scholarly journals Optimal Assessment and Quantification of Iodine Nutrition in Pregnancy and Lactation: Laboratory and Clinical Methods, Controversies and Future Directions

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2378 ◽  
Author(s):  
Creswell J Eastman ◽  
Gary Ma ◽  
Mu Li
Keyword(s):  
Brain Damage ◽  
Iodine Deficiency ◽  
Placental Transfer ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
School Age Children ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Psychomotor Tests

Iodine intake must be boosted during pregnancy to meet the demands for increased production and placental transfer of thyroid hormone essential for optimal foetal development. Failure to meet this challenge results in irreversible brain damage, manifested in severity from neurological cretinism to minor or subtle deficits of intelligence and behavioural disorders. Attention is now being focused on explaining observational studies of an association between insufficient iodine intake during pregnancy and mild degrees of intellectual impairment in the offspring and confirming a cause and effect relationship with impaired maternal thyroid function. The current qualitative categorisation of iodine deficiency into mild, moderate and severe by the measurement of the median urinary iodine concentration (MUIC) in a population of school-age children, as a proxy measure of dietary iodine intake, is inappropriate for defining the degree or severity of gestational iodine deficiency and needs to be replaced. This review examines progress in analytical techniques for the measurement of urinary iodine concentration and the application of this technology to epidemiological studies of iodine deficiency with a focus on gestational iodine deficiency. We recommend that more precise definitions and measurements of gestational iodine deficiency, beyond a spot UIC, need to be developed. We review the evidence for hypothyroxinaemia as the cause of intrauterine foetal brain damage in gestational iodine deficiency and discuss the many unanswered questions, from which we propose that further clinical studies need to be designed to address the pathogenesis of neurodevelopmental impairments in the foetus and infant. Agreement on the testing instruments and standardization of processes and procedures for Intelligence Quotient (IQ) and psychomotor tests needs to be reached by investigators, so that valid comparisons can be made among studies of gestational iodine deficiency and neurocognitive outcomes. Finally, the timing, safety and the efficacy of prophylactic iodine supplementation for pregnant and lactating women needs to be established and confirmation that excess intake of iodine during pregnancy is to be avoided.

scholarly journals Qualitative Determination of Urinary Iodine Concentration and Related Intelligence Quotient among High School Young Teenagers

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Samuel Jacob Bunu ◽  
Diepreye Ere ◽  
Celebrate E Alabo
Keyword(s):  
Intelligence Quotient ◽  
Growth Regulation ◽  
Urinary Iodine ◽  
Good Health ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
The Body ◽  
School Age Children ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition

Nutritional Essential Balance is a common trend in life. Iodine is not produced in the body and it is vital in maintaining good health, therefore it is needed to be consumed regularly. Essential iodine supplies are found in the ocean's bounty such as, sea salt, and fish. On land, iodine levels in the soil are great and are sufficiently maintained by plants such as cereals, vegetables. Several of the body functions rely upon iodine, including energy production, mental development, thyroid hormones production, reproductive glands support, and maintenance of the strong lymphatic system as well as cell growth regulation. Small amounts of iodine are found in the blood, nerves, and other organs of the body, but most of the body's iodine is present in the thyroid, breasts, ovaries, uterus, and prostate glands. The study was aimed to determine and evaluate the level of iodine concentration in the urine of school-age children, and its correlation to their intelligence quotient (IQ). The Titrimetric method was used in iodine urine concentration analysis.  Urine (5 ml) was measured from a universal bottle and transferred to a beaker and 20 ml of water was added. After preparing the test mixture, it was titrated with 0.001M sodium thiosulphate using a burette, and at the endpoint colorless solution was obtained, this done for all the samples. From the results, the median urinary iodine levels were 117.7µg/L which is within the adequate iodine intake range (100-199 µg/L). This suggests that iodine was not deficient in any form amongst the school children. There may also be no risk of mental impairment and goiter development among these children if iodine concentration in urine is a risk factor. Therefore, checking the iodine nutrition of a population is vital and a good marker in the assessment of iodine deficiency-related disorders.

