Scientific Opinion on Dietary Reference Values for iodine

Nitrate, Nitrite, and Iodine Concentrations in Commercial Edible Algae: An Observational Study

Edible algae are a natural source of nutrients, including iodine, and can also contain nitrogen in the form of nitrate (NO3-) and nitrite (NO2-) as they can fix nitrogen from seawater. This study aimed to analyse the NO3-, NO2-, and iodine concentrations in eighteen macroalgae and five microalgae species commercially available in the United Kingdom. NO3- and NO2- concentrations were measured using high-performance liquid chromatography (HPLC), and iodine was determined using inductively coupled plasma mass spectrometry (ICP-MS). NO3- and iodine concentrations in macroalgae (NO3-: 4050.13 ± 1925.01 mg/kg; iodine: 1925.01 ± 1455.80 mg/kg) were significantly higher than in microalgae species (NO3-: 55.73 ± 93.69 mg/kg; iodine: 17.61 ± 34.87 mg/kg; p < 0.001 for both). In the macroalgae group, nori had the highest NO3- (17,191.33 ± 980.89 mg/kg) and NO2- (3.64 ± 2.38 mg/kg) content, as well as the highest iodine content. Among microalgae, Dunaliella salina had the highest concentration of NO3- (223.00 ± 21.93 mg/kg) and iodine (79.97 ± 0.76 mg/kg), while Spirulina had the highest concentration of NO2- (7.02 ± 0.13 mg/kg). These results indicate that commercially available edible algae, particularly macroalgae species, could be a relevant dietary source of NO3- and iodine.

The Role of Nutrition on Thyroid Function

Thyroid function is closely linked to nutrition through the diet-gut-thyroid axis. This narrative review highlights the influence of nutritional components and micronutrients on thyroid development and function, as well as on the gut microbiota. Micronutrients such as iodine, selenium, iron, zinc, copper, magnesium, vitamin A, and vitamin B12 influence thyroid hormone synthesis and regulation throughout life. Dietary changes can alter the gut microbiota, leading not just to dysbiosis and micronutrient deficiency but also to changes in thyroid function through immunological regulation, nutrient absorption, and epigenetic changes. Nutritional imbalance can lead to thyroid dysfunction and/or disorders, such as hypothyroidism and hyperthyroidism, and possibly contribute to autoimmune thyroid diseases and thyroid cancer, yet controversial issues. Understanding these relationships is important to rationalize a balanced diet rich in essential micronutrients for maintaining thyroid health and preventing thyroid-related diseases. The synthetic comprehensive overview of current knowledge shows the importance of micronutrients and gut microbiota for thyroid function and uncovers potential gaps that require further investigation.

Ecophysiological and nutritional characterisation of two morphotypes of Cakile maritima subsp. maritima Scop. from Puglia region, Southern Italy

Cakile maritima subsp. maritima Scop. (sea rocket) is a succulent halophyte with significant potential as a nutritious food source, being rich in essential nutrients such as vitamins, minerals, and antioxidants. This annual species exhibits two distinct leaf morphotypes: entire lamina (EL) and pinnatifid lamina (PL). Our understanding of their ecophysiological and nutritional profiles is still limited. The present study investigated the wild EL and PL sea rocket plants from southern Italy during their vegetative stage. The bio-morphological traits (leaf mass area-LMA, dry matter and chlorophyll concentrations), main inorganic ions, key antioxidants (carotenoids, anthocyanins, phenols, flavonoids, glucosinolates, vitamin C as ascorbic and dehydroascorbic acid), and antioxidant activity (by FRAP, DPPH, ABTS assays) were analyzed. Additionally, photosynthetic gas exchange and chlorophyll fluorescence were measured. PL plants showed thicker leaves (higher LMA) and greater accumulation of photo-protective pigments (carotenoids and anthocyanins), despite similar chlorophyll levels. The PL plants also demonstrated higher photosynthetic activity, transpiration rates, and stomatal conductance, with reduced non-photochemical quenching. The EL morphotype had higher cation (K, Mg, Ca, Na) and vitamin C (135.3 mg 100 g-1 FW) concentrations, while no significant disparities were observed between the morphotypes in phenolic concentration (208.5 mg g.a.e. 100 g-1 FW), flavonoids (71.5 mg q.e. 100 g-1 FW), or glucosinolates (61 mg g-1 FW). Interestingly, while the EL type had higher vitamin C, the PL morphotype showed superior antioxidant activity (FRAP, DPPH) and seems to be better adapted to water/nutrient scarcity typical of southern Italy. Both morphotypes offer potential as high-nutritional foods, however, future research should investigate the genotype-specific production of antioxidant compounds in EL and PL plants in response to environmental stresses, including salinity for potential exploitation as a new crop.

Prevalence of iodine deficiency and associated factors among school-age children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Currently, iodine deficiency has become a significant burden globally; where 2 billion people and 29.8% of school-age children are iodine deficient. It is a leading cause of preventable brain damage among children, resulting in impaired cognitive and motor development. Even though salt iodization was started to be implemented to alleviate this burden in Ethiopia, primary studies assessing iodine deficiency in the country show highly variable findings, and no systematic review was conducted to determine the pooled prevalence of the problem which makes it difficult to assess the effect of the intervention as well as to design appropriate and timely measures. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of iodine deficiency and the common factors affecting its occurrence among school-age children in Ethiopia.

METHOD

To obtain the eligible studies, databases (EMBASE, Scopus, Hinari, and PubMed), websites (Google and Google Scholar), and references of the eligible studies were searched systematically. Data were extracted using an Excel spreadsheet and analyzed using the STATA 17 version. The I2 test was used to assess heterogeneity between the studies. A DerSimonian and Laird random-effects model was used to estimate the pooled prevalence and pooled odds ratio. A funnel plot and Egger's test were used to detect publication bias.

RESULT

A total of 15 eligible studies, representing 15,611 school-age children, were included in the systematic review and meta-analysis. The pooled prevalence of iodine deficiency among school-age children in Ethiopia was found to be 58% (95%CI 44.00-77.00), while the highest prevalence was recorded in the Oromia Region, which was 64% (95% CI 49-79). Goitrogenic food consumption (adjusted odds ratio (AOR) 2.93, 95% CI 1.60-5.35) and being female (adjusted odds ratio (AOR) 1.87, 95% CI 1.43-2.44) showed a significant association with the prevalence of iodine deficiency.

CONCLUSION

Iodine deficiency among school-age children in Ethiopia was noticeably high. Goitrogenic food consumption and the sex of the child were determinant factors for the occurrence of iodine deficiency among the children. Therefore, appropriate advice should be given to households to limit goitrogenic foods in the diet of their children by giving due attention to their female children.

Effect of Macro and Microalgae Addition on Nutritional, Physicochemical, Sensorial, and Functional Properties of a Vegetable Cream

Algae are a booming resource in the food industry due to their several health benefits. This study assesses the impact of the combined use of selected macro- and microalgae to improve the nutritional profile and the labeling of a vegetable cream by the introduction of nutrition and health claims. As macroalgae, two Ascophyllum nodosum L., one natural (An) and one smoked (AnS), were selected for their high iodine concentration and flavor notes. A new strain of Chlorella vulgaris, golden (CvG), was selected as the microalgae, which is rich in proteins and has a neutral sensorial profile (golden color and mild flavor). In this study, two vegetable creams were compared. The control (CTRL) versus one enriched with a mixture of macroalgae and microalgae (CV-AN). Sensory, physicochemical, and functional properties of both vegetable creams were evaluated. The bioactivity assessed was the effect of iodine as a health claim and antioxidant and antihypertensive properties. CV-AN vegetable cream showed significantly higher values (p < 0.05) for protein content, iodine value, and antioxidant activity, with no significant differences (p > 0.05) in antihypertensive activity or sensory panel. The incorporation of these algae resulted in a vegetable cream with a better nutritional profile and sensory acceptability comparable to the control, offering protein and iodine source claims in the labeling.

