Socio-biomedical predictors of child nutrition in India: an ecological analysis from a nationally representative Demographic and Health Survey, 2015–2016

Background Despite significant economic growth and development, undernutrition among children remains a major public health challenge for low- and middle-income countries in the twenty-first century. In Millennium Development Goals, India committed halving the prevalence of underweight children by 2015. This study aimed to explain the geographical variation in child malnutrition level and understand the socio-biomedical predictors of child nutrition in India. Methods We used the data from India’s National Family Health Survey 2015–2016. The survey provided estimates of stunting, wasting, and underweight at the national, state, and district level to measure nutritional status of under-five children. Level of stunting, wasting and underweight at the district level are considered as outcome variables. We have used variance inflation factor to check the multicollinearity between potential predictors of nutrition. In this study, we performed spatial analysis using ArcGIS and multiple linear regression analysis using Stata version 15. Results Five states (Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Meghalaya) had very high prevalence of stunting (40% and above). High prevalence of wasting was documented in Jharkhand, Madhya Pradesh, Chhattisgarh, and Karnataka (23 to 29%). Jharkhand, Madhya Pradesh, Maharashtra, and Chhattisgarh had the highest proportion of underweight children in the country. We found that electricity and clean fuel use in the household, use of iodized salt, and level of exclusive breastfeeding had significantly negative influence on the stunting level in the districts. The use of iodized salt has similar effect on the wasting status of under-five children in the districts (b: − 0.27, p < 0.10). Further, underweight level had a negative association with clean fuel use for cooking (b: − 0.17, p < 0.01), use of iodized salt (b: − 0.36, p < 0.10), breastfeeding within one hour (b: − 0.18, p < 0.10), semisolid/solid food within 6–8 months (b: − 0.11, p < 0.05) and Gross Domestic Product of the districts (b: − 0.53, p < 0.10). Conclusion In the study, a variety of factors including electricity and clean fuel use in the household, use of iodized salt, level of exclusive breastfeeding, breastfeeding within one hour, semisolid/solid food within 6–8 months and Gross Domestic Product of the districts have a significant association with nutritional status of children.

Knowledge, Practice, and Availability of Iodized Salt and Associated Factors in Jibat Woreda, West Shoa Zone, Ethiopia

Appropriate knowledge, practice, and availability of iodized salt are used to eliminate iodine deficiency disorders. However, little is known about the availability of adequately iodized salt in the western part of Ethiopia. Thus, the aim of this study was to assess knowledge, practice, and availability of iodized salt and associated factors at household level in Jibat woreda, Ethiopia. Community-based cross-sectional study was conducted using structured and pretested questionnaire interview. Sampling salt was tested by the iodometric titration method. The result showed that iodine content more than 90% was considered as adequately iodized salt. The result of this study shown that among the 357 salt samples, 191(53.5%) households had good knowledge on iodized salt while 166 (46.5%) had poor knowledge on iodized salt. In addition, the result of the study revealed that 162 (45.4%) had good practice of iodized salt, whereas 195 (54.6%) had poor practice of iodized salt. The result of this study also shown that 149 (41.7%) households were using adequately iodized salt while 208 (58.3%) were using inadequate iodized salt in study area. Residence area, education level, household job, and average monthly income were significantly associated with knowledge of iodized salt at household level. Residence area, educational level, average monthly income, and expose to sunlight were significantly associated with availability of adequately iodized salt. In this finding, the knowledge and practices of iodized salt at household level in Jibat woreda, Ethiopia, were poor, and the availability of iodine in iodized salt was inadequate. This is associated to residence area, education level of household, and average monthly income. Therefore, any concerned body/institution should have to work in the above gabs of the knowledge, practice, and availability of iodized salt.

