scholarly journals Development and validation of an iodine-specific FFQ to estimate iodine intake in Australian pregnant women

2015 ◽  
Vol 113 (6) ◽  
pp. 944-952 ◽  
Author(s):  
Dominique Condo ◽  
Maria Makrides ◽  
Sheila Skeaff ◽  
Shao J. Zhou

Adequate iodine is important during pregnancy to ensure optimal growth and development of the offspring. We validated an iodine-specific FFQ (I-FFQ) for use in Australian pregnant women. A forty-four-item I-FFQ was developed to assess iodine intake from food and was administered to 122 pregnant women at 28 weeks gestation. Iodine supplement use was captured separately at 28 weeks gestation. Correlation between iodine intake from food estimated using the I-FFQ and a 4 d weighed food record as well as correlation between total iodine intake and 24 h urinary iodine excretion (UIE), 24 h urinary iodine concentration (UIC), spot UIC and thyroid function were assessed at 28 weeks gestation. A moderate correlation between the two dietary methods was shown (r0·349,P< 0·001), and it was strengthened with the addition of iodine supplements (r0·876,P< 0·001). There was a fair agreement (k= 0·28,P< 0·001) between the two dietary measures in the classification of women as receiving adequate ( ≥ 160 μg/d) or inadequate ( < 160 μg/d) iodine intake from food, but the limits of agreement from the Bland–Altman plot were large. Total iodine intake was associated with 24 h UIE (β = 0·488,P< 0·001) but not with spot UIC. Iodine intake from food using the I-FFQ was assessed at study entry ( < 20 weeks gestation) in addition to 28 weeks gestation, and there was a strong correlation in iodine intake at the two time points (r0·622,P< 0·001), which indicated good reproducibility. In conclusion, the I-FFQ provides a valid tool for estimating iodine intake in pregnant women and can be used to screen women who are at risk of inadequate intake.

2007 ◽  
Vol 10 (12A) ◽  
pp. 1596-1599 ◽  
Author(s):  
Fereidoun Azizi

AbstractObjective: To describe studies evaluating urinary iodine excretion during pregnancy and lactation in women living in cities with adequate or more than adequate iodine intake.Design: Cross-sectional study conducted between 1996 and 1998 in pregnant women and a study of lactating women conducted in 2003.Settings and Subjects: Pregnant women attending prenatal clinics in four cities in the Islamic Republic of Iran. Urinary iodine excretion and thyroid volume was measured in 403 women. In a second study, 100 lactating women from Taleghani Hospital in Gorgan, Iran were evaluated for thyroid size, and both urinary and breast milk iodine concentrations were determined.Results: In Rasht city, 84% of pregnant women had a urinary iodine concentration of ≥ 200 μg l-1, while in the other cities this percentage ranged from 45 to 55%. When data were combined for the cities of Ilam, Isfahan and Tehran, where women have an adequate or more than adequate median urinary iodine concentration, 51% of pregnant women had a urinary iodine concentration less than that recommended during pregnancy. In Rasht, where the median urinary iodine concentration indicates an excessive iodine intake, 15.4% of pregnant women had a urinary iodine concentration < 200 μg l-1. The mean urinary iodine concentration in lactating women was 250 μg l-1, and 16% of women had a urinary iodine concentration < 100 μg l-1. Grade 1 goitre was present in 8% of lactating women, and another 8% had grade 2 goitre.Conclusions: Findings of this study call for further attention to iodine intake during pregnancy and lactation. The currently recommended intake of iodine through universal salt iodisation may not be adequate for pregnant and lactating women, and supplementation during pregnancy and lactation should be further considered in light of the latest recommendations.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Norman Blumenthal ◽  
Karen Byth ◽  
Creswell J. Eastman

Aim. The primary objective of the study was to assess the iodine nutritional status, and its effect on thyroid function, of pregnant women in a private obstetrical practice in Sydney.Methods. It was a cross-sectional study undertaken between November 2007 and March 2009. Blood samples were taken from 367 women at their first antenatal visit between 7 and 11 weeks gestation for measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels and spot urine samples for urinary iodine excretion were taken at the same time as blood collection.Results. The median urinary iodine concentration (UIC) for all women was 81 μg/l (interquartile range 41–169 μg/l). 71.9% of the women exhibited a UIC of <150 μg/l. 26% of the women had a UIC <50 μg/l, and 12% had a UIC <20 μg/l. The only detectable influences on UIC were daily milk intake and pregnancy supplements. There was no statistically significant association between UIC and thyroid function and no evidence for an effect of iodine intake on thyroid function.Conclusions. There is a high prevalence of mild to moderate iodine deficiency in women in Western Sydney but no evidence for a significant adverse effect on thyroid function. The 6.5% prevalence of subclinical hypothyroidism is unlikely to be due to iodine deficiency.


