consumption is rapidly increasing in the UK and for many consumers plant-based diets are presumed to be healthier than standard diets. ND alternatives have different nutritional compositions, and their consumption could present challenges on a public-health level. Aim: To compare the price and nutritional composition of dairy and ND milks and cheeses in UK supermarkets. Methods: Macro and micronutrient data was recorded from Alpro's website and the 6 leading UK grocers for their own-label ND milks and cheeses. For missing micronutrient values the McCance & Widdowson's dataset was used. 99 total products were extracted: 57 ND milks, 7 dairy milks, 10 dairy cheeses and 25 ND cheeses. Dairy milk and cheese were used as control against which all ND products were compared. Results: Soya and coconut milks had lower values of carbohydrates, sugars, calcium, iodine, and potassium (p < 0.01) than dairy. Almond milk had lower values of carbohydrates (p = 0.01), sugars, calcium, iodine, and potassium (p < 0.01) compared to dairy milk. Protein was significantly (p < 0.01) lower for all ND except soya. Dairy cheeses had higher values for energy, protein, iodine, potassium, riboflavin, vitamin B12 and calcium (p < 0.01) than ND. Median prices were similar between dairy and ND milks, whereas ND cheeses were significantly more expensive compared to dairy (p < 0.01). Conclusions: ND alternatives fall short in several key nutrients compared to dairy. Fortification, accurate labelling and nutrition education are needed to help consumers make healthy and informed choices.
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Affiliation(s)
- Alex Glover
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
| | - Helen E. Hayes
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
| | - He Ni
- Guangdong Provincial Key Lab of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Vassilios Raikos
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
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2
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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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3
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Cannas A, Rayman MP, Kolokotroni O, Bath SC. Iodine status of pregnant women from the Republic of Cyprus. Br J Nutr 2023; 129:126-134. [PMID: 35236523 PMCID: PMC9816652 DOI: 10.1017/s0007114522000617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 01/21/2023]
Abstract
Iodine supply is crucial during pregnancy to ensure that the proper thyroid function of mother and baby support fetal brain development. Little is known about iodine status or its dietary determinants in pregnant women in the Republic of Cyprus. We therefore recruited 128 pregnant women at their first-trimester ultrasound scan to a cross-sectional study. We collected spot-urine samples for the measurement of urinary iodine concentration (UIC, µg/l) and creatinine concentration (Creat, g/l), the latter of which allows us to correct for urine dilution and to compute the iodine-to-creatinine ratio (UI/Creat). Women completed a FFQ and a general questionnaire. We used a General Linear model to explore associations between maternal and dietary characteristics with UI/Creat. The median UIC (105 µg/l) indicated iodine deficiency according to the WHO criterion (threshold for adequacy = 150 µg/l), and the UI/Creat was also low at 107 µg/g. Only 32 % (n 45) of women reported the use of iodine-containing supplements; users had a higher UI/Creat than non-users (131 µg/g v. 118 µg/g), though this difference was NS in the adjusted analysis (P = 0·37). Of the dietary components, only egg intake was significantly associated with a higher UI/Creat in adjusted analyses (P = 0·018); there was no significant association with milk, dairy products or fish intake. Our results suggest that pregnant women in Cyprus have inadequate iodine status and are at risk of mild-to-moderate iodine deficiency. Further research on dietary sources in this population is required.
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Affiliation(s)
- Andrea Cannas
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Margaret P. Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Ourania Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia, Medical School, Nicosia, 1700, Cyprus
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
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Pregnant Dutch Women Have Inadequate Iodine Status and Selenium Intake. Nutrients 2022; 14:nu14193936. [PMID: 36235589 PMCID: PMC9572179 DOI: 10.3390/nu14193936] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Iodine and selenium are essential for thyroid hormone synthesis. Iodine and selenium interact. Pregnancy increases the maternal iodine requirement. We previously reported inadequate iodine status in pregnant Dutch women. Since little is known about their selenium intake, we investigated the iodine status and selenium intake in relation to iodine and selenium supplement use during pregnancy. Iodine status was established in 201 apparently healthy pregnant women as 24 h iodine excretion (24H-UIE; sufficient if median ≥225 µg), iodine concentration (24H-UIC; ≥150 µg/L) and iodine/creatinine ratio (24H-UICR; ≥150 µg/g). Selenium intake was calculated from 24 h selenium excretion. Iodine status in pregnancy proved insufficient (medians: 24H-UIE 185 µg; 24H-UIC 95 µg/L; 24H-UICR 141 µg/g). Only women taking 150 µg iodine/day were sufficient (median 24H-UIE 244 µg). Selenium intake was below the Estimated Average Requirement (EAR; 49 µg/day) in 53.8%, below the Recommended Dietary Allowance (RDA; 60 µg/day) in 77.4% and below the Adequate Intake (AI; 70 µg/day) in 88.7%. Combined inadequate iodine status and selenium intake <RDA was found in 61%. Women who want to become pregnant should, consistently with WHO and ETA recommendations, be advised to use a 150 µg iodine-containing supplement. Concomitant selenium supplementation should be added to this advice, at least in The Netherlands.
