More than two-thirds of dietary iodine in children in northern Ghana is obtained from bouillon cubes containing iodized salt

AbstractObjectiveBouillon cubes are widely consumed by poor households in sub-Saharan Africa. Because their main ingredient is salt, bouillon cubes could be a good source of iodine if iodized salt is used in their production and if their consumption by target groups is high. Our objective was to measure the iodine content of bouillon cubes, estimate their daily intake in school-aged children and evaluate their potential contribution to iodine intakes.DesignIn a cross-sectional study, we measured urinary iodine concentrations (UIC) and estimated total daily iodine intakes. We administered a questionnaire on usage of bouillon cubes. We measured the iodine content of bouillon cubes, household salt, drinking-water and milk products.SettingPrimary schools in northern Ghana.SubjectsSchoolchildren aged 6–13 years.ResultsAmong school-aged children (n250), median (interquartile range) UIC and estimated iodine intake were 242 (163–365) µg/l and 129 (85–221) µg/d, indicating adequate iodine status. Median household salt iodine concentration (n100) was only 2·0 (0·83–7·4) µg/g; 72 % of samples contained <5 µg iodine/g. Iodine concentrations in drinking-water and milk-based drinks were negligible. Median iodine content of bouillon cubes was 31·8 (26·8–43·7) µg/g, with large differences between brands. Estimated median per capita consumption of bouillon cubes was 2·4 (1·5–3·3) g/d and median iodine intake from bouillon cubes was 88 (51–110) µg/d.ConclusionsDespite low household coverage with iodized salt, iodine nutrition in school-aged children is adequate and an estimated two-thirds of their dietary iodine is obtained from bouillon cubes.

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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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Assessing the impact of drinking water iodine concentrations on the iodine intake of Chinese pregnant women living in areas with restricted iodized salt supply

European Journal of Nutrition ◽

10.1007/s00394-020-02308-y ◽

2020 ◽

Author(s):

M. Gao ◽

W. Chen ◽

S. Dong ◽

Y. Chen ◽

Q. Zhang ◽

...

Keyword(s):

Drinking Water ◽

Pregnant Women ◽

Iodine Intake ◽

Iodized Salt ◽

The Impact

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Iodine Intake through Processed Food: Case studies from Egypt, Indonesia, the Philippines, the Russian Federation and Ukraine, 2010-2015

10.20944/preprints201707.0056.v1 ◽

2017 ◽

Author(s):

Jacky Knowles ◽

Frits van der Haar ◽

Magdy Shehata ◽

Gregory Gerasimov ◽

Bimo ◽

...

Keyword(s):

Case Studies ◽

Russian Federation ◽

Food Industry ◽

Daily Intake ◽

Iodine Intake ◽

The Philippines ◽

Iodized Salt ◽

Potential Contribution ◽

Processed Food ◽

The Russian Federation

The current performance indicator for universal salt iodization (USI) is the percent of households using adequately iodized salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the GAIN-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodized salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodized salt in selected food products was modelled according to the formula: Quantity of salt per unit of food product x minimum regulated iodine level of salt at production x average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodized salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodized salt use in the food industry in order to achieve optimal population iodine status.

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Improving the Accuracy of Iodization of the Dietary Salt Supplies of Populations

European Journal of Nutrition & Food Safety ◽

10.9734/ejnfs/2015/21031 ◽

2015 ◽

pp. 688

Author(s):

Pieter Jooste ◽

Frits Van Der Haar

Keyword(s):