Combined Supplementation of Two Selenium Forms (Organic and Inorganic) and Iodine in Dairy Cows' Diet to Obtain Enriched Milk, Cheese, and Yogurt

This study evaluated the effects of dietary supplementation in dairy cows with two Se forms (organic and inorganic) and I at the maximum levels permitted in the European Union, with the aim to obtain naturally enriched milk and derived products. A total of 20 Holstein Friesian cows in lactation were fed 2 diets for 64 days: a control diet with a supply of 0.57 mg of inorganic Se and 0.57 mg of I per kg of ration in dry matter (DM), and an experimental diet (SeI) with a supply of 0.34 mg of inorganic Se, 0.23 mg of organic Se, and 5.68 mg of I per kg of ration in DM. The SeI diet did not modify the performance or, in general, the metabolic profile of cows. Se and I levels in milk were affected by diet type and time of measurement (p < 0.01). Thus, a marked increase of both microminerals was evident between the beginning and the end of the test, when the SeI diet was administered. For Se, this increase ranged from 1.95 to 3.29 μg/100 g of milk; and for I, from 19.69 to 110.06 μg/100 g of milk. The SeI diet increased (p < 0.01) the Se and I content in the cheese, reaching levels of 16.4 μg/100 g for Se and 269.7 μg/100 g for I. An increase in I was observed in yogurt from the SeI diet (p < 0.001). The supplementation of two forms of Se and I in the cows' ration, at the levels evaluated, produced milk and dairy products enriched in these microelements without altering their quality parameters. However, a responsible intake of these products is necessary to avoid risks of deficiencies or excesses that could negatively affect the health of consumers.

Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health

The role of minerals in female fertility, particularly in relation to the menstrual cycle, presents a complex area of study that underscores the interplay between nutrition and reproductive health. This narrative review aims to elucidate the impacts of minerals on key aspects of the reproductive system: hormonal regulation, ovarian function and ovulation, endometrial health, and oxidative stress. Despite the attention given to specific micronutrients in relation to reproductive disorders, there is a noticeable absence of a comprehensive review focusing on the impact of minerals throughout the menstrual cycle on female fertility. This narrative review aims to address this gap by examining the influence of minerals on reproductive health. Each mineral's contribution is explored in detail to provide a clearer picture of its importance in supporting female fertility. This comprehensive analysis not only enhances our knowledge of reproductive health but also offers clinicians valuable insights into potential therapeutic strategies and the recommended intake of minerals to promote female reproductive well-being, considering the menstrual cycle. This review stands as the first to offer such a detailed examination of minerals in the context of the menstrual cycle, aiming to elevate the understanding of their critical role in female fertility and reproductive health.

Iodine: a scoping review for Nordic Nutrition Recommendations 2023

Iodine is essential for the synthesis of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). As in many other parts of the world, insufficient iodine intake and consequently insufficient iodine status is a public health challenge in the Nordic and Baltic countries. The main dietary sources of iodine in the Nordic and Baltic countries include cow's milk, saltwater fish, eggs, products containing iodised salt, and iodised table salt. Only Denmark (DK), Finland (FI) and Sweden (SE) have implemented mandatory (DK) or voluntary (SE, FI) salt iodisation. New data, as well as recent studies from the Nordic and Baltic countries, strengthen the evidence that the main health challenges related to insufficient iodine intake remain thyroid function and thyroid disease, mental development, and cognitive function. Excessive intakes can also cause hyperthyroidism, autoimmune thyroid disease, and thyroid cancer.

Adoption of a Short-Term (4-Week) Vegan Diet as Part of 'Veganuary' Significantly Reduces Saturated Fatty Acid (SFA), Cholesterol, B12, and Iodine Intake in Omnivorous Individuals-An Observational Study

Global veganism campaigns like 'Veganuary' have gained popularity. We conducted an observational study to assess the impact of a 4-week vegan diet during 'Veganuary' on nutrient intake, status, knowledge, and motivations for veganism. Data were collected before and after 'Veganuary', using Food Frequency Questionnaires (FFQs) to estimate dietary intake. Micronutrient knowledge and motivation were assessed through questionnaires. A total of 154 UK adults aged 18-60 years (2019: n81; 2020: n73) participated. Groups were vegetarians and omnivores committed to a 4-week vegan diet during 'Veganuary'. Control groups were vegans and omnivores who did not transition. Short-term vegan diets significantly decreased intake of iodine, B12, cholesterol, and saturated fatty acids (SFAs) in omnivores. Micronutrient knowledge was low, and motivation for veganism varied. Short-term vegan diets reduce macro- and micronutrient intake in omnivores. Veganuary participants could benefit from nutritional guidance or supplementation. Attention is required for UK micronutrient intake and knowledge. Motivations for vegan pledges may influence diets, warranting further research.

Curly Kale (Brassica oleracea var. Sabellica L.) Biofortified with 5,7-Diiodo-8-quinolinol: The Influence of Heat Treatment on Iodine Level, Macronutrient Composition and Antioxidant Content

Many disorders are a result of an inadequate supply of macronutrients and micronutrients in the diet. One such element is iodine. This study used curly kale (Brassica oleracea var. Sabellica L.) biofortified with the 5,7-diiodo-8-quinolinol iodine compound. The effect of the heat treatment on the chemical composition of the curly kale was studied. In addition, iodine bioavailability was evaluated in in vivo studies. Our investigation showed that iodine loss depends on the type of heat treatment as well as on the variety of kale. Curly kale biofortified with iodoquinoline had significantly higher iodine levels after thermal processing (steaming, blanching, boiling) than the vegetable biofortified with KIO3. Generally, steaming was the best thermal processing method, as it contributed to the lowest iodine loss in curly kale. The red variety of kale, 'Redbor F1', showed a better iodine stability during the heat treatment than the green variety, 'Oldenbor F1'. The thermal treatment also significantly affected the dry matter content and the basic chemical composition of the tested varieties of the 5,7-diI-8-Q biofortified kale. The steaming process caused a significant increase in total carbohydrates, fiber, protein and crude fat content ('Oldenbor F1', 'Redbor F1'), and antioxidant activity ('Oldenbor F1'). On the other hand, boiling caused a significant decrease, while steaming caused a significant increase, in protein and dry matter content ('Oldenbor F1', 'Redbor F1'). The blanching process caused the smallest significant decrease in ash compared to the other thermal processes used ('Oldenbor F1'). A feeding experiment using Wistar rats showed that iodine from the 5,7-diI-8-Q biofortified kale has a higher bioavailability than that from the AIN-93G diet. A number of promising results have been obtained, which could form the basis for further research.

Association of Maternal Diet with Infant Birthweight in Women with Gestational Diabetes Mellitus

OBJECTIVE

This study aimed to explore the potential impact of pre-pregnancy and early pregnancy maternal nutrition on the incidence of small-for-gestational-age neonates (SGA) in women with gestational diabetes mellitus (GDM).

METHODS

A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24-28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence.

RESULTS

In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates.

CONCLUSIONS

The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus.

Recent data on iodine intake in Croatian schoolchildren: results of 2014-2019 survey

BACKGROUND

Both insufficient and excessive iodine intake can lead to a broad range of disorders. A cross-sectional survey was conducted to assess iodine status in schoolchildren from Croatia.

DESIGN

957 healthy 6 to 12-year-olds were enrolled (381 from northwestern region, 190 from eastern region, 215 from north Adriatic, and 171 from central Dalmatia region). Urinary iodine concentration (UIC) was measured in spot urine samples. Thyroid volume (Tvol) was recorded by ultrasound device. Standard anthropometric measures were taken, and body surface area (BSA) was determined. Tvol medians were calculated as a function of age, sex and BSA and compared with reference values.

