Influence of knowledge on iodine content in foodstuffs and prophylactic usage of iodized salt on urinary iodine excretion and thyroid volume of adults in southern Germany

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1±22.4 mg/kg creatinine (0.412 μmol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7±73 mg/kg creatinine (1.24 μmol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.

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Comparison of urinary iodine excretion and thyroid volume in students with or without constant iodized salt intake

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0029-1211931 ◽

2009 ◽

Vol 105 (S 04) ◽

pp. 43-45 ◽

Cited By ~ 1

Author(s):

R. Gärtner ◽

G. Bechtner ◽

M. Rafferzeder ◽

W. Greil

Keyword(s):

Salt Intake ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodized Salt ◽

Urinary Iodine Excretion ◽

Iodine Excretion

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Prevalence of Goiter and Urinary Iodine Excretion Levels in Children Around Chernobyl*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.82.10.4285 ◽

1997 ◽

Vol 82 (10) ◽

pp. 3430-3433 ◽

Cited By ~ 1

Author(s):

Kiyoto Ashizawa ◽

Yoshisada Shibata ◽

Shunichi Yamashita ◽

Hiroyuki Namba ◽

Masaharu Hoshi ◽

...

Keyword(s):

Urinary Iodine ◽

Rank Correlation ◽

Thyroid Volume ◽

Iodine Content ◽

Significant Negative Correlation ◽

Urinary Iodine Excretion ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient ◽

Medical Diagnostic ◽

Iodine Excretion

Abstract The prevalence of goiter among children living in areas affected by the Chernobyl accident was investigated by analysis of data on approximately 120,000 children examined at five medical diagnostic centers in Belarus, Russia, and the Ukraine. Examinations of thyroid gland were conducted with an arch-automatic ultrasonographic instrument at the five centers under the same protocol. The diagnosis of goiter was established when the thyroid volume exceeded a limit calculated from age, height, and body weight of a child. A considerable variation by region was noted in the prevalence of goiter. Highest in the Kiev region, the prevalence in the five regions was 54% in Kiev, 38% in the Zhitomir regions of the Ukraine, 18% in Gomel, 22% in the Mogilev regions of Belarus, and 41% in the Bryansk region of Russia. Urinary iodine content was measured in approximately 5700 children, and an endemic iodine deficient zone was confirmed in the Bryansk, Kiev, and Zhitomir regions. A significant negative correlation was observed between the prevalence of goiter and the median level of urinary iodine content (Spearman’s rank correlation coefficient was −0.35, P = 0.025).

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Current Status of Iodine Deficiency in Mongolia in 1998-1999

Asia Pacific Journal of Public Health ◽

10.1177/101053950001200205 ◽

2000 ◽

Vol 12 (2) ◽

pp. 79-84 ◽

Cited By ~ 4

Author(s):

C. Yamada ◽

D. Oyunchimeg ◽

P. Enkhtuya ◽

A. Erdenbat ◽

A. Buttumur ◽

...

Keyword(s):

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Content ◽

Iodized Salt ◽

Current Status ◽

Urinary Iodine Excretion ◽

Salt Iodization ◽

Thyroid Glands ◽

Elimination Programme ◽

Iodine Excretion

In 1992, the Mongolian government conducted a nationwide palpation study of the thyroid glands, and the study showed an overall goiter rate of 30%. As a result of this, the Mongolian Government launched its Iodine Deficiency Disorders (IDD) Elimination Programme in 1996 and its primary strategy was salt iodization. In 1998 and 1999, we carried out programme monitoring studies in 11 provinces. The results showed: among schoolchildren, a goiter rate was 22.8% (n=6,535), median values of urinary iodine excretion ranged from 11 μg/l to 256 μg/l (n=1,930), and usage rates of iodized salt (>20 PPM iodine content) in their households ranged from 3% to 82%. We concluded that severe iodine deficiency in 1992 was improved from moderate to mild severity a few years later by salt iodization. However, stronger official commitments and community participation are needed to improve the programme so that iodized salt will be made more widely available. Asia Pac JPublic Health 2000;12(2): 79-84