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Contribution of base diet, voluntary fortified foods and supplements to micronutrient intakes in the UK. J Nutr Sci 2022; 11:e51. [PMID: 35836696 PMCID: PMC9241063 DOI: 10.1017/jns.2022.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of the present study was to evaluate the contribution of voluntary fortified foods and supplements to reducing micronutrient shortfalls in the UK population. A secondary analysis of the UK National Diet and Nutrition Survey was conducted (2012/13–2013/14, N 2546, 1·5–95 years). Micronutrient intakes were derived from food consumption intake data and food composition data and calculated as the proportion below or above the Dietary Reference Values for males and females of different age groups, for those on a base diet only, users of fortified foods but no supplements and users of fortified foods and supplements. Of the population consuming a base diet only, 21–45 % and 5–29 % fell below the Estimated Average Requirement (EAR) for minerals and vitamins, respectively. About 3–13 % fewer consumers of fortified foods fell below the EAR for vitamins and minerals. Supplements barely reduced the prevalence of intakes below the EAR. Among supplement non-users and users, 99 and 96 % failed to meet the reference intakes for vitamin D. More women than men were at risk of inadequacies of micronutrient intakes. The prevalence of inadequacies declined with increasing age. Voluntary fortified foods but not supplements made a meaningful contribution to intakes of vitamin and minerals, without risk of unacceptably high intakes. These insights may help the UK to define approaches to address micronutrients of concern in vulnerable groups.
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Mullan K, McMullan P, Kayes L, McCance D, Hunter A, Woodside JV. Thyroglobulin levels among iodine deficient pregnant women living in Northern Ireland. Eur J Clin Nutr 2022; 76:1542-1547. [PMID: 35513447 DOI: 10.1038/s41430-022-01144-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Iodine deficiency has re-emerged among pregnant cohorts in the UK. Thyroglobulin (Tg) is a protein produced uniquely by the thyroid gland which appears to mount a U-shaped response to extremes of iodine status. Tg has been suggested as an alternative marker for chronic iodine deficiency but the value of Tg in pregnancy has not been fully elucidated. A recent non-European study suggested a median Tg ≤10 µg/L with <3% of values >44 µg/L was indicative of sufficiency in the second trimester of pregnancy. METHODS We measured serum Tg levels in each trimester in 241 pregnant women living in Northern Ireland, a population with mild iodine deficiency at all stages of pregnancy as defined by urinary iodine concentration (UIC) and iodine: creatinine ratio (ICR). Women with Tg antibodies (6% in 1st trimester) were excluded. RESULTS The median UIC in this cohort was in the deficient range at 73, 94 and 117 µg/L in sequential trimesters (adequacy ≥ 150 µg/L). Corresponding median Tg levels were 19, 16 and 16 µg/L respectively. Median Tg for all samples was 17 μg/L (IQR 11-31) suggestive of iodine deficiency. Tg was >44 μg/L in 14.3%, 9.4% and 12.4% of women in sequential trimesters respectively. Women with either UIC/ICR below the cut-offs 150 µg/L and 150 µg/g creatinine had higher Tg concentrations in 1st and 2nd trimester (p < 0.01; p < 0.001) but not in 3rd trimester. CONCLUSION This study adds to the evolving evidence that Tg measurement is of value in reflecting iodine status in pregnancy.
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Affiliation(s)
- Karen Mullan
- Royal Victoria Hospital (Regional Centre for Endocrinology and Diabetes), Belfast, Antrim, UK
| | - Paul McMullan
- Royal Victoria Hospital (Regional Centre for Endocrinology and Diabetes), Belfast, Antrim, UK
| | - Lucy Kayes
- Royal Victoria Hospital (Regional Centre for Endocrinology and Diabetes), Belfast, Antrim, UK.