RESULTS

Total sample size included 490 boys and 467 girls. Overall median UIC was 250.68 µg/L, with statistically significant variance in geographical regions (median UIC was 244.71 µg/L in northwestern, 208.02 µg/L in eastern, 216.07 µg/L in north Adriatic and 366.43 µg/L in central Dalmatia region). There were 10.08% of samples with UIC < 100 mcg/L while 38.24% of samples had UIC > 300 mcg/L. Age-matched Tvol medians in schoolchildren from all regions of Croatia were at the upper limits of reference values, but in north Adriatic and central Dalmatia exceeded the 97th percentile. BSA-matched Tvol was within the reference range in all regions.

CONCLUSIONS

Our results demonstrate sufficient (more than adequate) iodine intake in schoolchildren of Croatia, and excessive iodine intake in central Dalmatia region. Total thyroid volumes in schoolchildren of Croatia were within the normal range, however borderline enlarged age-matched thyroid glands were observed in coastal areas.

Approach strategies and application of metabolomics to biotechnology in plants

Metabolomics refers to the technology for the comprehensive analysis of metabolites and low-molecular-weight compounds in a biological system, such as cells or tissues. Metabolites play an important role in biological phenomena through their direct involvement in the regulation of physiological mechanisms, such as maintaining cell homeostasis or signal transmission through protein-protein interactions. The current review aims provide a framework for how the integrated analysis of metabolites, their functional actions and inherent biological information can be used to understand biological phenomena related to the regulation of metabolites and how this information can be applied to safety assessments of crops created using biotechnology. Advancement in technology and analytical instrumentation have led new ways to examine the convergence between biology and chemistry, which has yielded a deeper understanding of complex biological phenomena. Metabolomics can be utilized and applied to safety assessments of biotechnology products through a systematic approach using metabolite-level data processing algorithms, statistical techniques, and database development. The integration of metabolomics data with sequencing data is a key step towards improving additional phenotypical evidence to elucidate the degree of environmental affects for variants found in genome associated with metabolic processes. Moreover, information analysis technology such as big data, machine learning, and IT investment must be introduced to establish a system for data extraction, selection, and metabolomic data analysis for the interpretation of biological implications of biotechnology innovations. This review outlines the integrity of metabolomics assessments in determining the consequences of genetic engineering and biotechnology in plants.

Effects of an Extract of the Brown Seaweed Ascophylum nodosum on Postprandial Glycaemic Control in Healthy Subjects: A Randomized Controlled Study

The effects of the consumption of an extract of the brown seaweed Ascophyllum nodosum (BSW) on postprandial glucose and insulin responses to white bread were investigated in an acute, randomized, double-blind, three-arm, crossover, controlled trial in healthy, normoglycemic subjects. Sixteen subjects were administered either control white bread (50 g total digestible carbohydrates) or white bread with 500 mg or 1000 mg of BSW extract. Biochemical parameters were measured in venous blood over 3 h. Significant inter-individual variation in the glycaemic response to white bread was observed. Analysis of the responses of all subjects to either 500 mg or 1000 mg of BSW extract versus control revealed no significant effects of treatments. The variation in response to the control was used to classify individuals into glycaemic responders and non-responders. In the sub-cohort of 10 subjects with peak glucose levels after white bread above 1 mmol/L, we observed a significant decrease in maximum levels of plasma glucose after the intervention meal with 1000 mg of extract compared with the control. No adverse effects were reported. Further work is warranted to define all factors that determine "responders" to the effects of brown seaweed extracts and identify the cohort that would benefit the most from their consumption.

Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review

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".

Risk Assessment of Micronutrients Deficiency in Vegetarian or Vegan Children: Not So Obvious

Vegetarian diets have gained in popularity worldwide and therefore an increasing number of children may be exposed to the resulting nutritional consequences. Among them, the risk of micronutrient shortfall is particularly of concern. This narrative review aims to assess and discuss the relevance of micronutrient deficiency risk based on the available data. It mainly draws attention to iron, zinc, iodine, and vitamins B12 and D intake. Diets that are more restrictive in animal source foods, such as vegan diets, have a greater likelihood of nutritional deficiencies. However, the actual risk of micronutrient deficiency in vegetarian children is relatively difficult to assert based on the limitations of evidence due to the lack of well-designed studies. The risk of vitamin B12 deficiency must be considered in newborns from vegan or macrobiotic mothers and children with the most restrictive diet, as well as the risk of iron, zinc, and iodine deficiency, possibly by performing the appropriate tests. A lacto-ovo-vegetarian diet exposes a low risk if it uses a very varied diet with a sufficient intake of dairy products. Vegan and macrobiotic diets should be avoided during pregnancy and childhood. There is a need for education and nutrition guidance and the need for supplementation should be assessed individually.

Iodine Availability through Iodized Salt in Portugal: 2010–2021 Sales Evolution and Distribution

Salt iodization programs are considered the most cost-effective measures to ensure adequate iodine intake in iodine-deficient populations. Portuguese women of childbearing age and pregnant women were reported to be iodine-deficient, which led the health authorities, in 2013, to issue a recommendation for iodine supplementation during preconception, pregnancy and lactation. In the same year, iodized salt became mandatory in school canteens. Of note, no regulation or specific programs targeting the general population, or the impact of iodized salt availability in retailers, are known. The present study analyzed iodized salt supermarket sales from 2010 to 2021 from a major retailer, identifying the proportion of iodized salt in total salt sales and its distribution in mainland Portugal. Data on iodine content were collected through the nutritional label information. Of a total of 33 salt products identified, 3 were iodized (9%). From 2010 to 2021, the weighted sales of iodized salt presented a growing tendency, reaching the maximum of 10.9% of total sales (coarse plus fine salt) in 2021. Iodized salt reached a maximum of 11.6% of total coarse salt in 2021, a maximum of 2.4% of the total fine salt in 2018. The overall sales of iodized salt and their contribution to iodine intake are extremely low, prompting additional studies to understand the consumer’s choice and awareness of the benefits of iodized salt.

Improving Pregnant Women's Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates

(1) Measuring usual iodine intake is a complex task due to the food consumption variability and its natural concentration in food. Therefore, the use of covariates to adjust statistical methods to estimate usual intake could improve the estimates obtained through dietary surveys. This study aims to evaluate the influence of salt and seasoning usage covariates on the estimates of usual iodine intake and the prevalence of its inadequacy. (2) A cross-sectional study was conducted with Brazilian pregnant women's food consumption data obtained with 24-h recall (n = 2247). The usual iodine intake was adjusted for intraindividual variability, supplement use, temporal effects, data collection methods, and sociodemographic characteristics with the tool UCD/NCI SIMPLE in the SAS software. Then, salt and seasoning usage covariates were used to adjust the distribution. The harmonized intake reference values for populations were used to assess intake adequacy. (3) The adjustments for salt and seasoning usage yielded a higher mean of usual iodine intakes. The only exception was the adjustment for the "habit of adding salt to meals after preparing/cooking", which produced a lower mean of usual intake and increased the prevalence of insufficient intake. (4) Salt and seasoning usage covariates affect the estimates evaluated. However, more studies are necessary to evaluate the influence observed.