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Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher's survey: A historical review with some new goitre prevalence data

Acta Endocrinologica ◽

10.1530/acta.0.1230577 ◽

1990 ◽

Vol 123 (6) ◽

pp. 577-590 ◽

Cited By ~ 86

Author(s):

Hans Bürgi ◽

Zeno Supersaxo ◽

Beat Selz

Keyword(s):

Military Service ◽

Urinary Iodine ◽

Historical Review ◽

Mental Deficiency ◽

Preventive Measure ◽

Iodine Content ◽

Cost Effective ◽

Iodized Salt ◽

Urinary Iodine Excretion ◽

Human Consumption

Abstract. In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and 1980, to the present 15 mg I per kg. In 1988, 92% of retail salt and 76% of all salt for human consumption (including food industry) was iodized, even though its use is voluntary. Urinary iodine excretion, previously between 18 and 64 μg per per day, has now risen to 150 μg per day. No new endemic cretins born after 1930 have been identified. Goitre disappeared rapidly in newborns and schoolchildren, more slowly in army recruits, and incompletely in elderly adults. In some Cantons (by constitution in charge of health matters and the salt monopoly) which allowed iodized salt only in 1952, disappearance of goitre lagged behind accordingly, proof that iodized salt was the cause of regression. The Swiss data provide evidence that isolated deafness, mental deficiency, and short stature, each without the other attributes of cretinism have also decreased. Adverse effects of iodized salt were minimal, possibly because the initial iodine content of salt was chosen very low. Iodization of salt has proved a highly cost-effective preventive measure in Switzerland.

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Thirty years of a Ban on the Sale of Noniodized Salt: Impact on Iodine Nutrition in Children in Himachal Pradesh, India

Food and Nutrition Bulletin ◽

10.1177/156482650502600301 ◽

2005 ◽

Vol 26 (3) ◽

pp. 255-258 ◽

Cited By ~ 7

Author(s):

Umesh Kapil ◽

Thakur Dutt Sharma ◽

Preeti Singh ◽

Sada Nand Dwivedi ◽

Supreet Kaur

Keyword(s):

Positive Impact ◽

Urinary Iodine ◽

Iodine Content ◽

Himachal Pradesh ◽

The State ◽

Urinary Iodine Excretion ◽

Successful Implementation ◽

Iodine Nutrition ◽

Salt Iodization ◽

Iodine Excretion

Background A survey conducted by the central iodine-deficiency disorders team in Himachal Pradesh, a state in the goiter-endemic belt of India, revealed that 10 of its 12 districts have an endemic prevalence of goiter. The survey was conducted to provide health program managers data to determine whether it would be necessary to initiate intervention measures. Objective To assess the status of urinary iodine excretion and household salt iodization levels after three decades of a complete ban on the sale of noniodized salt in this goiter-endemic state in India as measured by assessment of urinary iodine excretion levels and iodine content of salt at the household level. Methods The guidelines recommended by WHO/UNICEF/ICCIDD for a rapid assessment of salt iodization were adopted. In each of the 12 studied districts, all senior secondary schools were enlisted and one school was selected by using a random sampling procedure. Two hundred fifty children 11 to 18 years of age were included in the study. Urine samples were collected from a minimum of 170 children and analyzed using the wet digestion method. Salt samples were also collected from a minimum of 170 children and analyzed using the spot testing kit. Results All districts had a median urinary iodine excretion level > 200 μg/L and 82% of the families were consuming salt with an iodine content of 15 ppm or higher. Conclusions The results of the present study highlight the successful implementation of the salt iodization program in the state of Himachal Pradesh. This positive impact may be due to the comprehensive strategy adopted by the state government to improve the quality of salt, development of an effective monitoring information system and effective information, education, and communication activities.