| | - David McCance
- Royal Victoria Hospital (Regional Centre for Endocrinology and Diabetes), Belfast, Antrim, UK
| | - Alyson Hunter
- Royal Jubilee Maternity Hospital, Royal Victoria Hospital, Belfast, Antrim, UK
| | - Jayne V Woodside
- Centre for Public Health, Institute of Clinical Science, Queens University Belfast, Belfast, UK
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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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Chen X, Wu C, Wang Z, Wu C, Guo Y, Zhu X, Hu YP, Shi Z, Song Q, Cui X, Su J, Zang J. Iodine nutrition status and thyroid autoimmunity during pregnancy: a cross-sectional study of 4635 pregnant women. Nutr J 2022; 21:7. [PMID: 35093086 PMCID: PMC8801104 DOI: 10.1186/s12937-022-00760-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Pregnant women in Shanghai have long been at risk for mild iodine deficiency. Because thyroid autoimmunity in pregnant women can lead to premature birth and miscarriage as well as neurodevelopmental deficits in the fetus, the aim of this study was to explore the association of iodine nutrition status with thyroid antibodies during pregnancy. METHODS A pregnancy-birth cohort was conducted including 4635 pregnant women in Shanghai, China. The eligible participants underwent a face-to-face interview and completed questionnaire surveys to collect baseline information and diet intake. Spot urine samples were collected to test urine iodine. Thyroid antibodies including thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and thyrotrophic antibodies (TRAb) were tested. Single-factor analysis and logistic regression were used to evaluate the association between iodine status and thyroid autoimmunity during pregnancy. RESULTS The median urinary iodine excretion level in the sample was 138.14 μg/L (interquartile range [IQR] 80.90-219.00 μg/L). Among all the subjects, 25.9% consumed non-iodized salt, 54.5% had iodine deficiency, and 31.0% had thyroid autoimmunity. The proportion of patients with iodine deficiency was significantly higher among those who consumed non-iodized salt (36.9% vs. 33.1%; p = 0.04). After adjusting for age, educational status, former smoker status, former drinker status, first pregnancy, and previous thyroid disease, non-iodized salt (odds ratio [OR] = 1.394 [confidence interval, CI, 1.165-1.562]; p = 0.003), iodine-rich food (OR = 0.681 [CI 0.585-0.793]; p = 0.003), iodized nutritional supplements (OR = 0.427 [CI 0.347-0.526]; p = 0.003), were found to be individually associated with thyroid autoimmunity in all participants. The results of the multivariable restricted cubic spline regression analysis showed a non-linear relationship between the continuous change in iodine intake and thyroid autoimmunity (p = 0.019). Participants with iodine deficiency (urinary iodine concentration, UIC,< 100 μg/L) had an increased risk of testing positive for thyroid antibodies (TPOAb/TgAb/TRAb[+]; OR = 1.324 [CI 1.125-1.559]; p < 0.001). Moreover, this associated existed even after removing participants with previous thyroid disease. CONCLUSION Inadequate iodine nutrition in pregnant women is an independent risk factor for thyroid autoimmunity in Shanghai. It's important to maintain the adequate iodine status in pregnant women.
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Affiliation(s)
- Xiao Chen
- Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, 200033 China
| | - Chunfeng Wu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Zhengyuan Wang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Chunxiang Wu
- Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, 200033 China
| | - Yan Guo
- Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, 200033 China
| | - Xiaoxia Zhu
- Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, 200033 China
| | - Yan Ping Hu
- Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, 200033 China
| | - Zehuan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Qi Song
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Xueying Cui
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Jin Su
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Jiajie Zang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
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9
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HPLC Analysis of the Urinary Iodine Concentration in Pregnant Women. Molecules 2021; 26:molecules26226797. [PMID: 34833891 PMCID: PMC8619590 DOI: 10.3390/molecules26226797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022] Open
Abstract
Iodine is an essential component for fetal neurodevelopment and maternal thyroid function. Urine iodine is the most widely used indicator of iodine status. In this study, a novel validated ion-pair HPLC-UV method was developed to measure iodine concentration in clinical samples. A sodium thiosulfate solution was added to the urine sample to convert the total free iodine to iodide. Chromatographic separation was achieved in a Pursuit XRs C8 column. The mobile phase consisted of acetonitrile and a water phase containing 18-crown-6-ether, octylamine and sodium dihydrogen phosphate. Validation parameters, such as accuracy, precision, limits of detection and quantification, linearity and stability, were determined. Urinary samples from pregnant women were used to complete the validation and confirm the method's applicability. In the studied population of 93 pregnant women, the median UIC was lower in the group without iodine supplementation (117 µg/L, confidence interval (%CI): 95; 138) than in the supplement group (133 µg/L, %CI: 109; 157). In conclusion, the newly established ion-pair HPLC-UV method was adequately precise, accurate and fulfilled validation the criteria for analyzing compounds in biological fluids. The method is less complicated and expensive than other frequently used assays and permits the identification of the iodine-deficient subjects.