2020 ◽  
Vol 26 (2) ◽  
pp. 63-69
Author(s):  
Scrinic Olesea ◽  
Delia Corina Elena ◽  
Toma Geanina Mirela ◽  
Circo Eduard

Abstract Objective: Assessment of iodine nutritional status in pregnant women in the perimarine area of Romania, a region without iodine deficiency. Adequate iodine intake is the main source for normal thyroid function, ensuring the need for maternal thyroid hormones during pregnancy, but also for the development and growth of children in the fetal and postpartum period. Material and method: Prospective study performed on 74 pregnant women in the first 2 trimesters of pregnancy, originating from the perimarin area. The following indicators of iodine status were analyzed: urinary iodine concentration (UIC), the ratio between urinary iodine concentration and urinary creatinine (UIC/UCr), the prevalence of maternal goiter and the value of neonatal TSH (thyroid stimulating hormone). Results: The mean gestational age was 11 weeks. The ways of iodine intake are: iodized salt - 59.4%, iodized salt and iodine supplements- 23%, only iodine supplements -10.8% and 6.8% consume only non-iodized salt. The median of UIC was 133.03 mcg/l considered insufficient iodine intake (normal in pregnancy UIC >150 mcg/l), but the adjustment of UIC to urinary creatinine reveals a median of 152.83 mcg/g, a value that reflects an adequate iodine intake. The prevalence of goiter was 25.6% characteristic for a moderate iodine deficiency. The prevalence of neonatal TSH >5 mIU/L was registered in 18.8% characteristic of mild iodine deficiency. Conclusions: Monitoring of the iodine nutritional status is recommended for the prevention of disorders due to iodine deficiency under the conditions of universal salt iodization. Perimarine areas considered sufficient in iodine may show variations in iodine status in subpopulations under certain physiological conditions, such as pregnancy. An indicator of iodine status of the population is UIC, but the UIC/UCr ratio may be a more optimal indicator for pregnant women, to avoid possible overestimated results of iodine deficiency in pregnancy.


2019 ◽  
Vol 123 (9) ◽  
pp. 987-993 ◽  
Author(s):  
Wen Chen ◽  
Shu Gao ◽  
Wenxing Guo ◽  
Long Tan ◽  
Ziyun Pan ◽  
...  

AbstractIodine intake and excretion vary widely; however, these variations remain a large source of geometric uncertainty. The present study aims to analyse variations in iodine intake and excretion and provide implications for sampling in studies of individuals or populations. Twenty-four healthy women volunteers were recruited for a 12-d sampling period during the 4-week experiment. The duplicate-portion technique was used to measure iodine intake, while 24-h urine was collected to estimate iodine excretion. The mean intra-individual variations in iodine intake, 24-h UIE (24-h urinary iodine excretion) and 24-h UIC (24-h urinary iodine concentration) were 63, 48 and 55 %, respectively, while the inter-individual variations for these parameters were 14, 24 and 32 %, respectively. For 95 % confidence, approximately 500 diet samples or 24-h urine samples should be taken from an individual to estimate their iodine intake or iodine status at a precision range of ±5%. Obtaining a precision range of ±5% in a population would require twenty-five diet samples or 150 24-h urine samples. The intra-individual variations in iodine intake and excretion were higher than the inter-individual variations, which indicates the need for more samples in a study on individual participants.