Magnitude and factors associated with Availability of Adequately Iodized Salt at Households of Pregnant Mothers in Wonago district, south Ethiopia

Background Salt iodization is the most cost-effective, safe and sustainable strategy to eliminate iodine deficiency disorders. It is especially damaging during pregnancy and in early child hood. Adding iodine to salt provides protection from brain damage due to iodine deficiency for whole populations. However, little was known about the availability of adequately iodized salt in South Ethiopia. The aim of this study was to assess prevalence and factors associated with availability of adequately iodized salt at the households of pregnant mothers in Wonago District, South Ethiopia, 2018. Methods Community-based cross-sectional study was conducted from May 14-29, 2018 in Wonago district. Using a stratified two stage random sampling technique, a total of 604 pregnant mothers were included in the study. The level of salt iodine content was determined using the rapid field test kit, considering a value of <15 parts per million (PPM) and ≥15 PPM with the corresponding color chart on the rapid test kit for classification. Multivariable logistic regression model was fitted to identify factors associated with the availability of adequately iodized salt. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association. Result Availability of adequately iodized salt at households of pregnant mothers was 19.9%. House hold head, husband education, average monthly household income and time of salt addition during cooking were independently associated with adequately iodized salt availability. Accordingly, participatory male headed households [AOR=2.1(95%CI 1.08, 3.96)], women with an average monthly household income of ≥ 817 ETB [AOR=7.3(95%CI 3.03, 17.70)] and those who added salt late or after cooking during food preparation [AOR=2.17(1.08, 4.38)] were more likely to utilize adequately iodized salt. Conversely, women whose husband had no formal education were less likely [AOR=0.33(95%CI 0.11, 0.88)] to utilize iodized salt. Conclusion Compared to the recommended standard, use of adequately iodized salt among pregnant women is very low. Paternal conditions and household income level are key predictors of use of adequately iodized salt.

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.

Knowledge and Utilization of Iodized Salt and Associated Factors among Households of Fitche Town, Central Ethiopia, 2020: A Community based Cross-Sectional Study

Adequate knowledge and proper utilization of iodized salt in the household is a significant factor in the prevention of iodine deficiency disorders. This study was aimed at assessing knowledge and utilization of iodized salt and associated factors among the Fitche town community. A total of 470 individuals in the household were participated. About 58.6% of the respondents had good knowledge of iodized salt use and 52.6% use adequately iodized salt. Having higher monthly income [adjusted odds ratio (AOR)=2.97, 95%confidence interval (CI):1.05-8.42], having family health insurance [AOR=2.57, 95%CI:1.15-5.74] and being aware of iodine deficiency consequences [AOR=1.88, 95%CI:1.03-3.40)] were significantly associated with proper utilization of iodized salt. Besides, acquiring health advice on iodized salt [AOR=2.20, 95%CI:1.10-4.40] and educational status [AOR=0.14, 95%CI:0.03-0.56] were shown significant association with the knowledge of respondents on iodized salt use. Even though knowledge of iodized salt use in the study area is higher as compared to other findings, the coverage of proper iodized salt utilization is less than the world health organization recommendation of iodized salt use in households. Therefore, promoting the knowledge and utilization of iodized salt should be strengthened. Additionally, routine testing and monitoring for iodine levels in salt sold in the markets and used by households have enormous benefits.

Estimated contribution of most commonly consumed industrialized processed foods to salt intake and iodine intakes in Sri Lanka

In Sri Lanka dietary patterns are shifting towards increased consumption of industrially processed foods (IPF). This study aimed to estimate the contribution of IPF to salt and iodine intake and assess the possible impact of salt reduction on iodized salt intake. The assessment was conducted using guidance published by the Iodine Global Network. National nutrition and household income expenditure surveys were used to estimate adult per capita consumption of household salt and commonly consumed salt-containing IPF. Industry and laboratory data were used to quantify salt content of IPF. Modelling estimated the potential and current iodine intake from consumption of household salt and using iodized salt in the identified IPF. Estimates were adjusted to investigate the likely impact on iodine intake of achieving 30% salt reduction. IPF included were bread, dried fish and biscuits, with daily per capita consumption of 32g, 10g and 7g respectively. Daily intake of household salt was estimated to be 8.5g. Potential average national daily iodine intake if all salt in these products was iodized was 166μg. Estimated current daily iodine intake, based on iodization of 78% of household salt and dried fish being made with non-iodized salt, was 111μg nationally, ranging from 90 to 145μg provincially. Estimated potential and current iodine intakes were above the estimated average requirement of 95μg iodine for adults, however, current intake was below the recommended nutrient intake of 150μg. If the 30% salt reduction target is achieved, estimated current iodine intake from household salt, bread and biscuits could decrease to 78μg. The assessment together with data for iodine status suggest that current iodine intake of adults in Sri Lanka is adequate. Recommendations to sustain with reduced salt intake are to strengthen monitoring of population iodine status and of food industry use of iodized salt, and to adjust the salt iodine levels if needed.

