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

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.

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.


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.


2020 ◽  
Vol 9 (5) ◽  
pp. 379-386
Author(s):  
Ning Yao ◽  
Chunbei Zhou ◽  
Jun Xie ◽  
Xinshu Li ◽  
Qianru Zhou ◽  
...  

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.


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 ◽  
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.


2000 ◽  
Vol 70 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Nahid Salarkia ◽  
Fereidoun Azizi ◽  
Masood Kimiagar ◽  
Hamid Zakeri ◽  
Sedigheh Soheilikhah ◽  
...  

As the production, distribution and consumption of iodized salt has increased in recent years, this study was carried out to assess iodine status in Tehran in 1996. 1146 families comprising 5140 subjects in the twenty districts of Tehran city from all age groups were randomly selected. Thyroid size was examined by palpation and graded according to the WHO classification. In 163 families selected randomly, thyroid size was determined by ultrasonography and urinary iodine was measured by digestion method. Serum T4, T3 and TSH (IRMA) concentrations were also assayed by kits. Percentage of grades 1 & 2 goiter were 44 & 44% in females and 49 & 33% in males respectively. Median urinary iodine was 17.5 mug/dl. Mean serum T4, T3 and TSH were 8.41 ± 1.4 mug/dl, 170 ± 37 ng/dl and 1.4 ± 0.8 mu/ml, respectively. In 118 children aged 6–10 years median urinary iodine was 17.5 mug/dl. Thyroid volume in children was 4.3 ± 1.9 ml. No correlation was established between the thyroid volume and goiter grade. This study points to the adequacy of iodine intake in the majority of families residing in Tehran.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2520
Author(s):  
Katelyn Hlucny ◽  
Brenda M. Alexander ◽  
Ken Gerow ◽  
D. Enette Larson-Meyer

Background: The iodine status of the US population is considered adequate, but subpopulations remain at risk for iodine deficiency and a biomarker of individual iodine status has yet to be determined. The purpose of this study was to determine whether a 3 day titration diet, providing known quantities of iodized salt, is reflected in 24 h urinary iodine concentration (UIC), serum iodine, and thyroglobulin (Tg). Methods: A total of 10 participants (31.3 ± 4.0 years, 76.1 ± 6.3 kg) completed three, 3 day iodine titration diets (minimal iodine, US RDA, (United States Recommended Daily Allowance), and 3× RDA). The 24 h UIC, serum iodine, and Tg were measured following each diet. The 24 h UIC and an iodine-specific food frequency questionnaire (FFQ) were completed at baseline. Results: UIC increased an average of 19.3 μg/L for every gram of iodized salt consumed and was different from minimal to RDA (p = 0.001) and RDA to 3× RDA diets (p = 0.04). Serum iodine was different from RDA to 3× RDA (p = 0.006) whereas Tg was not responsive to diet. Baseline UIC was associated with iodine intake from milk (r = 0.688, p = 0.028) and fish/seafood (r = 0.646, p = 0.043). Conclusion: These results suggest that 24 h UIC and serum iodine may be reflective of individual iodine status and may serve as biomarkers of iodine status.


2014 ◽  
Vol 18 (4) ◽  
pp. 686-694 ◽  
Author(s):  
Pantea Nazeri ◽  
Parvin Mirmiran ◽  
Golaleh Asghari ◽  
Nilufar Shiva ◽  
Yadollah Mehrabi ◽  
...  