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10
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Threapleton DE, Waiblinger D, Snart CJ, Taylor E, Keeble C, Ashraf S, Bi S, Ajjan R, Azad R, Hancock N, Mason D, Reid S, Cromie KJ, Alwan NA, Zimmermann M, Stewart PM, Simpson NA, Wright J, Cade JE, Hardie LJ, Greenwood DC. Prenatal and Postpartum Maternal Iodide Intake from Diet and Supplements, Urinary Iodine and Thyroid Hormone Concentrations in a Region of the United Kingdom with Mild-to-Moderate Iodine Deficiency. Nutrients 2021; 13:nu13010230. [PMID: 33466826 PMCID: PMC7830764 DOI: 10.3390/nu13010230] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Iodine is essential for normal thyroid function, supporting healthy fetal and child development. Iodine requirements increase in pregnancy, but many women in regions without salt iodization have insufficient intakes. We explored associations between iodide intake and urinary iodine concentration (UIC), urinary iodine/creatinine ratio (I/Cr), thyroid stimulating hormone, thyroglobulin, free triiodothyronine, free thyroxine and palpable goiter in a region of mild-to-moderate iodine insufficiency. A total of 246 pregnant women aged 18–40 in Bradford, UK, joined the Health and Iodine in Babies (Hiba) study. They provided detailed information on diet and supplement use, urine and serum samples and were assessed for goiter at around 12, 26 and 36 weeks’ gestation, and 6, 18 and 30 weeks postpartum. Dietary iodide intake from food and drink was estimated using six 24 h recalls. During pregnancy, median (IQR) dietary iodide intake was 101 µg/day (54, 142), with 42% from dairy and 9% from white fish. Including supplements, intake was 143 µg/day (94, 196), with 49% < UK reference nutrient intake (140 µg/day). Women with Pakistani heritage had 129 µg/day (87, 190) median total intake. Total intake during pregnancy was associated with 4% (95% CI: 1%, 7%) higher UIC, 5% (3%, 7%) higher I/Cr, 4% (2%, 6%) lower thyroglobulin and 21% (9%, 32%) lower odds of palpable goiter per 50 µg/day. This cohort consumed less iodide in pregnancy than UK and World Health Organization dietary recommendations. UIC, I/Cr and thyroglobulin were associated with intake. Higher intake was associated with fewer goiters. Because dairy was the dominant source of iodide, women following plant-based or low-dairy diets may be at particular risk of iodine insufficiency.
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Affiliation(s)
- Diane E. Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Charles J.P. Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
| | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
| | - Claire Keeble
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
| | - Samina Ashraf
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Shazia Bi
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Ramzi Ajjan
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Neil Hancock
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.H.); (J.E.C.)
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds LS2 9JT, UK;
| | - Kirsten J. Cromie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
| | - Nisreen A. Alwan
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland;
| | - Paul M. Stewart
- Faculty of Medicine and Health, 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;
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; (D.W.); (S.A.); (S.B.); (R.A.); (D.M.); (J.W.)
| | - Janet E. Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.H.); (J.E.C.)
| | - Laura J. Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
| | - Darren C. Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (D.E.T.); (C.J.P.S.); (E.T.); (C.K.); (R.A.); (K.J.C.); (L.J.H.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
- Correspondence: ; Tel.: +44-(0)11-3343-1813
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11
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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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Yu Z, Zheng C, Zheng W, Wan Z, Bu Y, Zhang G, Ding S, Wang E, Zhai D, Ma ZF. Mild-to-moderate iodine deficiency in a sample of pregnant women and salt iodine concentration from Zhejiang province, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:3811-3818. [PMID: 32596780 DOI: 10.1007/s10653-020-00640-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
Since 2011, Zhejiang province has eliminated iodine deficiency disorders (IDD) in its populations. Following this achievement, a new revised iodine concentration in iodised salt was implemented in Zhejiang in 2012. However, the re-emergence of iodine deficiency has been reported in pregnant women. Therefore, the aim of this study was to assess household salt iodine concentration and iodine status of pregnant women in Zhejiang province, China. We conducted a cross-sectional study between April 2018 and August 2018 in Quzhou, Zhejiang province. Pregnant women aged ≥ 18 years who did not have a history of thyroid disease were recruited into the study. They were asked to complete socio-demographic questionnaires including a food frequency questionnaire (FFQ). In addition, a spot urine sample and a household table salt sample were also provided by each participant. A total of 625 pregnant women agreed to participate. The overall median urinary iodine concentration (UIC) was 130 µg/L, indicating mild-to-moderate iodine deficiency in pregnant women. The coverage of iodised salt was 85.2%, and of these, the rate of adequately iodised salt was 98.1%. In conclusion, our results confirmed the re-emergence of iodine deficiency in pregnant women as reported by other studies conducted in Zhejiang province. Therefore, urgent public health actions are needed to improve iodine status of pregnant women in order to prevent the adverse consequences of IDD on the neurodevelopment of foetus.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Wangfeng Zheng
- Quzhou Hospital of Traditional Chinese Medicine, 117 Quhua Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
- School of Public Health, Soochow University, Suzhou, 215123, People's Republic of China
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Erhui Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, People's Republic of China.
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Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population? Public Health Nutr 2020; 23:2467-2477. [PMID: 32476639 DOI: 10.1017/s1368980020000403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The monitoring of the populations' iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland. DESIGN The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women). SETTING The study was conducted in 2017 within the National Health Programme in five regions of Poland. PARTICIPANTS The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6-12 years). RESULTS In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l. CONCLUSIONS Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.