Optimizing Growth: The Case for Iodine

Iodine is an essential micronutrient and component of thyroid hormone. An adequate dietary iodine intake is critical to maintain and promote normal growth and development, especially during vulnerable life stages such as pregnancy and early infancy. The role of iodine in cognitive development is supported by numerous interventional and observational studies, and when iodine intake is too low, somatic growth is also impaired. This can be clearly seen in cases of untreated congenital hypothyroidism related to severe iodine deficiency, which is characterized, in part, by a short stature. Nevertheless, the impact of a less severe iodine deficiency on growth, whether in utero or postnatal, is unclear. Robust studies examining the relationship between iodine and growth are rarely feasible, including the aspect of examining the effect of a single micronutrient on a process that is reliant on multiple nutrients for optimal success. Conversely, excessive iodine intake can affect thyroid function and the secretion of optimal thyroid hormone levels; however, whether this affects growth has not been examined. This narrative review outlines the mechanisms by which iodine contributes to the growth process from conception onwards, supported by evidence from human studies. It emphasizes the need for adequate iodine public health policies and their robust monitoring and surveillance, to ensure coverage for all population groups, particularly those at life stages vulnerable for growth. Finally, it summarizes the other micronutrients important to consider alongside iodine when seeking to assess the impact of iodine on somatic growth.

Dietary Zinc Is Associated with Cardiac Function in the Older Adult Population

The elderly is a group at particularly high cardiovascular risk. The coexistence of chronic diseases and use of multiple medications creates the need to look for non-pharmacological agents to improve cardiovascular health in that population. In view of reports on the potential role of zinc in enhancing pathways of myocardial tissue repair, the aim of this study was to evaluate the association between dietary zinc intake and cardiac structure and function in individuals of advanced age. The study group included 251 community-dwelling patients, with a median age of 80 years. Dieta 6.0 software was used for calculation of zinc consumption. Percentage of Recommended Dietary Allowance (RDA) for zinc correlated with left ventricular ejection fraction (LVEF) (r = 0.196, p < 0.05), left ventricular mass index (r = -0.137, p < 0.05) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.153, p < 0.05), while zinc density did so with E/E' ratio (r = -0.127, p < 0.05). In a multiple stepwise regression analysis, the best determinants of LVEF were %RDA for zinc (p = 0.014; β = 0.143), presence of coronary artery disease (p < 0.001; β = -0.39) and age (p = 0.036; β = -0.12). Furthermore, %RDA for zinc (p = 0.009; β = 0.16), female sex (p = 0.005; β = -0.171), beta-blocker use (p = 0.024; β = -0.136), body mass index (p = 0.008; β = 0.16) and heart rate (p = 0.0006; β = -0.209) had an independent effect on TAPSE. In conclusion, in individuals of very advanced age, lower zinc intake is associated with poorer cardiac function. Therefore, increasing the recommended zinc intake in this group deserves consideration.

Assessment of Dietary Intake of Iodine and Risk of Iodine Deficiency in Children with Classical Galactosaemia on Dietary Treatment

Iodine is an essential mineral required for the synthesis of thyroid hormones. Iodine plays a critical role in growth and neurocognitive development. Classical galactosaemia is a disorder resulting from an inborn error in galactose metabolism. Its current management consists of life-long lactose and galactose dietary restriction. This study estimated dietary intakes of iodine in infants and children with classical galactosaemia in the Republic of Ireland. The diets of 43 participants (aged 7 months-18 years) with classical galactosaemia were assessed for iodine intake using an iodine-specific food frequency questionnaire. Intakes were compared to the European Food Safety Authority (EFSA) dietary recommendations for iodine intake. The potential role of iodine fortification of dairy alternative products was also examined. There were no significant differences observed between sex, ethnicity and parental education and meeting dietary iodine recommendations. Differences, however, were seen between age groups, causing the p value to approach statistical significance (p = 0.06). Infants consuming infant formula were likely to meet iodine recommendations. However, over half (53%) of children aged 1-18 years had average intakes below the recommendations for age. For these children, consumption of iodine-fortified dairy alternative milk was the leading source of iodine in the diets, followed by fish/shellfish and eggs. An assessment of iodine intake should be undertaken during dietetic reviews for those with classical galactosaemia. Mandatory iodine fortification of all dairy alternative products would result in 92% of the total population cohort meeting iodine recommendations based on their current consumption.

Citrinin Exposure in Germany: Urine Biomarker Analysis in Children and Adults

Citrinin (CIT), a mycotoxin known to exert nephrotoxicity, is a contaminant in food and feed. Since CIT contamination is not regularly analyzed, data on its occurrence and especially levels in food commodities are insufficient for conducting a conventional exposure assessment. Yet, human biomonitoring, i.e., an analysis of CIT and its metabolite dihydrocitrinone (DH-CIT) in urine samples allows to estimate exposure. This study investigated CIT exposure in young (2-14 years) and adult (24-61 years) residents of three federal states in Germany. A total of 179 urine samples from children and 142 from adults were collected and analyzed by a targeted LC-MS/MS based method for presence of CIT and DH-CIT. At least one of the biomarkers was detected and quantified in all urines, which indicated a widespread dietary exposure to the mycotoxin in Germany. Interestingly, the biomarker concentrations of CITtotal (sum of CIT and DH-CIT) were higher in children's urine (range 0.05-7.62 ng/mL; median of 0.54 ng/mL) than in urines from adults (range 0.04-3.5 ng/mL; median 0.3 ng/mL). The biomarker levels (CITtotal) of individual urines served to calculate the probable daily CIT intake, for comparison to a value of 0.2 µg/kg bw/day defined as 'level of no concern for nephrotoxicity' by the European Food Safety Authority. The median exposure of German adults was 0.013 µg/kg b.w., with only one urine donor exceeding this provisional tolerable daily intake (pTDI) for CIT. The median exposure of children was 0.05 µg/kg bw per day (i.e., 25% of the pTDI); however, CIT exposure in 12 individuals (6.3% of our study group) exceeded the limit value, with a maximum intake of 0.46 µg/kg b.w. per day. In conclusion, these results show evidence for non-negligible exposure to CIT in some individuals in Germany, mainly in children. Therefore, further biomonitoring studies and investigations aimed to identify the major sources of CIT exposure in food commodities are required.

Food Safety Risks Posed by Heavy Metals and Persistent Organic Pollutants (POPs) related to Consumption of Sea Cucumbers

The global production of sea cucumbers was 245 thousand tons in 2020. Sea cucumbers are important food items in Asian and Pacific cuisines, the highest proportion being consumed in China as "bêche-de-mer" dried, gutted, boiled and salted body wall. However, consumption of sea cucumbers is expanding in China and globally, and the high demand has led to decline in populations of sea cucumbers, due to overexploitation. Aquaculture, together with novel fisheries on new species in new regions is easing the demand. Thus, an assessment of food safety is warranted. A literature search on food hazards was performed. A high proportion of the selected papers concerned heavy metals and metalloid hazards, such as mercury (Hg), cadmium (Cd), lead (Pb), and arsenic (As). No specific maximum limits (MLs) have been set for contents of these in sea cucumbers. Thus, the contents were compared with maximum limits set for aquatic animals in general or bivalve molluscs if available. With regard to Hg and Cd levels, none of the samples exceeded limits set by the European Commission or the National Standard of China, while for Pb, samples from highly industrialised areas exceeded the limits. Surprisingly, data on contaminants such as POPs, including dioxins and dl-PCB, PAH and PFAS as well as microbial hazards were scarce. The availability of fresh sea cucumber has increased due to aquaculture. To preserve the original flavour some consumers are reported to prefer to eat raw sea cucumber products, sashimi and sushi, which inevitably causes challenges from the microbial food safety perspective. Altogether, this paper highlights specific needs for knowledge, in particular when harvesting new species of sea cucumbers or in industrialized regions. Systematic monitoring activities, appropriate guidelines and regulations are highly warranted to guide the utilization of sea cucumbers.

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

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.