scholarly journals Iodine nutrition among the adult population of the Faroe Islands – a population-based study

2021 ◽  
pp. 1-22
Author(s):  
Herborg Líggjasardóttir Johannesen ◽  
Gunnar Sjúrðarson Knudsen ◽  
Stig Andersen ◽  
Pál Weihe ◽  
Anna Sofía Veyhe
Keyword(s):  
Iodine Deficiency ◽  
Adult Population ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Population Based ◽  
Iodine Intake ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Faroe Islands ◽  
Iodine Nutrition

Abstract The World Health Organization recommends monitoring iodine status in all populations with median urinary iodine concentration below 100 µg/L suggesting iodine deficiency. There are no data on the iodine intake among the population of the Faroe Islands. This study aimed to provide data on iodine nutrition in a representative sample of the general adult population from the Faroe Islands. We conducted a population-based cross-sectional survey in 2011-2012 and measured iodine in urine from 491 participants (294/197 men/women) using the ceri/arsen method after alkaline ashing. Participants include around 100 subjects in each of four adult decades and included participants from both the capital city and villages. The median urinary iodine concentration was low within the recommended range 101 µg/L (range 21-1870 µg/L). No samples were in the range suggesting severe iodine deficiency, but half of the samples were in the range of just adequate or mildly insufficient iodine intake with urinary iodine concentration markedly lower in women than in men (86 versus 115 µg/L; P<0·001). Intake of fish and whale meals affected the urinary iodine concentrations. In conclusion, nearly half of the population had an iodine excretion in the range of borderline or mild iodine deficiency. The lowest iodine nutrition level among Faroese women is a concern as it may extend to pregnancy with increased demands on iodine nutrition. In addition, we found large variations and the intermittently excessive iodine intakes warrants follow-up on thyroid function in the population of the Faroe Islands.

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
Keyword(s):  
At Risk ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Urinary Iodine Concentration ◽  
Nutrition Survey ◽  
Iodine Status ◽  
Adults And Children ◽  
The Uk

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.

scholarly journals Urinary iodine concentration: a biochemical parameter for assessing the iodine status

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 30-35
Author(s):  
GM Molla
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Urinary Iodine Concentration ◽  
Lactating Women ◽  
Iodine Status ◽  
Excessive Iodine ◽  
Pregnancy And Lactation ◽  
Neonates And Infants

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

scholarly journals Indicators of Iodine Status in Pregnancy and Postpartum in a Group of Pregnant Women from Perimarine Area of Romania

2020 ◽  
Vol 26 (2) ◽  
pp. 63-69
Author(s):  
Scrinic Olesea ◽  
Delia Corina Elena ◽  
Toma Geanina Mirela ◽  
Circo Eduard
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Urinary Iodine Concentration ◽  
Urinary Creatinine ◽  
Iodine Status ◽  
In Pregnancy

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.

scholarly journals Women Remain at Risk of Iodine Deficiency during Pregnancy: The Importance of Iodine Supplementation before Conception and Throughout Gestation

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 172 ◽  
Author(s):  
Kristen Hynes ◽  
Judy Seal ◽  
Petr Otahal ◽  
Wendy Oddy ◽  
John Burgess
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Supplement Use ◽  
Iodine Supplementation ◽  
The Impact

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.

Iodine intake from supplements and diet during pregnancy and child cognitive and motor development: the INMA Mother and Child Cohort Study

2017 ◽  
Vol 72 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Mario Murcia ◽  
Mercedes Espada ◽  
Jordi Julvez ◽  
Sabrina Llop ◽  
Maria-Jose Lopez-Espinosa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Motor Function ◽  
Iodine Deficiency ◽  
Motor Development ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Urinary Iodine Concentration ◽  
Neuropsychological Development ◽  
Salt Consumption

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.

scholarly journals Lower educational status interferes with maternal iodine intake during both pregnancy and lactation