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Gargari SS, Fateh R, Bakhshali-Bakhtiari M, Saleh M, Mirzamoradi M, Bakhtiyari M. Maternal and neonatal outcomes and determinants of iodine deficiency in third trimester of pregnancy in an iodine sufficient area. BMC Pregnancy Childbirth 2020; 20:174. [PMID: 32188421 PMCID: PMC7079485 DOI: 10.1186/s12884-020-02863-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 03/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mild to moderate iodine deficiency in pregnant women may expose them to the increased risk of the development of goiter and thyroid disorder. There is a relationship between low maternal UIC (Urinary iodine concentration) in pregnancy and diminished placental weight and neonatal head circumference. The current study was an attempt to assess iodine nutritional status, its determinants and relationship with maternal and neonatal outcomes. METHODS In this population based cross-sectional study, which was conducted from April 2017 to September 2018, information was collected from 884 women of 20-45 years old who referred for periodic pregnancy visits. UIC was measured in random urine samples by applying a manual method which was based on the Sandell-Kolthoff technique. Information related to neonatal and maternal complications was collected from the individuals enrolled in the study through systematic follow-ups of the research team in each hospitals and the referral of trained midwives to the place of delivery and the retrieval of the case files. RESULTS The results showed that out of 884 participants 838 (94.8%) had a urinary iodine concentration of more than 150 micrograms/litre and 46 (5.2%) showed urinary iodine concentrations less than 150 micrograms/litre. The median (IQR) urinary iodine concentration in the third trimester was 176 (165-196) μg/l. According to the WHO criteria 46 of the participants (5.2%) had insufficient urinary iodine concentrations, 805 (91.06%) had adequate urinary iodine concentrations while 33 (3.73%) showed more than adequate levels. There were no participants with urinary iodine concentrations higher than 500 micrograms/litre. The main influencing factors on maternal iodine deficiency in this study were weight gain during pregnancy (Odds Ratio (OR) =0.88, 95% CI: 0.82-0.95), number of previous pregnancy (OR = 0.59, 95% CI: 0.39-0.89) the interval between the most recent pregnancies (OR = 0.78, 95% CI: 0.64-0.95), whether or not the pregnancy has been Planned (OR = 2.92, 95% CI: 1.29-6.58) and nutritional complement consumption (OR = 3.64, 95% CI: 1.44-9.1). The need for a neonatal intensive care unit (NICU) admission (OR = 4.64, 95% CI: 1.81-11.9) and preterm birth (OR = 3.29, 95% CI: 1.51-7.1) were significantly related with maternal iodine deficiency before delivery. Also there is no significant differences regarding the mean maternal urinary iodine concentration between the normal and different maternal complications groups (p = 0.47). CONCLUSION Iodine deficiency in pregnant women can be improved by appreciate planning for pregnancy, proper inter-pregnancy time interval (> 12 months to < 5 years), appropriate nutrition during pregnancy. Besides, controlling maternal urinary iodine concentrations is important to prevent neonatal complications such as preterm delivery and NICU admission.
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Affiliation(s)
- Soraya Saleh Gargari
- Department of Gynecology & Obstetrics, Shohada Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Fateh
- Department of Gynecology & Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Bakhshali-Bakhtiari
- Department of Gynecology & Obstetrics, Shohada Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Saleh
- Department of Gynecology & Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mirzamoradi
- Department of Gynecology & Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
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15
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Mullan K, Hamill L, Doolan K, Young I, Smyth P, Flynn A, Walton J, Meharg AA, Carey M, McKernan C, Bell M, Black N, Graham U, McCance D, McHugh C, McMullan P, McQuaid S, O'Loughlin A, Tuthill A, Bath SC, Rayman M, Woodside JV. Iodine status of teenage girls on the island of Ireland. Eur J Nutr 2019; 59:1859-1867. [PMID: 31321499 DOI: 10.1007/s00394-019-02037-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/29/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Karen Mullan
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital Belfast, Belfast, Ireland.
| | | | | | | | | | | | | | | | | | | | | | | | - Una Graham
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital Belfast, Belfast, Ireland
| | - David McCance
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital Belfast, Belfast, Ireland
| | | | - Paul McMullan
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital Belfast, Belfast, Ireland
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Chen Y, Chen W, Du C, Fan L, Wang W, Gao M, Zhang Y, Cui T, Hao Y, Pearce EN, Wang C, Zhang W. Iodine Nutrition and Thyroid Function in Pregnant Women Exposed to Different Iodine Sources. Biol Trace Elem Res 2019; 190:52-59. [PMID: 30280309 DOI: 10.1007/s12011-018-1530-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
Pregnant women are more vulnerable to iodine deficiency and iodine excess. The study aimed to assess the changes in iodine nutrition and thyroid function of pregnant women exposed to different iodine sources resulting in various iodine intakes during pregnancy. From 2016 to 2017, 2004 healthy pregnant women aged 20-35 years from Shandong and Tianjin, China, were enrolled. Urinary iodine concentration (UIC), drinking water iodine content (WIC), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroglobulin (Tg), serum thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. Pregnant women in both Shandong and Tianjin were iodine sufficient, but the median UIC in pregnant women was significantly higher in Shandong (244 μg/L) than that in Tianjin (159 μg/L). No differences were found in UIC over the course of gestation in Shandong. In Tianjin, the UIC decreased during 13-24 weeks and stabilized thereafter. Compared with Tianjin, TSH levels were higher and FT3 and FT4 levels were lower in Shandong. Both FT3 and FT4 significantly decreased during pregnancy in Shandong and Tianjin. TSH and Tg increased over the course of gestation in both Shandong and Tianjin. The iodine status of pregnant women in Tianjin and Shandong were sufficient, but different changing patterns in UIC and thyroid function during pregnancy were presented. More attention should be focused on iodine nutrition of pregnant women, even in iodine-sufficient areas.