Iodine Deficiency Disorders: Current State of the Problem in the Bryansk Region

BACKGROUND: The Bryansk region is one of the regions of the Russian Federation most affected by the accident at the Chernobyl nuclear power plant on April 26, 1986.In the conditions of a chronic uncompensated deficiency of iodine in the diet in the first months after the accident, an active seizure of radioactive iodine by the thyroid tissue took place, which inevitably resulted in an increase in thyroid diseases from the population in the future. The article presents the results of a control and epidemiological study carried out in May 2021 by specialists of the National Medical Research Center of Endocrinology of the Ministry of Health of Russia, aimed at assessing the current state of iodine provision in the population of the Bryansk region.AIM: Assessment of iodine supply of the population of the Bryansk region.MATERIALS AND METHODS: The research was carried out in secondary schools of three districts of the Bryansk region (Bryansk, Novozybkov and Klintsy).The study included 337 schoolchildren of pre-pubertal age (8–10 years), all children underwent: measurement of height and weight immediately before the doctor’s examination, which included palpation of the thyroid gland (thyroid gland); Thyroid ultrasound using a portable device LOGIQe (China) with a multi-frequency linear transducer 10–15 MHz; determination of iodine concentration in single portions of urine. A qualitative study for the presence of potassium iodate in samples of table salt (n = 344) obtained from households and school canteens was carried out on the spot using the express method.RESULTS: According to the results of a survey of 337 pre-pubertal children, the median urinary iodine concentration (mCIM) is 98.3 μg / L (range from 91.5 to 111.5 μg / L, the proportion of urine samples with a reduced iodine concentration was 50.1%). According to the ultrasound of the thyroid gland, 17% of the examined children had diffuse goiter, the frequency of which varied from 9.4 to 29% in the areas of study. The share of iodized salt consumed in the families of schoolchildren in the study areas was 17.8% (values range from 15.6 to 19%), which indicates an extremely low level of iodized salt consumption by the population. All salt used for cooking in school canteen areas of the study was iodized, which confirms compliance with the requirements of SanPiN 2.4.5.2409–08.CONCLUSION: Despite the active implementation in the Bryansk region of various preventive programs of IDD and social activities to promote the use of iodized salt, in the absence of mass prevention with the help of iodized salt to date, their unsatisfactory results should be noted.

Analysis of the correlation between high iodized salt intake and the risk of thyroid nodules: a large retrospective study