Changes in lipids metabolism indices as a result of different form of selenium supplementation in chickens

Selenium is an essential element that is important for many metabolic processes. Feed components used in chicken nutrition, especially cereals, may be deficient in selenium, hence selenium supplementation is necessary. Taking into account the progress in breeding, and thus the higher demand of birds for this element, it seems obvious to investigate an increased selenium dose in the diet of chickens. The aim of the study was to evaluate the effect of feed enriched with different forms of selenium at an increased dose of 0.5 mg/kg feed on the profile and metabolism of fatty acids in the breast muscle and liver of chickens. The study was conducted on 300 Ross 308 chickens reared for 42 days under standard conditions. The control group received feed supplemented with sodium selenite at a dose of 0.3 mg/kg feed. The research groups received different forms of selenium (sodium selenate, selenised yeast, nano-selenium) at an increased dose of 0.5 mg/kg feed. The study showed that the administration of different forms of selenium in the feed affected its concentration in the breast muscle and liver (p ≤ 0.01). Nano-selenium was found to have a high bioavailability, but also a lower risk of toxicity compared to other forms of selenium. Using different forms of selenium (p ≤ 0.01) at a dose of 0.5 mg/kg feed can significantly modify the fatty acid profile, lipid and enzymatic indices of fatty acid metabolism in breast muscle and liver.

Biological Potential, Gastrointestinal Digestion, Absorption, and Bioavailability of Algae-Derived Compounds with Neuroprotective Activity: A Comprehensive Review

Currently, there is no known cure for neurodegenerative disease. However, the available therapies aim to manage some of the symptoms of the disease. Human neurodegenerative diseases are a heterogeneous group of illnesses characterized by progressive loss of neuronal cells and nervous system dysfunction related to several mechanisms such as protein aggregation, neuroinflammation, oxidative stress, and neurotransmission dysfunction. Neuroprotective compounds are essential in the prevention and management of neurodegenerative diseases. This review will focus on the neurodegeneration mechanisms and the compounds (proteins, polyunsaturated fatty acids (PUFAs), polysaccharides, carotenoids, phycobiliproteins, phenolic compounds, among others) present in seaweeds that have shown in vivo and in vitro neuroprotective activity. Additionally, it will cover the recent findings on the neuroprotective effects of bioactive compounds from macroalgae, with a focus on their biological potential and possible mechanism of action, including microbiota modulation. Furthermore, gastrointestinal digestion, absorption, and bioavailability will be discussed. Moreover, the clinical trials using seaweed-based drugs or extracts to treat neurodegenerative disorders will be presented, showing the real potential and limitations that a specific metabolite or extract may have as a new therapeutic agent considering the recent approval of a seaweed-based drug to treat Alzheimer’s disease.

The Role of Iodine for Thyroid Function in Lactating Women and Infants

Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.

Risk–benefit assessment of seaweed Allergenicity risk assessment of novel protein

As the world population rapidly grows, there is a clear need for alternative food sources, particularly for the provision of protein. Seaweed is one such alternative source of protein that requires greater investigation. In this context, a working programme within the European Food Risk Assessment (EU‐FORA) Fellowship Programme framework was developed at National Food Institute – Technical University of Denmark. This Programme is an initiative of the EFSA with the aim to build a European risk assessment community. The purpose of this technical report is to describe the activities in which the fellow was involved. As part of the Research Group for Risk–Benefit, the fellow performed a risk–benefit assessment of seaweed Palmaria palmata gaining an in‐depth expertise in all the steps. The health impact of Palmaria palmata consumption was estimated, considering its high nutritional value but also highlighting concerns towards some components. Simultaneous to the work on the risk–benefit, the fellow also worked within the Research Group for Food Allergy, specifically on the allergenicity risk assessment of a plant‐based novel protein (seaweed protein) using different laboratory assays. Seaweed protein digestibility was assessed, and its digestion products were characterised and assessed for immunogenicity. Finally, the fellow collaborated with the Research Group for Microbial Biotechnology and Biorefining in the development of a novel food (alfalfa protein) application dossier to be submitted to EFSA, gaining expertise in the risk assessment of a novel food. In conclusion, the present working programme, together with additional activities and training provided by different institutions, enabled the fellow to gain a broader perspective in food safety, particularly concerning seaweed, novel foods and the safety assessment of novel proteins.

Risk–Benefit Assessment of an Increase in the Iodine Fortification Level of Foods in Denmark—A Pilot Study

Iodine deficiency is one of the most common nutritional disorders worldwide. In Denmark, the mandatory iodine fortification of salt of 13 ppm was introduced in 2000 to eradicate mild to moderate iodine deficiency and the fortification level was increased to 20 ppm in 2019. However, the optimal iodine intake is a narrow interval, and the risk of disease increases with intakes both below and above this interval. In this study, we quantified the risk–benefit balance in the Danish adult population by increasing the mandatory fortification level. We applied a risk–benefit assessment approach in which population-level iodine intakes before and after the increase in fortification were integrated with epidemiological evidence of the association between iodine nutrition status and risk of relevant diseases to estimate the number of cases caused or prevented and estimated health impact in terms of disability-adjusted life years (DALY). We estimated an overall beneficial health impact and prevention of 34.9 (95% UI: −51.6; −21.7) DALY per 100,000 adults in the population annually with the increase in fortification level. Prevention of low IQ in children due to maternal iodine deficiency was the primary contributor to overall health gain. The gain in healthy life years comes at the expense of extra cases of goiter due to iodine excess. Due to lack of data, hypo- and hyperthyroidism related to iodine status were not included. Neither were children as a population group. Because of this, as well as uncertainties inherent in the model and data used, results should be interpreted with caution. We argue that nation-specific, quantitative assessments of the public health impact of fortification programs provide transparent, evidence-based decision support. Future research should aim to enable the inclusion of all relevant health effects as well as children in the assessment.

Effect of a Fortified Dairy-Based Drink on Micronutrient Status, Growth, and Cognitive Development of Nigerian Toddlers- A Dose-Response Study

Malnutrition results in a high prevalence of stunting, underweight, and micronutrient deficiencies. This study investigated the effect of a multi-nutrient fortified dairy-based drink on micronutrient status, growth, and cognitive development in malnourished [height-for-age z-score (HAZ) and/or weight-for-age z-score (WAZ) < -1 SD and >-3 SD] Nigerian toddlers (n = 184, 1-3 years). The product was provided in different daily amounts (200, 400, or 600 ml) for 6 months. At baseline and endline, venous blood and urine samples were collected to determine micronutrient status. Bodyweight, height, waist, and head circumference were measured, and corresponding Z-scores were calculated. The Bayley-III Screening Test was used to classify the cognitive development of the children. In a modified per-protocol (PP) population, the highest prevalence's of micronutrient deficiencies were found for vitamin A (35.5%) and selenium (17.9%). At endline, there were no significant improvements in iodine, zinc, vitamin B12, and folate status in any of the three groups. Regarding vitamin D status (25OHD), consumption of 600 and 400 ml resulted in an improved status as compared to baseline, and in a difference between the 600- and 200-ml groups. Consumption of 600 ml also increased vitamin A and selenium status as compared to baseline, but no differences were found between groups. Within the groups, WAZ, weight-for-height z-score (WHZ), and BMI-for-age z-score (BAZ) improved, but without differences between the groups. For HAZ, only the 600 ml group showed improvement within the group, but it was not different between groups. For the absolute weight, height, and head circumference only trends for differences between groups were indicated. Cognition results did not differ between the groups. Within groups, all showed a decline in the per cent of competent children for receptive language. To study the effects of a nutritional intervention on linear growth and cognition, a longer study duration might be necessary. Regarding the improvement of micronutrient status, 600 ml of fortified dairy-based drink seems most effective.

Clinical Trial Registration

https://clinicaltrials.gov/ct2/show/NCT03411590?term=NCT03411590.&draw=2&rank=1, identifier: NCT03411590.

Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver scientific advice related to nutrient profiling for the development of harmonised mandatory front‐of‐pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. This Opinion is based on systematic reviews and meta‐analyses of human studies on nutritionally adequate diets, data from the Global Burden of Disease framework, clinical practice guidelines, previous EFSA opinions and the priorities set by EU Member States in the context of their Food‐Based Dietary Guidelines and associated nutrient/food intake recommendations. Relevant publications were retrieved through comprehensive searches in PubMed. The nutrients included in the assessment are those likely to be consumed in excess or in inadequate amounts in a majority of European countries. Food groups with important roles in European diets have been considered. The Panel concludes that dietary intakes of saturated fatty acids (SFA), sodium and added/free sugars are above, and intakes of dietary fibre and potassium below, current dietary recommendations in a majority of European populations. As excess intakes of SFAs, sodium and added/free sugars and inadequate intakes of dietary fibre and potassium are associated with adverse health effects, they could be included in nutrient profiling models. Energy could be included because a reduction in energy intake is of public health importance for European populations. In food group/category‐based nutrient profiling models, total fat could replace energy in most food groups owing to its high‐energy density, while the energy density of food groups with low or no fat content may be well accounted for by the inclusion of (added/free) sugars. Some nutrients may be included in nutrient profiling models for reasons other than their public health importance, e.g. as a proxy for other nutrients of public health importance, or to allow for a better discrimination of foods within the same food category.

Iodine from brown algae in human nutrition, with an emphasis on bioaccessibility, bioavailability, chemistry, and effects of processing: A systematic review

Brown algae are becoming increasingly popular as a food source and dietary supplement in Europe and other Western countries. As they are highly rich in iodine, they represent a potential new dietary iodine source. Iodine deficiency has been re-emerging in Europe, and it is important to ensure adequate intake through one's diet. However, macroalgae, and especially brown algae, may contain very high amounts of iodine, and both iodine deficiency and excessive iodine may increase the risk of negative health effects. The iodine content of algae or foods containing algae is currently not regulated in the European Union. The aim of this paper is to review the literature to determine the chemical species of iodine in brown algae, the loss of iodine during processing, and the bioavailability and bioaccessibility of iodine. A systematic search of the literature was performed in April 2021, via the databases Web of Science and PubMed. The review includes studies of iodine in brown macroalgae in relation to bioavailability, bioaccessibility, processing and speciation. A meta-analysis was conducted in relation to the following topics: (i) the correlation between total iodine and iodide (I- ) content in brown algae; (ii) the correlation between the loss of iodine during processing and the I- content; and (iii) the correlation between bioavailability and the I- content. The bioavailability of iodine from brown algae was generally high, with in vivo bioavailability ranging from 31% to 90%. The in vitro bioavailability of iodine (2%-28%) was systematically lower than in vivo bioavailability (31%-90%), indicating an inadequate in vitro methodology. Processing may reduce the iodine content of brown algae, and a higher I- content was positively correlated with increased iodine loss during processing. Although processing strategies may reduce the iodine content of brown algae significantly, the iodine content may still be high after processing. These findings may be used in food safety evaluations of brown algae as well as in the development of macroalgae-containing foods with iodine contents suitable for human consumption. Further research on processing techniques to reduce the iodine content in brown macroalgae are warranted.

Risk-Benefit Assessment of Feed Additives in the One Health Perspective

Safety and sustainability of animal feeds is a pillar of the safety of the entire food chain. Feed additive assessment incorporates consumer safety as well as animal health and welfare, which, in turn, can affect productivity and hence food security. The safety of feed users and the environment are other important components of the assessment process which, therefore, builds on a One Health perspective. In several instances the assessment entails a balanced assessment of benefits and risks for humans, animals and/or the environment. Three case studies are selected to discuss issues for a consistent framework on Risk-Benefit Assessment (RBA) of feed additives, based on EFSA opinions and literature: (a) Supplementation of feeds with trace elements with recognized human toxicity (cobalt, iodine) - RBA question: can use levels, hence human exposure, be reduced without increasing the risk of deficiency in animals?; (b) Aflatoxin binders in dairy animals - RBA question: can the use reduce the risk for human health due to aflatoxin M1, without unexpected adverse effects for animals or humans?; (c) Use of formaldehyde as preservative in feedstuffs to prevent microbial contamination - RBA question: is the reduction of microbiological risks outweighed by risks for the consumers, farmed animals or the workers? The case studies indicate that the safety of use of feed additives can involve RBA considerations which fit into a One Health perspective. As in other RBA circumstances, the main issues are defining the question and finding "metrics" that allow a R/B comparison; in the case of feed additives, R and B may concern different species (farm animals and humans). A robust assessment of animal requirements, together with sustainability considerations, might be a significant driving force for a RBA leading to a safe and effective use.

Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study

Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted. Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged >18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed. Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day). Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.

Iodine Requirements in Pediatrics: From Fetal Life to Adolescence

The aim of this mini-review is to present the current knowledge on iodine requirements in developmental age, from conception to adolescence. It is based on the analysis of updated national and international guidelines on iodine intake and the prevention of iodine deficiency. Health policy initiatives carried out in industrialized countries in previous decades have led to a dramatic improvement in nutritional iodine status in the general population. However, the prevention of iodine deficit continues to be a concern, especially for vulnerable categories, like adolescents and pregnant women.

Iodine Content of Wild and Farmed Seafood and Its Estimated Contribution to UK Dietary Iodine Intake

Iodine is an important nutrient for human health and development, with seafood widely acknowledged as a rich source. Demand from the increasing global population has resulted in the availability of a wider range of wild and farmed seafood. Increased aquaculture production, however, has resulted in changes to feed ingredients that affect the nutritional quality of the final product. The present study assessed the iodine contents of wild and farmed seafood available to UK consumers and evaluated its contribution to current dietary iodine intake. Ninety-five seafood types, encompassing marine and freshwater fish and shellfish, of wild and farmed origins, were purchased from UK retailers and analysed. Iodine contents ranged from 427.4 ± 316.1 to 3.0 ± 1.6 µg·100 g-1 flesh wet weight (mean ± SD) in haddock (Melanogrammus aeglefinus) and common carp (Cyprinus carpio), respectively, being in the order shellfish > marine fish > freshwater fish, with crustaceans, whitefish (Gadiformes) and bivalves contributing the greatest levels. Overall, wild fish tended to exhibit higher iodine concentrations than farmed fish, with the exception of non-fed aquaculture species (bivalves). However, no significant differences were observed between wild and farmed Atlantic salmon (Salmo salar), rainbow trout (Oncorhynchus mykiss), and turbot (Psetta maxima). In contrast, farmed European seabass (Dicentrarchus labrax) and seabream (Sparus aurata) presented lower, and Atlantic halibut (Hippoglossus hippoglossus) higher, iodine levels than their wild counterparts, most likely due to the type and inclusion level of feed ingredients used. By following UK dietary guidelines for fish consumption, a portion of the highest oily (Atlantic mackerel, Scomber scombrus) and lean (haddock) fish species would provide two-thirds of the weekly recommended iodine intake (980 µg). In contrast, actual iodine intake from seafood consumption is estimated at only 9.4-18.0% of the UK reference nutrient intake (140 µg·day-1) across different age groups and genders, with females obtaining less than their male equivalents.

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25-79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008-2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008-2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.

Elemental Composition of Algae-Based Supplements by Energy Dispersive X-ray Fluorescence

The aim of this study is to evaluate the elemental composition of fifteen algae-based supplements commonly sold in the Portuguese market, by energy dispersive X-ray fluorescence. Despite the fact that the majority of Kelp samples were a good source of iodine, the levels observed might well contribute to an excess in the human body, which can cause dysfunction of the thyroid gland. Furthermore, the presence of lead in Sea spaghetti, Arame, Hijiki and Wakame caused a considerable risk to public health vis a vis possible ingestion of a high daily dose. Regarding arsenic, great variability was observed in all the samples with concentrations equal to or above 60 μg/g in the case of Arame, KelpJ and Hijiki. Although algae mainly accumulate organic arsenic, some also contain high levels of its inorganic form, as is commonly pointed out for Hijiki. Thus, regular ingestion of these supplements must also take into account the mentioned facts. There is no doubt that these supplements are also good sources of other nutrients, but the lack of accurate regulations and control should alert consumers to avoid indiscriminate use of these types of products.