Quality Assurance ◽

Quantitative Methods ◽

Manufacturing Industry ◽

Quality Management System ◽

Iodine Content ◽

Iodized Salt ◽

Dietary Salt ◽

Salt Iodization ◽

Salt Iodine ◽

Salt Industry

Objectives: The mandate of this working group was to assess the importance of salt iodine quality in successful IDD prevention and control. Examine the role of salt iodine content in quality assurance, inspection, surveillance, and coalition oversight of IDD programs. Methods: Scientific literature, technical reports and a range of data and information sources were reviewed to determine whether accurate salt iodization was making a critical contribution toward safe and successful IDD programs. Results: Evidence and examples were collected on salt iodine data in quality assurance of iodization by salt industry, assessments of iodized salt quality by inspectors in factories and markets, surveillance of USI strategies and dietary iodine supplies by program managers, and in provision of coalition oversight by high-level officials. Conclusions: Because salt iodization is a supply-based strategy, reliable accuracy at the source is most critical. It is therefore vital that each salt factory should adopt a quality management system, with standard operating procedures at least for the manufacturing and packaging of iodized salt. Titration is preferred but other quantitative methods with e.g. the WYD Checker, i-Reader or Bioanalyt can also yield accurate data. Improved accuracy down the supply chain is desirable, especially in surveillance, but commonly points to the need for ensured accuracy at the source when quality failures are discovered. The need remains for an agreed approach to obtain reliable data of the use of iodized salt in the food manufacturing industry.

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Abstract P359: Assessment of Household Salt Types, Iodine Intake, and Iodine Status in 2019-2020 NHANES

Circulation ◽

10.1161/circ.141.suppl_1.p359 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Abby G Ershow ◽

Jaime Gahche ◽

Nancy Potischman ◽

Judith Spungen ◽

Pamela Pehrsson

Keyword(s):

At Risk ◽

Dietary Supplements ◽

Age Groups ◽

Urinary Iodine ◽

Iodine Content ◽

Iodine Intake ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Iodine Status ◽

The U.S

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.

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Validation of a User-Friendly and Rapid Method for Quantifying Iodine Content of Salt

Food and Nutrition Bulletin ◽

10.1177/15648265120334s309 ◽

2012 ◽

Vol 33 (4_suppl3) ◽

pp. S330-S335 ◽

Cited By ~ 9

Author(s):

Fabian Rohner ◽

Greg S. Garrett ◽

Arnaud Laillou ◽

Simone K. Frey ◽

Ralf Mothes ◽

...

Keyword(s):

Salt Content ◽

Colorimetric Method ◽

Iodine Content ◽

Iodine Concentration ◽

Iodine Intake ◽

Determination Limit ◽

Potassium Iodate ◽

Salt Iodization ◽

Salt Iodine ◽

User Friendly

Background Despite considerable progress made in the past decade through salt iodization programs, over 2 billion people worldwide still have inadequate iodine intake, with devastating consequences for brain development and intellectual capacity. To optimize these programs with regard to salt iodine content, careful monitoring of salt iodine content is essential, but few methods are available to quantitatively measure iodine concentration in a simple, fast, and safe way. Objective We have validated a newly developed device that quantitatively measures the content of potassium iodate in salt in a simple, safe, and rapid way. Methods The linearity, determination and detection limit, and inter- and intra-assay variability of this colorimetric method were assessed and the method was compared with iodometric titration, using salt samples from several countries. Results Linearity of analysis ranged from 5 to 75 mg/kg iodine, with 1 mg/kg being the determination limit; the intra- and interassay imprecision was 0.9%, 0.5%, and 0.7% and 1.5%, 1.7%, and 2.5% for salt samples with iodine contents of 17, 30, and 55 mg/kg, respectively; the interoperator imprecision for the same samples was 1.2%, 4.9%, and 4.7%, respectively. Comparison with the iodometric method showed high agreement between the methods ( R2 = 0.978; limits of agreement, −10.5 to 10.0 mg/kg). Conclusions The device offers a field- and user-friendly solution to quantifying potassium iodate salt content reliably. For countries that use potassium iodide in salt iodization programs, further validation is required.

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Naturally occurring iodine in humic substances in drinking water in Denmark is bioavailable and determines population iodine intake

British Journal Of Nutrition ◽

10.1017/s0007114507803941 ◽

2008 ◽

Vol 99 (2) ◽

pp. 319-325 ◽

Cited By ~ 23

Author(s):

Stig Andersen ◽

Klaus M. Pedersen ◽

Finn Iversen ◽

Steen Terpling ◽

Peter Gustenhoff ◽

...