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Effects of Giving Iodized Salt, Counseling of Iodine and Goitrogenic Sources of Food in Mothers Who Have Elementary School Children Against Urinary Iodine Excretion

Health Notions ◽

10.33846/hn30506 ◽

2019 ◽

Vol 3 (5) ◽

pp. 238-243

Author(s):

I Ketut Swiryajaya ◽

Iswari Pauzi

Keyword(s):

Elementary School ◽

Treatment Group ◽

School Children ◽

Elementary School Children ◽

Urinary Iodine ◽

Iodized Salt ◽

Control Group ◽

Urinary Iodine Excretion ◽

Iodine Excretion ◽

The Mean

As a result of IDD is the occurrence of impaired child growth makes researchers interested in conducting research on "Provision of iodized salt, food counseling about the source of iodine and goitrogenic substances with urinary iodine excretion status in elementary school children". Research on IDD is often carried out in primary school-age children, aged 6-12 years because of their vulnerability to iodine deficiency. The purpose of this study was to determine the effect of iodized salt interventions and counseling patterns of iodized and goitrogenic food consumption patterns on levels of urinary yodiun excretion in families with elementary school children. Research methods: The design of this study included quasi-experimental using a specific design that is "pre and post test control group design". The study population was elementary school children with a sample size of 30 children aged 9 -12 years in each group. Data collected included the consumption of nutrients by the 24-hour recall method, the results of urine iodine examination by the spectrophotometric method. The collected data is then analyzed with an independent sample T test. The results showed there were differences in urinary yodiun excretion levels in the two groups (treatment and control), while the mean in the treatment group before intervention was 106.97 ug / L and after the intervention was 43.19 ug / L. Whereas in the control group, the level of urinary yodiun excretion before intervention was 117.30 μg / L and after the intervention was 243.19 μg / L. The mean of respondents who consumed goitrogenic sources in the treatment group before the intervention (Yes = 63%, No = 37%), after the intervention (Yes = 23%, No = 77%). Whereas in the Control group before the intervention (Yes = 56%, No = 73%), after the intervention (Yes = 23%, No = 77%). The average amount of protein consumption before treatment was 47.91 µg/L ± 6.54 and 50.15 µg/L ± 12.52 after treatment. For consumption, an increase with a mean before treatment was 89.88 µg/L ± 38.45 and after treatment was 113 µg/L ± 26. The results of the independent sample t-test showed that in the treatment group there was no significant difference between after and before the intervention (p = 0.058). Whereas in the control group there were significant differences between before and after the intervention (p = 0.002). It can be concluded that there are many factors that need to be controlled in the provision of interventions, especially the use, type of salt and goitronic as well as the method of examination of iodine analysis in urine. Keywords: iodized salt; iodine food sources; goitrogenic; urinary iodine excretion

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Thyroid volume and morphology and urinary iodine excretion in a Danish municipality

Acta Endocrinologica ◽

10.1530/acta.0.1290505 ◽

1993 ◽

Vol 129 (6) ◽

pp. 505-510 ◽

Cited By ~ 32

Author(s):

Birte Nygaard ◽

Peter Gideon ◽

Harriet Dige-Petersen ◽

Niels Jespersen ◽

Karsten Sølling ◽

...

Keyword(s):