A Single Dose of Marine Chlorella vulgaris Increases Plasma Concentrations of Lutein, β-Carotene and Zeaxanthin in Healthy Male Volunteers

The beneficial health effects of Chlorella vulgaris have been associated with the presence of several nutrients and antioxidants, including carotenoids. However, the in vivo bioavailability of Chlorella is still poorly evaluated. In this work, a human intervention study was conducted in 11 healthy men to evaluate the bioavailability of carotenoids within 3 days after the intake of a single dose (6 g) of dried marine Chlorella vulgaris containing lutein (7.08 mg), β-carotene (1.88 mg) and zeaxanthin (1.47 mg). Subjects were instructed to follow a low carotenoid diet during the experimental phase, starting 1 week earlier. On the day of the experiment, dried microalgae formulated in vegetarian hard capsules were ingested, and blood samples were collected up to 72 h for the analysis of plasma carotenoids concentration by high-performance liquid chromatography with diode-array detection. For all carotenoids, the estimated AUC and C_max values were significantly different from zero (p < 0.05), indicating that a single dose of marine Chlorella vulgaris increased plasma concentrations of lutein (C_min-corrected AUC = 1002 µg·h/L, C_max = 20.4 µg/L), β-carotene (AUC = 1302 µg·h/L, C_max = 34.9 µg/L) and zeaxanthin (AUC = 122.2 µg·h/L, C_max = 3.4 µg/L). The bioavailability of other compounds, namely, polyunsaturated fatty acids and trace elements, was also assessed post-prandial for the first time, showing that linoleic acid, docosahexaenoic acid and iodine were absorbed after microalgae intake. These findings support the use of Chlorella vulgaris as a source of carotenoids, PUFA and essential trace elements with associated health benefits.

Relationship between salt consumption and iodine intake in a pediatric population

PURPOSE

The World Health Organization recommends reduction of salt intake to < 5 g/day and the use of iodized salt to prevent iodine deficiency states. A high prevalence of excess salt consumption and an inadequate iodine intake has been previously shown in an Italian pediatric population. It was appropriate, therefore, to analyse in the same population the relationship occurring between salt consumption and iodine intake.

METHODS

The study population was made of 1270 children and adolescents. Estimates of salt consumption and iodine intake were obtained by measuring 24 h urinary sodium and iodine excretion.

RESULTS

The iodine intake increased gradually across quartiles of salt consumption independently of sex, age and body weight (p < 0.001). Median iodine intake met the European Food Safety Authority adequacy level only in teenagers in the highest quartile of salt consumption (salt intake > 10.2 g/day). We estimated that approximately 65-73% of the total iodine intake was derived from food and 27-35% from iodized salt and that iodized salt made actually only 20% of the total salt intake.

CONCLUSION

In this pediatric population, in face of an elevated average salt consumption, the use of iodized salt was still insufficient to ensure an adequate iodine intake, in particular among teenagers. In the perspective of a progressive reduction of total salt intake, the health institutions should continue to support iodoprophylaxis, in the context of the national strategies for salt reduction. In order for these policies to be successful, in addition to educational campaigns, it is needed that the prescriptions contained in the current legislation on iodoprophylaxis are made compelling through specific enforcement measures for all the involved stakeholders.

Is There an Ideal Diet to Protect against Iodine Deficiency?

Iodine deficiency is a global issue and affects around 2 billion people worldwide, with pregnant women as a high-risk group. Iodine-deficiency prevention began in the 20th century and started with global salt iodination programmes, which aimed to improve the iodine intake status globally. Although it resulted in the effective eradication of the endemic goitre, it seems that salt iodination did not resolve all the issues. Currently, it is recommended to limit the consumption of salt, which is the main source of iodine, as a preventive measure of non-communicable diseases, such as hypertension or cancer the prevalence of which is increasing. In spite of the fact that there are other sources of iodine, such as fish, seafood, dairy products, water, and vegetables, the high consumption of processed food with a high content of unionised salt, alternative diets or limited salt intake can still lead to iodine deficiency. Thus, iodine deficiency remains a relevant issue, with new, preventive solutions necessary. However, it appears that there is no diet which would fully cover the iodine requirements, and iodine food supplementation is still required.

Spot urine iodine levels below the WHO recommendation are not related to impaired thyroid function in healthy children and adolescents

PURPOSE

Iodine deficiency in childhood and adolescence may lead to later thyroid dysfunction, stunted growth and cognitive impairment. The World Health Organization (WHO) has issued recommended age-dependent urine iodine concentration targets, but a critical threshold beyond which clinical sequelae are to be expected remains undefined. Our study aimed to investigate spot urine iodine concentration in a typical Central European cohort of children and adolescents, and consider the implications of these values in regard to laboratory parameters for evaluating thyroid function.

METHODS

Using the Sandell-Kolthoff method, spot urine iodine concentration was measured cross-sectionally from 1802 healthy children and adolescent in the age range of 0.25-18 years within the LIFE-Child epidemiological study based in and around the city of Leipzig (Germany). Additionally, serum thyroid biomarkers of these subjects were measured and correlated to urine iodine levels.

RESULTS

In our cohort, 61.39% of boys and 65.91% of girls had an iodine level of < 100 µg/L (57%, 67%, 65% of the age groups 0-5, 6-12 and 13-18 years), the median iodine excretion was 86 µg/L in boys and 80 µg/L in girls. The iodine levels revealed no significant correlation with the thyroid biomarkers TSH, FT4 and FT3. Moreover, iodine values revealed no correlation with levels of antibodies against thyroid peroxidase or thyroglobulin.

CONCLUSION

In our cohort of children and adolescents, the relatively high number of iodine levels below the WHO recommendation appears not to be related to clinical or subclinical thyroid diseases in the respective participants.

The role of vitamin D in metabolic and reproductive disturbances of polycystic ovary syndrome: A narrative mini-review

Vitamin D is a secosteroid hormone that plays a pivotal role in several metabolic and reproductive pathways in humans. Increasing evidence supports the role of vitamin D deficiency in metabolic disturbances and infertility in women with polycystic ovary syndrome (PCOS). Indeed, supplementation with vitamin D seems to have a beneficial role on insulin resistance and endometrial receptivity. On the other hand, exceedingly high levels of vitamin D appear to play a detrimental role on oocytes development and embryo quality. In the current review, we summarize the available evidence about the topic, aiming to suggest the best supplementation strategy in women with PCOS or, more generally, in those with metabolic disturbances and infertility. Based on the retrieved data, vitamin D seems to have a beneficial role on IR, insulin sensitivity and endometrial receptivity, but high levels and incorrect timing of administration seem to have a detrimental role on oocytes development and embryo quality. Therefore, we encourage a low dose supplementation (400-800 IU/day) particularly in vitamin D deficient women that present metabolic disturbances like PCOS. As far as the reproductive health, we advise vitamin D supplementation in selected populations, only during specific moments of the ovarian cycle, to support the luteal phase. However, ambiguities about dosage and timing of the supplementation still emerge from the clinical studies published to date and further studies are required.