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Affiliation(s)
- Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Cong Du
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Lili Fan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Wei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Yixin Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Yunmeng Hao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, USA
| | - Chongdan Wang
- Department of Obstetrics, Tanggu Maternity Hospital, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China.
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Maternal Iodine Status and Associations with Birth Outcomes in Three Major Cities in the United Kingdom. Nutrients 2019; 11:nu11020441. [PMID: 30791590 PMCID: PMC6412452 DOI: 10.3390/nu11020441] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/17/2022] Open
Abstract
Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004–2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks’ gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 μg/L, 95% confidence intervals (CI): 126, 158) and London (130 μg/L, 95% CI: 114, 177) and lowest in Leeds (116 μg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (−0.2% per 50 μg/L increase in UIC, 95% CI: −1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes.
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Abstract
OBJECTIVE The present study reviewed the literature on iodine status among women of childbearing age and pregnant women in the UK. Particular attention was given to study quality and methods used to assess iodine status. DESIGN A systematic review was conducted to examine the literature and critically evaluate study design. SETTING Studies were identified in PubMed, Web of Science, Scopus and Ovid MEDLINE databases, as well as from secondary references. PARTICIPANTS Women of childbearing age or pregnant, living in the UK. RESULTS Fifty-seven articles were identified and twelve articles were selected, including a total of 5283 women. Nine studies conducted urinary iodine assessments, three studies conducted dietary assessments only, and seven studies classified their target population as iodine deficient according to WHO criteria. CONCLUSIONS No single study from the selected articles could produce nationally representative results regarding the prevalence of iodine deficiency among the female population in the UK. Consideration of the evidence as a whole suggests that women of childbearing age and pregnant women in the UK are generally iodine insufficient. Further large-scale research is required for more accurate and reliable evidence on iodine status in the UK.
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19
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Wang Z, Liu P, Su X, Zou S, Song J, Liu S. A Comparison of Iodine Status in Children and Pregnant Women After a Policy Change in the Iodized Salt Standard in Shanghai, China. Biol Trace Elem Res 2018. [PMID: 29541993 DOI: 10.1007/s12011-018-1257-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In Shanghai, a new iodized salt standard was implemented in 2012. To provide evidence to the government, we compared iodine status before (35 mg/kg) and after (30 mg/kg) adjustment in vulnerable populations living in Shanghai. The probability-proportional-to-size sampling technique was used to select at least 360 pregnant women for urine iodine test and at least 1200 students for thyroid measurement and the household salt test. Of these students, at least 360 performed urine iodine test. The median thyroid volume and the median household salt iodine concentration of children aged 8-10 years were 1.80 ml and 24.8 mg/kg in 2015, and 0.97 ml and 28.3 mg/kg in 2011. The median urine iodine concentration (UIC) of pregnant women was 126.52 and 139.77 μg/L in 2015 and 2011. All differences were statistically significant (P < 0.05). The median UIC of students was 171.40 and 181.63 μg/L in 2015 and 2011, the difference was not statistically significant. Multivariate linear regression analysis showed that thyroid volume in children was associated with sex, age, region, and household salt iodized concentration. The current iodized salt concentration meets the basic needs of the population's iodine requirements except for pregnant women. Periodic monitoring is necessary particularly in vulnerable groups.