Background Currently, whether daily excess iodized salt intake increases the risk of thyroid nodules and even thyroid cancer remains controversial. Our research group aimed to provide a theoretical basis for the clinical guidance of daily iodized salt intake and the prevention of thyroid nodules through a retrospective analysis of the correlation between daily iodized salt intake and the risk of thyroid nodules and thyroid cancer in Hunan, China. Methods This study retrospectively analyzed the data of subjects who underwent a physical examination at the Health Management Center, Third Xiangya Hospital of Central South University, between January 1, 2017, and December 31, 2019. Subjects enrolled in this study underwent thyroid ultrasonography and tests to urine routines and liver and kidney function, and all subjects completed a questionnaire survey. The daily iodized salt intake of the study subjects was estimated based on spot urine methods (Tanaka). A multivariate logistic regression model was used to analyze the relationship between daily iodized salt intake and thyroid nodules and thyroid cancer. Results Among the 51,637 subjects included in this study, the prevalence of thyroid nodules was 40.25%, and the prevalence of thyroid cancer was 0.76%; among all enrolled subjects, only 3.59% had a daily iodized salt intake less than 5 g. In addition, we found that a daily intake of more than 5 g of iodized salt was not only an independent risk factor for the occurrence of thyroid nodules (odds ratio (OR): 2.08, 95% confidence interval (CI): 1.86–2.31, p < 0.001) but also an independent risk factor for the occurrence of thyroid cancer (OR: 5.81, 95% CI: 1.44–23.42, p = 0.012). A pooled analysis showed a significantly higher risk of thyroid nodules in subjects aged > 60 years with a daily iodized salt intake of more than 5 g compared to subjects aged < 60 years with a daily iodized salt intake of no more than 5 g (OR: 4.88, 95% CI: 4.29–5.54, p < 0.001); the risk of thyroid cancer was not significantly different between subjects aged > 60 years with a daily iodized salt intake of more than 5 g and those aged < 60 years with a daily iodized salt intake of no more than 5 g (OR: 2.15, 95% CI: 0.52–8.95, p = 0.281). The risk of thyroid nodules was not increased in physically active subjects with a daily iodized salt intake of more than 5 g compared to physically inactive subjects with a daily iodized salt intake of no more than 5 g (OR: 1.12, 95% CI: 0.97–1.28, p = 0.111). The same protective effect of physical activity was observed for thyroid cancer in subjects whose daily iodized salt intake exceeded 5 g. The risk of thyroid nodules was reduced for subjects with an education level of postgraduate and above, even when the daily iodized salt intake exceeded 5 g, compared to those with high school education and below and a daily iodized salt intake of no more than 5 g (OR: 0.79, 95% CI: 0.66–0.93, p = 0.005); however, a protective effect of education level on the occurrence of thyroid cancer was not observed. Independent risk factors affecting daily iodized salt intake greater than 5 g included age, triglycerides, family history of tumors, physical activity, and marital status. Conclusions Daily intake of more than 5 g of iodized salt increased the risk of thyroid nodules and thyroid cancer, while increased physical activity and education level reduced the risk of thyroid nodules and thyroid cancer caused by iodized salt intake.

Penyuluhan garam beryodium terhadap perubahan pengetahuan ibu rumah tangga dalam penggunaan garam yodium

Background: Disorders Due to Iodine Deficiency (IDD) is one of the main nutritional problems that cannot be eliminated due to an environment that is poor in iodine sources. Residents who live in areas with an iodine deficit and only consume available food and drink. Lack of knowledge about the causes of IDD is the driving force for the high incidence of health problems.Objectives: This study aims to determine whether there is an effect before and after the counseling is carried out on changes in the knowledge of housewives and the use of iodized salt.Methods: This type of research is a quasi-experimental research with pre-test and post-test. This research was conducted in Trienggadeng District, Pidie Jaya Regency, which was conducted in 2019. The sample size in this study was the entire population as a sample, namely all 39 housewives. Data collection includes primary data and maternal data. Data processing in this study with 4 stages, including stages namely; editing, coding, entry, processing, and cleaning data. Data analysis was carried out univariate and bivariate. The statistical test for bivariate analysis was using the T-dependent statistical test.Results: The results showed that the level of knowledge and use of iodized salt in housewives in Trienggadeng District, Pidie Jaya Regency. There is an effect of counseling the benefits of iodized salt before and after on increasing the knowledge of housewives, with a value of p = 0.001 (p < 0.05). There is an effect of counseling the benefits of iodized salt between before and after the use of iodized salt to housewives, with a value of p = 0.000 (p < 0.05). Conclusion: There is the influence of education on the benefits of iodized salt to increase knowledge of housewives, but it is also significant in household use.

Progress towards elimination of IDD in the Islamic Republic of Iran: a KAP survey of iodized salt consumption

It has been recognized for a number of years that iodine deficiency disorders constitute a health problem in the Islamic Republic of Iran. A programme for the prevention of such disorders was established in 1989 and intensive efforts have been made to overcome obstacles hindering its implementation. This study investigates the difficulties encountered, common factors behind the prevalence of iodine deficiency, the progress made in combating it and the results of a nationwide campaign to raise awareness of the need to consume iodized salt. The final part of the study presents general conclusions and recommendations which may be of use to countries facing a similar problem in the field of health and nutrition