The acceptance of zinc biofortified rice in Latin America: A consumer sensory study and grain quality characterization

Zinc deficiency is a major public health problem in vulnerable populations of Latin America and the Caribbean. Biofortification of rice (Oryza sativa L.) with zinc has the potential to alleviate zinc deficiencies. However, as plant breeding processes can alter grain culinary quality and favorable sensory attributes, grain quality and consumer acceptability need to be assessed prior to releasing a variety to the public. A grain quality characterization and a sensory acceptability analysis were carried out with two varieties of zinc biofortified rice and a local control both in Bolivia and Colombia. The aim of this study was to evaluate the physicochemical parameters that are significant in consumer acceptance and to determine the acceptability of zinc biofortified rice by consumers. Results of physicochemical parameters were analyzed using ANOVA. The sensory acceptability was evaluated in 243 adults utilizing a 7-point hedonic scale and a Wilcoxon's signed rank test was used to determine the overall acceptability of the varieties. Biofortified rice variety T2-11 and MAC-18 -control 1- were equally accepted by consumers in Bolivia with no significant differences (p<0.05). The grain quality analysis reported that both presented long and slender rice grains (L>7.5 mm and L/B>3), an intermediate to high amylose content (>25%) and a similar level of chalkiness. In Colombia, the biofortified variety 035 presented a higher score in overall acceptance in comparison to biofortified variety 021 and the local variety CICA4 -control 2-. However, no significant differences were observed (p<0.05). Conversely to the other two varieties, the biofortified variety 035 presented the largest size grain (L/B = 2.97), a lower chalkiness and an amylose content above 25%. This study shows that the grain quality properties of rice have an influence on acceptability and that zinc biofortified rice varieties are accepted by consumers.

Human Exposure to Iodine from the Consumption of Edible Seaweeds

The increasing consumption of wakame algae (Undaria pinnatifida) and kombu (Laminaria ochroleuca) because of their culinary appeal and beneficial properties means there is a need to study the composition of these new foods. Algae stand out for their high iodine content, this being an essential element whenever it is ingested at recommended levels but which, ingested in high quantities, can cause harmful effects to health such as hyperthyroidism and even goiter. The iodine content in 30 samples of algae from different geographical origins (Asia and Europe) has been determined by oxidation-reduction titration with sodium thiosulfate. European kombu algae (27.7 ± 5.4 mg/kg dry weight) have the highest mean average iodine concentrations. European algae have higher iodine content than Asian algae. Significant differences (p < 0.05) have been recorded among wakame algae according to geographical origin. The consumption of 4 g/day of European kombu algae means an intake of 111 μg/day of iodine, which is a value close to the RDI (recommended daily intake) set at 150 μg/day. It is necessary to monitor iodine levels in algae to avoid excessive intakes and harmful effects on health.

Iodine Accumulation and Tolerance in Sweet Basil (Ocimum basilicum L.) With Green or Purple Leaves Grown in Floating System Technique

Iodine deficiency is a serious world-wide public health problem, as it is responsible for mental retardation and other diseases. The use of iodine-biofortified vegetables represents a strategic alternative to iodine enriched salt for people with a low sodium diet. However, at high concentrations iodine can be toxic to plants. Therefore, research on plant iodine toxicity is fundamental for the development of appropriate biofortification protocols. In this work, we compared two cultivars of sweet basil (Ocimum basilicum L.) with different iodine tolerance: "Tigullio," less tolerant, with green leaves, and "Red Rubin," more tolerant and with purple leaves. Four greenhouse hydroponic experiments were conducted in spring and in summer with different concentrations of iodine in the nutrient solution (0.1, 10, 50, 100, and 200 μM), supplied as potassium iodide (KI) or potassium iodate (KIO3). Plant growth was not affected either by 10 μM KI or by 100 μM KIO3, while KI concentrations higher than 50 μM significantly reduced leaf area, total plant dry matter and plant height. The severity of symptoms increased with time depending on the cultivar and the form of iodine applied. Growth inhibition by toxic iodine concentrations was more severe in "Tigullio" than in "Red Rubin," and KI was much more phytotoxic than KIO3. Leaf iodine concentration increased with the iodine concentration in the nutrient solution in both varieties, while the total antioxidant power was generally higher in the purple variety. In both basil cultivars, a strong negative correlation was found between the photosynthesis and the leaf iodine content, with significant differences between the regression lines for "Tigullio" and "Red Rubin." In conclusion, the greater tolerance to iodine of the "Red Rubin" variety was associated with the ability to withstand higher concentrations of iodine in leaf tissues, rather than to a reduced accumulation of this element in the leaves. The high phenolic content of "Red Rubin" could contribute to the iodine tolerance of this purple cultivar.

Changes of trace element status during aging: results of the EPIC-Potsdam cohort study

Purpose

We aimed to evaluate age-dependent changes of six trace elements (TE) [manganese (Mn), iron (Fe), zinc (Zn), copper (Cu), iodine (I), and selenium (Se)] over a 20-year period.

Methods

TE concentrations were determined using repeated serum samples taken at baseline and after 20 years of follow-up from 219 healthy participants of the EPIC-Potsdam study, using inductively coupled plasma tandem mass spectrometry. For each TE, absolute and relative differences were calculated between the two time points, as well as the proportion of individuals within normal reference ranges. Interdependence between age-related TE differences was investigated using principal component analysis (PCA). Relationships between selected factors (lifestyle, sociodemographic, anthropometric factors, and hypertension) and corresponding TE longitudinal variability were examined using multivariable linear regression models.

Results

Median age of our study sample was 58.32 years (4.42) at baseline and 40% were females. Median Mn, Zn, Se concentrations and Se to Cu ratio significantly decreased during aging while median Fe, Cu, I concentrations and Cu to Zn ratio significantly increased. A substantial percentage of the participants, at both time points, had Zn concentrations below the reference range. The first PCA-extracted factor reflected the correlated decline in both Mn and Zn over time while the second factor reflected the observed (on average) increase in both Cu and I over time. Overall, none of the investigated factors were strong determinants of TE longitudinal variability, except possibly dietary supplement use, and alcohol use for Fe.

Conclusions

In conclusion, in this population-based study of healthy elderly, decrease in Mn, Zn, and Se concentrations and increase in Fe, Cu, and I concentrations were observed over 20 years of follow-up. Further research is required to investigate dietary determinants and markers of TE status as well as the relationships between TE profiles and the risk of age-related diseases.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-02143-w) contains supplementary material, which is available to authorized users.

Mineral and vitamin intake of infants and young children: the Nutri-Bébé 2013 survey

PURPOSE

Minerals and vitamins are essential for optimal growth and development, particularly during the first years of life. Therefore, regularly evaluating their intake makes sense. For this purpose, we report the data from the Nutri-Bébé 2013 survey in comparison with the European Food Safety Authority Adequate Intake (AI), or Average Requirement, (AR) according to age.

METHODS

This observational, nationally representative, cross-sectional survey was conducted in 1035 non-breastfed French children aged 0.5-35 months. Dietary intake was recorded using a food diary on three non-consecutive days, framed by two face-to-face interviews.

RESULTS

The intake of zinc, magnesium and water-soluble vitamins most of the time met the recommendations. From the first weeks of life, sodium intake exceeded the AI, with a maximum median intake of 1137 mg/day after the age of 30 months. However, it has decreased since 2005. Calcium median intake often exceeded the AI or AR, reaching a maximum of 780 mg/day between 18 and 23 months. Median vitamin A intake always exceeded the AI or AR but exceeded the recommended upper limit in only a few cases. After 2 years, median iron intake was clearly below the AR, i.e. lower than 6.0 mg/day. Dietary vitamin D intake was below the AI, thereby justifying adequate supplementation. Vitamin E intake was below the AI in 50-75% of toddlers.

CONCLUSION

This survey highlights excessive sodium intake as well as a shortfall of iron, vitamin D, and vitamin E intakes. The potential consequences of these discrepancies with respect to health outcomes remain to be assessed.