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

2020 ◽  
pp. 1-9
Author(s):  
M. Dineva ◽  
M. P. Rayman ◽  
S. C. Bath

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

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 30-35
Author(s):  
GM Molla

Iodine is a micronutrient, which is essential for the synthesis of thyroid hormones. Thyroid hormones play a major role in the development of different functional components in different stages of life. The relationship between iodine intake level of a population and occurrences of thyroid disorders U-shaped with an increase from both low and high iodine intake. Iodine deficiency disorders (IDDs) are a major health problem worldwide in all age groups, but infants, school children, and pregnant and lactating women are vulnerable. During pregnancy and lactation, the fetus and infants are sensitive to maternal iodine intake. Even mild iodine deficiency may lead to irreversible brain damage during this period. A main cause of IDDs of neonates and infants is maternal iodine deficiency. Universal salt iodization strategy has been initiated by the World Health Organization and United Nation International Children Emergency Fund by the year 1993 for correction and prevention of iodine deficiency. Excessive iodine causes hypothyroidism, iodine-induced hyperthyroidism and autoimmune thyroid diseases. Iodine deficiency and excessive iodine, both cause goiter. There are many indicators for assessing the IDDs, such as measurement of thyroid size by palpation or ultrasonography, serum thyroid stimulating hormone, and thyroglobulin but these are less sensitive, costly and sometimes interpretation is difficult. Urinary iodine concentration (UIC) is a well-accepted, cost-efficient, and easily obtainable indicator of iodine status. Since the majority of iodine absorbed by the body is excreted in the urine, it is considered a sensitive marker of current iodine intake and can reflect recent changes in iodine status. Iodine requirements are greatly increased during pregnancy and lactation, owing to metabolic changes. During intrauterine life, maternal iodine is the only source of iodine for a fetus. UIC determines the iodine status of pregnant and lactating women. Breast milk is the only source of iodine for exclusively breastfed neonates and infants. Breast milk iodine concentration can be determined by UIC. UIC predicts the adverse health consequences of excessive iodine intake such as goiter, hypothyroidism, and hyperthyroidism. This review presents that iodine status in different groups of a population can be determined by UIC which will be helpful in assessing the iodine status in a community, finding out the cause of thyroid disorders, to predict the risk of adverse health effects of iodine deficiency and excessive iodine, and in making plan for iodine supplementation.Mediscope Vol. 5, No. 2: Jul 2018, Page 30-35


Author(s):  
Patrick Wainwright ◽  
Paul Cook

Iodine deficiency is a significant global health concern, and the single greatest cause of preventable cognitive impairment. It is also a growing public health concern in the UK particularly among pregnant women. Biomarkers such as urinary iodine concentration have clear utility in epidemiological studies to investigate population-level iodine status, but determination of iodine status in individuals is much more problematic with current assays. This article reviews the available biomarkers of iodine status and their relative utility at the level of both populations and individuals for the investigation of iodine deficiency and iodine excess.


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.


Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 941 ◽  
Author(s):  
Sigrun Henjum ◽  
Anne Brantsæter ◽  
Astrid Kurniasari ◽  
Lisbeth Dahl ◽  
Eli Aadland ◽  
...  

Previous studies have documented mild to moderate iodine deficiency in pregnant and lactating women in Norway. This study focused on non-pregnant young women because their future children may be susceptible to the adverse effects of iodine deficiency. We assessed urinary iodine concentration (UIC), iodine intake from food and supplements, and iodine knowledge in 403 non-pregnant women, mainly students, aged 18–30 years. Iodine concentration was measured in spot urine samples analyzed by inductively coupled plasma mass spectrometry and iodine intake was calculated from a self-reported food frequency questionnaire. Knowledge about iodine was collected through the self-administered, paper-based questionnaire. Median (p25–p75) UIC was 75 (42–130) µg/L and 31% had UIC < 50 µg/L. Habitual iodine intake was 100 (69–136) µg/day. In multiple regression models, supplemental iodine, use of thyroid medication, and iodine intake from food were positively associated with UIC, while vegetarian practice was negatively associated, explaining 16% of the variance. Approximately 40% of the young women had low iodine knowledge score and no differences were found between women in different study programs. Young women in Norway are mild to moderately iodine-deficient, and public health strategies are needed to improve and secure adequate iodine status.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2399 ◽  
Author(s):  
Simona Censi ◽  
Jacopo Manso ◽  
Susi Barollo ◽  
Alberto Mondin ◽  
Loris Bertazza ◽  
...  

Background: Fifteen years after a nationwide voluntary iodine prophylaxis program was introduced, the aims of the present study were: (a) to obtain an up-to-date assessment of dietary iodine intake in the Veneto region, Italy; and (b) to assess dietary and socioeconomic factors that might influence iodine status. Methods: Urinary iodine concentration (UIC) was obtained in 747 school students (median age 13 years; range: 11–16 years). Results: The median UIC was 111 μg/L, with 56% of samples ≥ 100 μg/L, but 26% were < 50 μg/L, more frequently females. Iodized salt was used by 82% of the students. The median UIC was higher among users of iodized salt than among non-users, 117.0 ug/L versus 90 ug/L (p = 0.01). The median UIC was higher in regular consumers of cow’s milk than in occasional consumers, 132.0 μg/L versus 96.0 μg/L (p < 0.01). A regular intake of milk and/or the use of iodized salt sufficed to reach an adequate median UIC, although satisfying only with the combined use. A trend towards higher UIC values emerged in regular consumers of cheese and yogurt. Conclusion: Iodine status has improved (median UIC 111.0 μg/L), but it is still not adequate as 26% had a UIC < 50 μg/L in the resident population of the Veneto region. A more widespread use of iodized salt but also milk and milk product consumption may have been one of the key factors in achieving this partial improvement.