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Affiliation(s)
- Zhengyuan Wang
- Institute of Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Peng Liu
- Institute of Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaohui Su
- Institute of Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Shurong Zou
- Department of Nutrition Hygiene, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jun Song
- Department of Nutrition Hygiene, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shoujun Liu
- Institute of Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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20
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Knight BA, Shields BM, He X, Pearce EN, Braverman LE, Sturley R, Vaidya B. Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from South-West England: a cohort study. Thyroid Res 2018; 11:9. [PMID: 30002731 PMCID: PMC6035476 DOI: 10.1186/s13044-018-0053-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/27/2018] [Indexed: 01/17/2023] Open
Abstract
Background Iodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair fetal neurological development. As perchlorate and thiocyanate inhibit sodium-iodide symporter reducing the transport of iodine from circulation into the thyroid follicular cells, environmental exposure to these substances in pregnancy may impair maternal thyroid hormone synthesis. We aimed to explore the impact of perchlorate and thiocyanate exposure on thyroid status in a cohort of pregnant mothers from South West England. Methods Urine samples were obtained from 308 women participating in a study of breech presentation in late pregnancy. They had no known thyroid disease and a singleton pregnancy at 36–38 weeks gestation. Samples were analysed for urinary concentrations of iodine (UIC), perchlorate (UPC) and thiocyanate (UTC). Blood samples were taken for free T4 (FT4), thyrotropin (TSH) and thyroid peroxidase antibodies (TPO-Ab). Baseline data included age, parity, smoking status, ethnicity and BMI at booking. Following delivery, data on offspring’s sex, gestational age at birth and birthweight were collected. Results Participants had a mean (SD) age 31 (5) years, median (IQR) BMI 24.4 (22.0, 28.3) kg/m2, 42% were primiparous, 10% were smokers, and 96% were Caucasian. Median UIC was 88 μg/l, and 174/308 (57%) women had UIC < 100 μg/l. Log transformed UPC negatively correlated with FT4, but not with TSH, in the whole cohort (r = − 0.12, p = 0.03) and in the subgroup of women with UIC < 100 μg/l (r = − 0.15, p = 0.04). Regression analysis with the potential confounders (TPO-Ab status, UIC and UTC) identified UPC to be negatively associated with FT4 (p = 0.01). There was no correlation between UTC and FT4 or TSH. Maternal UPC or UTC was not associated with offspring birthweight. Conclusion Environmental perchlorate exposure is negatively associated with circulating FT4 levels in third trimester pregnant women. This may have an adverse impact on neurocognitive development of the fetus.
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Affiliation(s)
- Bridget A Knight
- 1NIHR Exeter Clinical Research Facility, Royal Devon & Exeter Hospital, University of Exeter Medical School, University of Exeter, Exeter, EX2 5DW UK.,2Research & Development Department, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Beverley M Shields
- 1NIHR Exeter Clinical Research Facility, Royal Devon & Exeter Hospital, University of Exeter Medical School, University of Exeter, Exeter, EX2 5DW UK
| | - Xuemei He
- 3Section of Endocrinology, Diabetes & Nutrition, Boston University School of Medicine, Boston, USA
| | - Elizabeth N Pearce
- 3Section of Endocrinology, Diabetes & Nutrition, Boston University School of Medicine, Boston, USA
| | - Lewis E Braverman
- 3Section of Endocrinology, Diabetes & Nutrition, Boston University School of Medicine, Boston, USA
| | - Rachel Sturley
- Centre for Women's Health, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Bijay Vaidya
- 5Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK.,6University of Exeter Medical School, Exeter, UK
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Wang Z, Xing M, Zhu W, Mao G, Mo Z, Wang Y, Chen Z, Lou X, Xia S, Wang X. Iodine Deficiency in Zhejiang Pregnant Women in the Context of Universal Salt Iodization Programme. Sci Rep 2018; 8:8835. [PMID: 29892022 PMCID: PMC5995927 DOI: 10.1038/s41598-018-26942-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/22/2018] [Indexed: 11/24/2022] Open
Abstract
Zhejiang introduced universal salt iodization (USI) programme in 1995 and has achieved the goal of elimination of iodine deficiency disorders (IDD) since 2011. However, no systematical data of iodine nutritional status in population in pregnancy is available. In this cross-sectional study, pregnant women were interviewed to complete questionnaires in addition to handing in samples of urine and household table salt between March 2016 to February 2017. Date of birth, age of pregnancy, ethnicity and dietary iodine habits were recorded. The overall median urinary iodine concentration in 8561 pregnant women was 130.47 µg/L, which was lower than the cut-off value of iodine sufficiency of 150 µg/L recommended by the WHO. Participants using non-iodized salt, taking non-iodine-containing supplements, in coastal and in Han group were independently associated with iodine deficiency. The current USI programme did not supply Zhejiang pregnant women with sufficient iodine intake. They are generally iodine deficient, which have great public health importance since even mild IDD in pregnancy have adverse effects on fetal neurodevelopment. We strongly recommend urgent measures to improve iodine intake in pregnancy.
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Affiliation(s)
- Zhifang Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China.,Zhejiang Provincial Center for Disease Control and Prevention, Key Medical Research Center, Hangzhou, 310051, China
| | - Mingluan Xing
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Wenming Zhu
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Guangming Mao
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Zhe Mo
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Yuanyang Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China
| | - Xiaoming Lou
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China.
| | - Shichang Xia
- Zhejiang Provincial Center for Disease Control and Prevention, Key Medical Research Center, Hangzhou, 310051, China.
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Department of Environmental and Occupational Health, Hangzhou, 310051, China.