AbstractObjectiveIodine deficiency still remains a major public health concern worldwide despite global progress in its elimination. The aims of the present study were to evaluate dietary iodine status in the mother and one adult member of each family and the association between mothers’ knowledge, attitude and behaviour and the dietary iodine status of adult family members in Tehran.DesignIn this cross-sectional study, 24 h urinary iodine and Na concentrations and the iodine content of household salt were measured. Mothers’ knowledge, attitude and behaviour were assessed using a questionnaire administered in face-to-face interviews.SettingHealth-care centres from four distinct areas of Tehran.SubjectsMother–adult family member pairs aged ≥19 years (n 290), enrolled through randomized cluster sampling.ResultsIn mothers and adult family members, median 24 h urinary iodine concentration was 73 (interquartile range (IQR) 36–141) µg/l and 70 (IQR 34–131) µg/l, dietary iodine intake was 143 (IQR 28–249) µg/d and 130 (IQR 26–250) µg/d and dietary salt intake was 8·0 (IQR 5·9–10·2) g/d and 7·5 (IQR 5·3–10·0) g/d, respectively. Significant correlations were observed between mothers’ attitude and behaviour and the 24 h urinary iodine concentration, dietary iodine intake and iodine content of salt of adult family members. In multiple analysis, lower quartiles of salt iodine content and salt intake and inappropriate behaviour scores in mothers increased the risk of urinary iodine concentration <100 µg/l in adult family members.ConclusionsThe present study showed that mothers’ behaviour, but not knowledge and attitude, was among major contributors to the suboptimal dietary iodine status observed in adult family members.


2015 ◽  
Vol 4 (2) ◽  
pp. 42-46 ◽  
Author(s):  
Fazli Subhan ◽  
Muhammad Jahangir ◽  
Saira Saira ◽  
Rehman Mehmood Khattak ◽  
Muhammad Shahab ◽  
...  

Pakistan is considered to be one of the most severely iodine deficient countries in the region. A decade earlier, 70% of the population was estimated to be at risk of iodine deficiency. However, the recent use of iodized salt has reduced the intensity of the problem. Earlier studies regarding iodine deficiency in Pakistan were restricted to the northern mountainous regions, but have now been extended to the sub-Himalaya areas and the plains of Punjab. The aim of the present study was to investigate the prevalence of goiter and iodine status among school children in district Kohat, Pakistan. The 30 cluster approach was adopted for the study. From each cluster, 40 samples were collected from school going children. The palpation method was used to measure goiter grade, whereas, for urinary iodine estimation, the wet digestion method was used. The prevalence of goiter in the district was found to be 35% (37.16% in boys and 33% in girls). The median urinary iodine concentration was found to be 56±31.19?g/L. Estimation of iodine content in salt illustrated that 56.8% people were consuming non-iodized salt and 43.5% were using iodized salt. The current study suggests a severe iodine deficiency in school children of district Kohat and regular iodine supplementation is required on an instant basis.South East Asia Journal of Public Health Vol.4(2) 2014: 42-46


2017 ◽  
Vol 39 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Fan-Fen Wang ◽  
Kam-Tsun Tang ◽  
Wen-Harn Pan ◽  
Justin Ging-Shing Won ◽  
Yao-Te Hsieh ◽  
...  

Background: In 2003, Taiwan’s iodine policy changed from mandatory to voluntary. The Nutrition and Health Survey in Taiwan (NAHSIT) 2001-2002 for schoolchildren showed adequate iodine nutrition, while NAHSIT 2005-2008 for adults showed the iodine status was at borderline adequacy. Objective: To investigate the iodine status of the Taiwanese population from schoolchildren to adulthood 10 years after the change of the salt iodization policy. Method: Urinary iodine was measured in samples from subjects in NAHSIT 2013. Results: The median urinary iodine concentration (UIC) of the Taiwanese population aged 6 years and above in 2013 was 96 μg/L, indicating mild iodine deficiency. The median UIC of 6- to 12-year-old schoolchildren was 124 μg/L (interquartile range [IQR]: 92-213 μg/L), and 115 μg/L (IQR: 80-166 μg/L), 125 μg/L (IQR: 74-161 μg/L), 73 μg/L (IQR: 52-131 μg/L), and 78 μg/L (IQR: 52-132 μg/L) in populations aged 13 to 18 years, 19 to 44 years, 45 to 64 years, and ≥65 years, respectively. Declining iodine nutrition in age groups ≥45 years old was noted that the median UIC of populations aged 45 to 64 years and ≥65 years was 99 and 88 μg/L, respectively, in NAHSIT 2005-2008. The median UIC of schoolchildren was not lower than that during the mandatory salt fortification period, but the distribution of urinary iodine levels signified a dietary pattern change. Conclusion: Wide-ranging variation in iodine nutrition levels was observed in different age groups. Universal salt iodization, as suggested by the World Health Organization, should be the best strategy to achieve adequate iodine nutrition.


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