Keyword(s):

Drinking Water ◽

Humic Substances ◽

Natural Waters ◽

Tap Water ◽

Urinary Iodine ◽

Iodine Content ◽

Iodine Intake ◽

Urinary Iodine Excretion ◽

Spot Urine ◽

Naturally Occurring

Iodine intake is important for thyroid function. Iodine content of natural waters is high in some areas and occurs bound in humic substances. Tap water is a major dietary source but bioavailability of organically bound iodine may be impaired. The objective was to assess if naturally occurring iodine bound in humic substances is bioavailable. Tap water was collected at Randers and Skagen waterworks and spot urine samples were collected from 430 long-term Randers and Skagen dwellers, who filled in a questionnaire. Tap water contained 2 μg/l elemental iodine in Randers and 140 μg/l iodine bound in humic substances in Skagen. Median (25; 75 percentile) urinary iodine excretion among Randers and Skagen dwellers not using iodine-containing supplements was 50 (37; 83) μg/24 h and 177 (137; 219) μg/24 h respectively (P < 0·001). The fraction of samples with iodine below 100 μg/24 h was 85·0 % in Randers and 6·5 % in Skagen (P < 0·001). Use of iodine-containing supplements increased urinary iodine by 60 μg/24 h (P < 0·001). This decreased the number of samples with iodine below 100 μg/24 h to 67·3 % and 5·0 % respectively, but increased the number of samples with iodine above 300 μg/24 h to 2·4 % and 16·1 %. Bioavailability of iodine in humic substances in Skagen tap water was about 85 %. Iodine in natural waters may be elemental or found in humic substances. The fraction available suggests an importance of drinking water supply for population iodine intake, although this may not be adequate to estimate population iodine intake.

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Community monitoring of the National Iodine Deficiency Disorders Control Programme in the National Capital Region of Delhi

Public Health Nutrition ◽

10.1017/s1368980010000297 ◽

2010 ◽

Vol 14 (5) ◽

pp. 754-757 ◽

Cited By ~ 1

Author(s):

Juhi Agarwal ◽

Chandrakant S Pandav ◽

Madhukar G Karmarkar ◽

Sirimavo Nair

Keyword(s):

Iodine Deficiency ◽

Primary Schools ◽

Iodine Content ◽

Control Programme ◽

Iodized Salt ◽

National Capital Region ◽

Iodine Deficiency Disorders ◽

Capital Region ◽

Community Monitoring ◽

National Capital

AbstractObjectiveThe present study was conducted to assess the current status of iodine-deficiency disorders (IDD) in the National Capital Region of Delhi (NCR Delhi) and evaluate the implementation and impact of the National Iodine Deficiency Disorders Control Programme (NIDDCP).DesignCross-sectional study.SettingSchool-going children (n1230) in the age group of 6–12 years were enrolled from thirty primary schools in the Municipal Corporation of Delhi. Thirty schools were selected using the probability-proportional-to-size cluster sampling methodology. In each identified school forty-one children were surveyed. Urine and salt samples were collected and studied for iodine concentration. A total of sixty salt samples from retail level were also collected.SubjectsSchoolchildren aged 6–12 years.ResultsThe median urinary iodine excretion (UIE) was found to be 198·4 μg/l. The percentage of children with UIE levels of <20·0, 20·0–49·9, 50·0–99·9 and ≥100·0 μg/l was 1·9, 4·3, 9·5 and 84·2 %, respectively. The proportion of households consuming adequately iodized salt (salt with iodine levels of at least 15 ppm at consumption level) was 88·8 %. The assessment of iodine content of salt revealed that only 6·1 % of the families were consuming salt with iodine content less than 7 ppm. At retail level 88·3 % of salt samples had >15 ppm iodine.ConclusionsSignificant progress has been achieved towards elimination of IDD from NCR Delhi. There is a need for further strengthening of the system to monitor the quality of iodized salt provided to the beneficiaries under the universal salt iodization programme and so eliminate IDD from NCR Delhi.

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