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Torlinska B, Bath SC, Janjua A, Boelaert K, Chan SY. Iodine Status during Pregnancy in a Region of Mild-to-Moderate Iodine Deficiency is not Associated with Adverse Obstetric Outcomes; Results from the Avon Longitudinal Study of Parents and Children (ALSPAC). Nutrients 2018; 10:nu10030291. [PMID: 29494520 PMCID: PMC5872709 DOI: 10.3390/nu10030291] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 12/26/2022] Open
Abstract
Severe iodine deficiency during pregnancy has been associated with pregnancy/neonatal loss, and adverse pregnancy outcomes; however, the impact of mild–to–moderate iodine insufficiency, though prevalent in pregnancy, is not well-documented. We assessed whether mild iodine deficiency during pregnancy was associated with pregnancy/infant loss, or with other adverse pregnancy outcomes. We used samples and data from the Avon Longitudinal Study of Parents and Children (ALSPAC), from 3140 singleton pregnancies and from a further 42 women with pregnancy/infant loss. The group was classified as mildly-to-moderately iodine deficient with a median urinary iodine concentration of 95.3 µg/L (IQR 57.0–153.0; median urinary iodine-to-creatinine ratio (UI/Creat) 124 µg/g, IQR 82–198). The likelihood of pregnancy/infant loss was not different across four UI/Creat groups (<50, 50–149, 150–250, >250 µg/g). The incidence of pre-eclampsia, non-proteinuric gestational hypertension, gestational diabetes, glycosuria, anaemia, post-partum haemorrhage, preterm delivery, mode of delivery, being small for gestational age, and large for gestational age did not differ significantly among UI/Creat groups, nor were there any significant differences in the median UI/Creat. We conclude that maternal iodine status was not associated with adverse pregnancy outcomes in a mildly-to-moderately iodine-deficient pregnant population. However, in view of the low number of women with pregnancy/infant loss in our study, further research is required.
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Affiliation(s)
- Barbara Torlinska
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Sarah C Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK.
| | - Aisha Janjua
- Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
| | - Kristien Boelaert
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK.
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Edgbaston, Birmingham B15 2TH, UK.
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
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Chambers L. Are plant-based milk alternatives putting people at risk of low iodine intake? NUTR BULL 2018. [DOI: 10.1111/nbu.12305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVE The World Health Organization, the United Nations Children's Fund, and the International Council for the Control of Iodine Deficiency Disorders recommend a median urinary iodine concentration (UIC) in pregnant women between 150 µg/L and 249 µg/L. In the present study, we evaluated whether in the urban area of Cassino (central Italy), after a national salt iodination program (30 mg/kg) was introduced in 2005, the increased demand of iodine during pregnancy was satisfied. METHODS Between January 2016 and April 2017, 99 pregnant women were enrolled to evaluate UIC in spot urine samples, serum level of thyrotropin, free thyroxine, antithyroglobulin and antithyroperoxidase autoantibodies, and thyroid volume by ultrasonography. Eighty clinically healthy non-pregnant women were evaluated as controls. RESULTS The median UIC was of 97.7 µg/L and 110.3 µg/L, respectively, in control and pregnant women. A significant increase (P < 0.001) of median thyroid volume was found in pregnant women, relative to control women, being, respectively, 10.4 mL (range 3.68-19.49 mL) and 7.16 mL (range 2.57-14.00 mL). A positive correlation was found between thyroid volume and anthropometric parameters, and an inverse correlation was identified between free thyroxine serum levels and anthropometric parameters. CONCLUSIONS This observational study found that the majority of pregnant women and their fetuses appear not to be protected from the detrimental consequences of iodine deficiency. Therefore, the identification of new strategies to increase the knowledge and awareness of the general population regarding the beneficial effects of iodine supplementation during pregnancy is highly required.
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Has iodized salt reduced iodine-deficiency disorders among school-aged children in north-west Iran? A 9-year prospective study. Public Health Nutr 2017; 21:489-496. [PMID: 29032778 DOI: 10.1017/s1368980017002609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Low iodine intakes are associated with goitre and other iodine-deficiency disorders (IDD) that have affected billions of people worldwide. We aimed to assess total goitre rate (TGR) and urinary iodine concentration (UIC) in schoolchildren between 2007 and 2015, percentage of iodized salt consumption by households, and salt iodine content at production, distribution and household levels in north-west Iran. Design/Setting/Subjects UIC assessed among schoolchildren in nine consecutive years; 240 schoolchildren aged 8-10 years selected by systematic random sampling each year in the West Azerbaijan Province. RESULTS Median UIC was >100 μg/l in all years. More than 50 % of children had iodine deficiency (UIC≤99 μg/l) in 2010 and 2011, while this rate was approximately 15-35 % in other years. Proportion with UIC below 50 μg/l was <20 % in all years except 2010 and 2011. Excessive UIC (≥300 μg/l) rate was between 5·4 and 27·5 %. TGR decreased from 44 % in 1996 to 7·6 % and 0·4 % in 2001 and 2007, respectively. Regular surveys from 2002 to 2015 showed that 98 % or more of households consumed iodized salt. Iodine level ≥20 ppm was observed in 87·5, 83 and 73 % of salt at production, distribution and household level, respectively (data from national study in 2007). The last national study in 2014 showed that median iodine level in household salt was 27 ppm. CONCLUSIONS Our focused data suggest that the universal salt iodization programme is improving the iodine status of schoolchildren in the West Azerbaijan Province of Iran. Reduction of TGR to less than 5 % in schoolchildren indicates successful elimination of IDD as a major public health problem.
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