2021 ◽  
Author(s):  
Laszlo Samson ◽  
Ildiko Hircsu ◽  
Monika Katko ◽  
Miklos Bodor ◽  
Annamaria Gazdag ◽  
...  
Keyword(s):  
Breast Milk ◽  
Iodine Deficiency ◽  
Inductively Coupled Plasma ◽  
Smoking Status ◽  
Urinary Iodine ◽  
Educational Status ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodine Nutrition ◽  
Pregnancy And Lactation

Objective: To investigate factors affecting conscious iodine intake among pregnant and lactating women in a rural area in Hungary. Methods: Pregnant women were studied and followed during lactation. Urinary and breast milk iodine concentration (UIC and MIC) were measured by inductively coupled plasma mass spectrometry. Potential interfering factors, including age, educational status and smoking were assessed. Results: During pregnancy and lactation, mild iodine deficiency was observed; median UIC were 66 and 49 µg/L, respectively. Educational status was found to be a strong determinant of both iodine nutrition and smoking status during pregnancy (p < 0.01 and p < 0.001) and lactation (p < 0.001 and p < 0.01). While smoking and non-smoking lactating mothers had similar concentrations of urinary iodine (median UIC: 47 and 51 µg/L, p = 0.95), the breast milk of smoking mothers contained less iodine (median MIC: 150 and 203 µg/L, p = 0.03). Conclusions: Both low iodine intake and smoking contribute to the higher risk of iodine deficiency in women with lower educational status. In smokers, MIC is often low in spite of normal UIC, presumably due to the iodine transport blocking effect of the cigarette smoke towards breast milk; normal UIC may be misinterpreted as sufficient iodine supply towards the child. Antenatal health promotion strategies should focus on young women with lower educational status, even in regions where sufficient iodine intake has been achieved in non-pregnant adults.

scholarly journals A Household-Based Survey of Iodine Nutrition in Moroccan Children Shows Iodine Sufficiency at the National Level But Risk of Deficient Intakes in Mountainous Areas

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 240
Author(s):  
Laila El Ammari ◽  
Naima Saeid ◽  
Anouar Talouizte ◽  
Hasnae Gamih ◽  
Salwa Labzizi ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Rural Areas ◽  
Economic Status ◽  
National Level ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Salt Iodization ◽  
Moroccan Children

Historically, mountainous areas of Morocco have been affected by endemic goiter and severe iodine deficiency. In 1995, Morocco legislated salt iodization to reduce iodine deficiency. There has been no national survey of iodine nutrition in school-age children for nearly 3 decades. Our aim was to assess iodine nutrition in a national sample of 6–12-year-old children in Morocco to inform the national salt iodization strategy. In this cross-sectional household-based survey, we randomly recruited healthy 6–12-year-old children from 180 clusters in four geographic zones (north and east, central, north and south) covering the 12 regions of Morocco. A questionnaire was completed, including socio-economic status and parental level of education. In addition, anthropometric measurements were taken to assess nutrition status, and a spot urine sample was collected to measure urinary iodine concentration (UIC). A total of 3118 households were surveyed, and 1043 eligible children were recruited, 56% from urban areas and 44% from rural areas. At the national level, the percentage of surveyed samples with UIC < 50 μg/L was 21.6% (19.2%; 24.2%), which exceeds the WHO suggestion of no more than 20% of samples below 50 μg/L, despite an adequate level of median urinary iodine concentration (mUIC) at 117.4 µg/L (110.2; 123.3). There were no statistically significant differences in mUIC comparing urban vs. rural areas and socio-economic status. However, the mUIC was significantly lower in the central (high-altitude non-coastal) zone (p < 0.004), where the mUIC (95% CI) was deficient at 89.2 µg/L (80.8; 102.9). There was also a significant difference in the mUIC by head of household education level (p = 0.008). The mUIC in Moroccan children >100 µg/L indicates iodine sufficiency at the national level. However, the percentage of surveyed samples with UIC < 50 μg/L above suggests that a significant proportion of children remain at risk for iodine deficiency, and it appears those at greatest risk are residing in the central (high altitude non-coastal) zone. A national level mUIC value may conceal discrepancies in iodine intake among different sub-groups, including those defined by geographic region.

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