Are plant-based milk alternatives putting people at risk of low iodine intake?

The impact of replacing milk with plant-based alternatives on iodine intake: a dietary modelling study

PURPOSE

Cow's milk is the primary source of iodine in the UK, but consumption of plant-based milk alternatives (PBMA) is increasing and these products are often not fortified with iodine. We evaluated the impact that replacing current milk consumption with PBMA would have on iodine intake.

METHODS

We used data from the National Diet and Nutrition Survey (2016-2019) for children (1.5-10 years), girls 11-18 years, and women of reproductive age (WRA). We used a dietary modelling approach with scenarios using brand-level iodine-fortification data (0, 13, 22.5, 27.4 and 45 µg/100 mL). Relative to usual diet, we calculated change in iodine intake, and the proportion with intake below the Lower Reference Nutrient Intake (LRNI) or above the upper limit.

RESULTS

For all groups, replacement with PBMA, either unfortified or fortified at the lowest concentration, resulted in a meaningful decrease in iodine intake, and increased the proportion with intake < LRNI; compared to usual diet, iodine intake reduced by 58% in children 1.5-3 years (127 vs. 53 µg/day) and the proportion with intake < LRNI increased in girls (11-18 years; 20% to 48%) and WRA (13% to 33%) if an unfortified PBMA was used. Replacement of milk with PBMA fortified at 27.4 µg/100 mL had the lowest impact.

CONCLUSION

Replacing milk with commercially available PBMAs has potential to reduce population iodine intake, depending on the fortification level. PBMAs fortified with ≥ 22.5 and < 45 µg iodine/100 mL would be required to minimize the impact on iodine intake. Research is needed on the impact of total dairy replacement.

Dairy as a Source of Iodine and Protein in the UK: Implications for Human Health Across the Life Course, and Future Policy and Research

This narrative review summarizes key concepts in dairy nutrition for supporting human health throughout the life course. Milk and dairy products have been a staple component of our diet for thousands of years and provide a wide range of important nutrients that are otherwise difficult to obtain from dairy-free diets. In this review, we provide a broad perspective on the nutritional roles of iodine and dairy protein in supporting human health during pregnancy and early life, childhood and adolescence, mid- and later-life. New methodologies to identify biomarkers of dairy intake via high-throughput mass spectrometry are discussed, and new concepts such as the role of the food matrix in dairy nutrition are introduced. Finally, future policy and research related to the consumption of dairy and non-dairy alternatives for health are discussed with a view to improving nutritional status across the lifespan.

Iodine status of consumers of milk-alternative drinks v. cows' milk: data from the UK National Diet and Nutrition Survey

Milk is the main source of iodine in the UK; however, the consumption and popularity of plant-based milk-alternative drinks are increasing. Consumers may be at risk of iodine deficiency as, unless fortified, milk alternatives have a low iodine concentration. We therefore aimed to compare the iodine intake and status of milk-alternative consumers with that of cows' milk consumers. We used data from the UK National Diet and Nutrition Survey from years 7 to 9 (2014-2017; before a few manufacturers fortified their milk-alternative drinks with iodine). Data from 4-d food diaries were used to identify consumers of milk-alternative drinks and cows' milk, along with the estimation of their iodine intake (µg/d) (available for n 3976 adults and children ≥1·5 years). Iodine status was based on urinary iodine concentration (UIC, µg/l) from spot-urine samples (available for n 2845 adults and children ≥4 years). Milk-alternative drinks were consumed by 4·6 % (n 185; n 88 consumed these drinks exclusively). Iodine intake was significantly lower in exclusive consumers of milk alternatives than cows' milk consumers (94 v. 129 µg/d; P < 0·001). Exclusive consumers of milk alternatives also had a lower median UIC than cows' milk consumers (79 v. 132 µg/l; P < 0·001) and were classified as iodine deficient by the WHO criterion (median UIC < 100 µg/l), whereas cows' milk consumers were iodine sufficient. These data show that consumers of unfortified milk-alternative drinks are at risk of iodine deficiency. As a greater number of people consume milk-alternative drinks, it is important that these products are fortified appropriately to provide a similar iodine content to that of cows' milk.

Plant-based (vegan) diets for pets: A survey of pet owner attitudes and feeding practices

People who avoid eating animals tend to share their homes with animal companions, and moral dilemma may arise when they are faced with feeding animal products to their omnivorous dogs and carnivorous cats. One option to alleviate this conflict is to feed pets a diet devoid of animal ingredients-a 'plant-based' or 'vegan' diet. The number of pet owners who avoid animal products, either in their own or in their pets' diet, is not currently known. The objective of this study was to estimate the number of meat-avoiding pet owners, identify concerns regarding conventional animal- and plant-based pet food, and estimate the number of pets fed a plant-based diet. A questionnaire was disseminated online to English-speaking pet owners (n = 3,673) to collect data regarding pet owner demographics, diet, pet type, pet diet, and concerns regarding pet foods. Results found that pet owners were more likely to be vegetarian (6.2%; 229/3,673) or vegan (5.8%; 212/3,673) than previously reported for members of the general population. With the exception of one dog owned by a vegetarian, vegans were the only pet owners who fed plant-based diets to their pets (1.6%; 59/3,673). Of the pet owners who did not currently feed plant-based diets but expressed interest in doing so, a large proportion (45%; 269/599) desired more information demonstrating the nutritional adequacy of plant-based diets. Amongst all pet owners, the concern most commonly reported regarding meat-based pet foods was for the welfare of farm animals (39%; 1,275/3,231). The most common concern regarding strictly plant-based pet foods was regarding the nutritional completeness of the diet (74%; 2,439/3,318). Amongst vegans, factors which predicted the feeding of plant-based diets to their pets were concern regarding the cost of plant-based diets, a lack of concern regarding plant-based diets being unnatural, and reporting no concern at all regarding plant-based diets for pets. Given these findings, further research is warranted to investigate plant-based nutrition for domestic dogs and cats.