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 172 ◽  
Author(s):  
Kristen Hynes ◽  
Judy Seal ◽  
Petr Otahal ◽  
Wendy Oddy ◽  
John Burgess

In Australia, pregnant women are advised to take an iodine supplement (I-supp) (150 µg/day) to reduce risks to the foetus associated with iodine deficiency (ID). To examine the impact of this recommendation on iodine status, and to identify factors that contribute to adequacy during gestation, supplement use and Urinary Iodine Concentration (UIC) was measured in 255 pregnant women (gestation range 6 to 41 weeks) in Tasmania. The median UIC (MUIC) of 133 µg/L (Inter-quartile range 82–233) was indicative of ID, being below the 150–249 µg/L range for adequacy during pregnancy. Women taking an iodine-containing-supplement (I-supp) had a significantly higher MUIC (155 µg/L) (n = 171) compared to the combined MUIC (112.5 µg/L) (n = 84) of those who had never (120 µg/L) (n = 61) or were no longer taking an I-supp (90 µg/L) (n = 23) (p = 0.017). Among women reporting I-supp use, the MUIC of those commencing the recommended 150 µg/day prior to conception was significantly higher than those starting supplementation following pregnancy confirmation: 196 (98–315) µg/L (n = 45) versus 137.5 (82.5–233.5) µg/L (n = 124), p = 0.032. Despite recommendations for iodine supplementation pregnant Tasmanian women remain at risk of ID. Commencing an I-supp of 150 µg/day prior to conception and continuing throughout pregnancy is required to ensure adequacy. Timely advice regarding the importance of adequate iodine nutrition, including supplementation is needed to reduce the risk of irreversible in utero neurocognitive damage to the foetus.


Author(s):  
Yozen Fuse ◽  
Yoshiya Ito ◽  
Yoshimasa Shishiba ◽  
Minoru Irie

Abstract Context Japan has been regarded as a long-standing iodine sufficient country without iodine fortification; however, data on nationwide iodine status is lacking. Objective This study aimed to characterize the iodine status in Japan. Methods From 2014 through 2019 a nationwide school-based survey was conducted across all districts in Japan. Urinary iodine concentration (UIC), creatinine (Cr) concentration and anthropometry were assessed in healthy school-aged children (SAC) aged 6 to 12 years. Their iodine status is regarded as generally representative of the nation's iodine status. Results A total of 32,025 children participated. The overall median UIC was 269 μg/L which was within the WHO’s adequacy range. There was a regional difference in UIC values within 14 regions, and the lowest and highest median UIC were found in Tanegashima Island (209 μg/L) and Nakashibetsu, Hokkaido (1,071 μg/L), respectively. The median UIC ≥ 300 μg/L was observed in 12 out of 46 regions. By using estimated 24-h urinary iodine excretion (UIE), the prevalence of SAC exceeding the upper tolerable limit of iodine for Japanese children was from 5.2 to 13.7%. The UIC values did not change with age, BSA and BMI percentile, while the Cr concentration simultaneously increased suggesting the effect of urinary creatinine on UI/Cr and estimated 24-h UIE values. Conclusions The iodine intake of Japanese people is adequate, but in some areas it is excessive. The incidence and prevalence of thyroid disorders associated with iodine intake should be obtained especially in the areas where high amounts of iodine are consumed.


2007 ◽  
Vol 10 (12A) ◽  
pp. 1584-1595 ◽  
Author(s):  
Michael B Zimmermann

AbstractObjectives:Monitoring of iodine status during pregnancy, lactation and infancy is difficult as there are no established reference criteria for urinary iodine concentration (UI) for these groups; so it is uncertain whether iodized salt programs meet the needs of these life stages.Design and Subjects:The method used in this paper was: 1) to estimate the median UI concentration that reflects adequate iodine intake during these life stages; and 2) to use these estimates in a review of the literature to assess whether salt iodisation can control iodine deficiency in pregnant and lactating women, and their infants.Results:For pregnancy, recommended mean daily iodine intakes of 220-250 μg were estimated to correspond to a median UI concentration of about 150 μg l− 1, and larger surveys from the iodine sufficient countries have reported a median UI in pregnant women ≥ 140 μg l− 1. Iodine supplementation in pregnant women who are mild-to-moderately iodine deficient is beneficial, but there is no clear affect on maternal or newborn thyroid hormone levels. In countries where the iodine intake is sufficient, most mothers have median breast milk iodine concentration (BMIC) greater than the concentration (100-120 μg l− 1) required to meet an infant's needs. The median UI concentration during infancy that indicates optimal iodine nutrition is estimated to be ≥ 100 μg l− 1. In iodine-sufficient countries, the median UI concentration in infants ranges from 90-170 μg l− 1, suggesting adequate iodine intake in infancy.Conclusions:These findings suggest pregnant and lactating women and their infants in countries with successful sustained iodised salt programs have adequate iodine status.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 858
Author(s):  
Tedson Lukindo ◽  
Ray Masumo ◽  
Adam Hancy ◽  
Sauli E. John ◽  
Heavenlight A. Paulo ◽  
...  