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.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Abby G Ershow ◽  
Jaime Gahche ◽  
Nancy Potischman ◽  
Judith Spungen ◽  
Pamela Pehrsson

Background: Iodine is an essential nutrient required for normal thyroid function in all age groups as well as healthy fetal, infant, and child development and growth. Because iodine levels in most foods are low, iodine usually must be provided through dietary supplements or fortified foods (such as salt). In recent NHANES cycles, sub-optimal iodine status has been observed in some U.S. populations, most notably pregnant women. Recent health campaigns have emphasized consuming less sodium and have focused on the primary source of the excess sodium in the U.S. diet: commercially prepared foods, most of which are made with non-iodized salt. Also, recent secular trends towards less home cooking and more use of non-iodized table salts may be contributing to relatively low usage of iodized salt, which was estimated in 2014 to comprise only half of retail salt sales. Therefore, for individuals who also limit their home use of salt in food preparation or at the table, an unintended consequence may be a decline in iodine intake. Population-level data thus are needed on the relative contributions of various foods to iodine intake in relation to iodine status markers, to characterize population groups at risk and develop guidance on appropriate dietary and supplementation strategies. Objective: Describe new measures of iodine intake and iodine status added into NHANES 2019-20, which is a nationally representative survey of the U.S. population. Methods: Iodine intake is being assessed through a questionnaire about household salt types (such as iodized salt or sea salt) and measured iodine content of household iodized salt, as well as individual 24-hour dietary recalls and use of iodine containing dietary supplements. This will be the first time NHANES will estimate dietary iodine intake using a newly developed USDA Special Interest Database on Iodine Content of Foods. Biomarkers include a thyroid panel (including thyroglobulin), inhibitors of iodine uptake in the thyroid (e.g., perchlorates), and urinary iodine concentration. Conclusions: The upcoming NHANES cycle will yield novel data on U.S. population coverage of household iodized salt, as well as individual thyroid and iodine status in relation to dietary iodine intake. Groups at risk from increased physiologic need or dietary preferences that limit iodine sources will be identified. A key tool in undertaking this work will be a new food composition database on the iodine content of U.S. foods. Clarification of key sources of iodine in the U.S. diet will be important in developing dietary guidance.


2017 ◽  
Vol 72 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Mario Murcia ◽  
Mercedes Espada ◽  
Jordi Julvez ◽  
Sabrina Llop ◽  
Maria-Jose Lopez-Espinosa ◽  
...  

BackgroundThe effect of mild-to-moderate maternal iodine deficiency on the neuropsychological development of their offspring is uncertain. We aimed to assess the association between iodine status during pregnancy and the cognitive and motor development of children at 4–5 years.MethodsWe conducted a prospective cohort study in four Spanish regions with recruitment of pregnant women between 2003 and 2008 and follow-up of their children up to 4–5 years (mean (SD)=4.8 (0.6)). Cognitive and motor function was assessed in 1803 children using the McCarthy Scales of Children’s Abilities. Dietary iodine and supplementation were measured through questionnaires twice during pregnancy. Urinary iodine concentration (UIC) was measured in spot samples. The residuals of a regression of UIC against creatinine were used to define a variable corrected for creatinine (UIC~Cr).ResultsNeither iodine supplements nor iodised salt consumption or maternal UIC were associated with cognitive or motor function. After adjusting for creatinine, children of women with UIC~Cr <100 µg/L had 3.93 (95% CI −6.18 to –1.69) general cognitive scores lower than the reference (150–249 µg/L). Dietary iodine was inversely associated with motor scores and milk but not other dairy products or seafood consumption accounted for this association (beta: −1.36; 95% CI −2.12 to –0.61; per one daily milk serving).ConclusionsWe found an association between low maternal urinary iodine and lower cognitive scores in childhood, although only when corrected for creatinine, adding to the evidence that iodine deficiency may have potential harmful effects on neurodevelopment. Iodine supplementation does not appear to improve child’s neurodevelopment at 4–5 years.


Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3483
Author(s):  
Inger Aakre ◽  
Lidunn Tveito Evensen ◽  
Marian Kjellevold ◽  
Lisbeth Dahl ◽  
Sigrun Henjum ◽  
...  

Seaweeds, or macroalgae, may be a good dietary iodine source but also a source of excessive iodine intake. The main aim in this study was to describe the iodine status and thyroid function in a group of macroalgae consumers. Two urine samples were collected from each participant (n = 44) to measure urinary iodine concentration (UIC) after habitual consumption of seaweed. Serum thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and peroxidase autoantibody (TPOAb), were measured in a subgroup (n = 19). A food frequency questionnaire and an iodine-specific 24 h recall were used to assess iodine intake and macroalgae consumption. The median (p25–p75) UIC was 1200 (370–2850) μg/L. Median (p25–p75) estimated dietary iodine intake, excluding macroalgae, was 110 (78–680) μg/day, indicating that seaweed was the major contributor to the iodine intake. TSH levels were within the reference values, but higher than in other comparable population groups. One third of the participants used seaweeds daily, and sugar kelp, winged kelp, dulse and laver were the most common species. Labelling of iodine content was lacking for a large share of the products consumed. This study found excessive iodine status in macroalgae consumers after intake of dietary seaweeds. Including macroalgae in the diet may give excessive iodine exposure, and consumers should be made aware of the risk associated with inclusion of macroalgae in their diet.


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