Urinary Iodine ◽

Thyroid Volume ◽

Entire Group ◽

Urinary Iodine Excretion ◽

Thyroid Disorder ◽

Who Grade ◽

Iodine Supplementation ◽

Ultrasound Study ◽

Group I ◽

Iodine Excretion

In order to throw light upon the eventual need for iodine supplementation in Denmark, four age groups of women (15, 30, 45 and 60 years) from the Holbaek municipality were invited for a clinical and ultrasound study of thyroid volume, structure and function. Of the 570 women invited, 391 accepted and were divided into the following groups: group I: 15 years, N= 113; group II: 30 years, N= 100; group III: 45 years, N=98; group IV: 60 years, N=80. The results were as follows: the thyroid gland was palpable in 39% and visible in 16% of the entire group; 19% had a family history of thyroid disorders and 7.6% had a previous thyroid disorder. Thyroid volumes (median (range)) as measured by ultrasound were 12 ml (4–29 ml), 18 ml (5–47 ml), 18 ml (7–64 ml) and 18 ml (9-51 ml) in groups I– IV, respectively. The calculated 24-h iodine excretion was 65 μg (19–365 μg), 88 μg (15-274 μg), 97 μg (40–737 μg) and 83 μg (50–999 μg) in groups I–IV, respectively. An abnormal echo structure was present in 3, 10, 21 and 30%, respectively. Defining a goitre as a thyroid volume above 28 ml indicated a goitre prevalence of 17% in females aged 30–60 years in the Holbaek area of Denmark. Among the 60-year-old women, 3% had a clinically significant goitre (WHO grade III). Thyroid volume did not correlate with iodine excretion. The benefit of iodine supplementation is discussed.

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Assessment of the iodine nutritional status among Chinese school-aged children

Endocrine Connections ◽

10.1530/ec-19-0568 ◽

2020 ◽

Vol 9 (5) ◽

pp. 379-386

Author(s):

Ning Yao ◽

Chunbei Zhou ◽

Jun Xie ◽

Xinshu Li ◽

Qianru Zhou ◽

...

Keyword(s):

Nutritional Status ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Content ◽

Iodine Concentration ◽

Iodine Intake ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

School Aged Children ◽

Goiter Prevalence

Objective The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children. Methods A total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated. Results The overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05). Conclusions The efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100–299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.

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Nutritional iodine status and obesity

Thyroid Research ◽

10.1186/s13044-021-00116-y ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Mariacarla Moleti ◽

Maria Di Mauro ◽

Giuseppe Paola ◽

Antonella Olivieri ◽

Francesco Vermiglio

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

Thyroid Hormones ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Intake ◽

Urinary Iodine Excretion ◽

Obese Children ◽

Iodine Status ◽

Iodine Excretion

AbstractIodine is an essential component of the thyroid hormones, thyroxine and triiodothyronine. Its availability strictly depends on iodine content of foods, which may vary from very low to very high. Inadequate iodine intake (deficiency or excess) may affect thyroid function resulting in hypothyroidism or hyperthyroidism. Based on median urinary iodine concentrations, epidemiological criteria have been established for the categorization and monitoring of nutritional iodine status of a population (or subgroups of populations). Additional methods for iodine intake assessment include measurement of thyroid size (by thyroid palpation or ultrasonography) and of biochemical parameters, such as neonatal thyroid stimulating hormone, thyroglobulin and thyroid hormones.Recent studies carried out in overweight/obese children and adults provide evidence that body mass index (BMI) may significantly influence the above indicators, thus theoretically affecting the epidemiological evaluation of nutritional iodine status in populations.In this short review, we analyze current knowledge on the effects of overweight and obesity on indicators of adequacy and monitoring of iodine status, namely urinary iodine excretion and thyroid volume and echogenicity.Data on urinary iodine excretion in overweight/obese children are divergent, as both increased and reduced levels have been reported in overweight/obese children compared to normal-weight controls.Whether gastrointestinal surgery may affect iodine absorption and lead to iodine deficiency in patients undergoing bariatric surgery has been evaluated in a limited number of studies, which excluded iodine deficiency, thus suggesting that supplements usually recommended after bariatric surgery do not need to include iodine.Albeit limited, evidence on thyroid volume and obesity is consistent with a direct relationship between thyroid volume and BMI, irrespective of nutritional iodine status. Finally, a higher frequency of thyroid hypoechoic pattern has been described in overweight/obese children. This finding has been recently related to an increased adipocyte infiltration and thyroid parenchyma imbibition mediated by inflammatory cytokines and should be considered when the frequency of thyroid hypoechoic pattern is used as non-invasive marker to indirectly assess thyroid autoimmunity in monitoring Universal Salt Iodization programs. Further studies, specifically addressing the role of schoolchildren body mass index as a factor potentially influencing iodine intake indicators are needed.

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