Background: Deficient and excess iodine intake during pregnancy can lead to serious health problems. In Tanzania, information available on iodine status during pregnancy is minimal. The aim of this study was to assess the iodine status and its association with sociodemographic factors in pregnant women in the Mbeya region, Tanzania. Method: A cross sectional survey involving 420 pregnant women (n=420) aged between 15-49 years registered in antenatal care clinics was conducted. Data were collected via interviews and laboratory analysis of urinary iodine concentration (UIC). Results: Median UIC was 279.4μg/L (+/-26.1) to 1915μg/L. Insufficient iodine intake (UIC below 150μg/L) was observed in 17.14% of participants, sufficient intake in 24.29% and 58.57% had intakes above the recommended level (>250μg/L). Rungwe district council (DC) had the highest proportion of patients (27.9%) with low iodine levels, while Chunya and Mbarali DCs had the greatest proportion of those with UIC’s, over the WHO recommended level. Fish consumption and education status were associated with increased risk of insufficient iodine while individuals in Mbalali DC aged between 35-49 years were associated with increased risk of UIC above recommended level. Conclusion: Both deficient and excess iodine intake remains a public health problem, especially in pregnant women in Tanzania. Therefore, educational programs on iodine intake are needed to ensure this population has an appropriate iodine intake to prevent any health risks to the mother and the unborn child.


Author(s):  
Bernadette L Dekker ◽  
Daan J Touw ◽  
Anouk N A van der Horst-Schrivers ◽  
Michel J Vos ◽  
Thera P Links ◽  
...  

ABSTRACT Background Measurement of the 24-h urinary iodine concentration or urinary iodine excretion (UIE) is the gold standard to determine iodine status; however, this method is inconvenient. The use of salivary iodine could be a possible alternative since salivary glands express the sodium-iodine symporter. Objectives We aimed to establish the correlation between the salivary iodine secretion and UIE, to evaluate the clinical applicability of the iodine saliva measurement. Methods We collected 24-h urine and saliva samples from 40 participants ≥18 y: 20 healthy volunteers with no specific diet (group 1), 10 patients with differentiated thyroid cancer with a low dietary intake (&lt;50 μg/d, group 2), and 10 patients with a high iodine status as the result of the use of amiodarone (group 3). Urinary and salivary iodine were measured using a validated inductively coupled plasma MS method. To correct for differences in water content, the salivary iodine concentration (SIC) was corrected for salivary protein and urea concentrations (SI/SP and SI/SU, respectively). The intra- and inter-individual CVs were calculated, and the Kruskal-Wallis test and Spearman's correlation were used. Results The intra-individual CVs for SIC, SI/SP, and SI/SU were 63.8%, 37.7%, and 26.9%, respectively. The inter-individual CVs for SIC, SI/SP, and SI/SU were 77.5%, 41.6% and 47.0%, respectively. We found significant differences (P &lt; 0.01) in urinary and salivary iodine concentrations between all groups [the 24-h UIE values were 176 μg/d (IQR, 96.1–213 μg/d), 26.0 μg/d (IQR, 22.0–37.0 μg/d), and 10.0*103 μg/d (IQR, 7.57*103–11.4*103 μg/d) in groups 1–3, respectively; the SIC values were 136 μg/L (IQR, 86.3–308 μg/L), 71.5 μg/L (IQR, 29.5–94.5 μg/L), and 14.3*103 μg/L (IQR, 10.6*103–25.6*103 μg/L) in groups 1–3, respectively]. Correlations between the 24-h UIE and SIC, SI/SP, and SI/SU values were strong (ρ = 0.80, ρ = 0.90, and ρ = 0.86, respectively; P &lt; 0.01). Conclusions Strong correlations were found between salivary and urinary iodine in adults with different daily iodine intakes. A salivary iodine measurement can be performed to assess the total iodine body pool, with the recommendation to correct for salivary protein or urea.


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