Epidemiology of Iodine Deficiency

Gizak, Małgorzata; Gorstein, Jonathan; Andersson, Maria

doi:10.1007/978-3-319-49505-7_3

Cited by 21 publications

(24 citation statements)

References 36 publications

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“…We found that children had the highest median UIC, the highest usual iodine intake and the lowest probability of inadequate iodine intake. Adequate iodine nutrition has been reported in school-age children in Sweden [ 44 ], Portugal [ 45 ], and Australia [ 46 ] and a number of countries globally, simultaneously to finding inadequate iodine status in pregnant women in the same populations [ 16 , 47 , 48 , 49 ]. As milk is a main iodine source in countries without mandatory salt iodization, higher consumption of milk and dairy products in younger age groups explains why children are iodine sufficient while their mothers are not.…”

Section: Discussionmentioning

confidence: 99%

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Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

et al. 2018

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Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC) and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children (n = 47), adolescents (n = 46), adults (n = 71), the elderly (n = 23), pregnant women (n = 45), ovo-lacto vegetarians (n = 25), and vegans (n = 19). In all participants combined, the median (95% CI) UIC was 101 (90, 110) µg/L, median (25th, 75th percentile) calculated iodine intake was 112 (77, 175) µg/day and median (25th, 75th percentile) estimated usual iodine intake was 101 (75, 150) µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82%) and vegans the lowest (14%) probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

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Section: Discussionmentioning

confidence: 99%

“…Denmark initiated monitoring of iodine status more than 20 years ago, and the findings resulted in implementation of mandatory fortification of industrial (commercial) bread with iodized salt [ 15 ]. Other countries in Europe and worldwide have handled this issue in different ways or have ignored it [ 6 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

et al. 2018

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“…Because of successful programs of universal salt iodization in former severely iodine-deficient regions around the world, public health concern has shifted toward mild to moderate iodine deficiency, which remains prevalent in many regions, especially among pregnant women [ 6 ]. Iodine deficiency is often thought to be a problem in developing countries, however industrialized countries are not immune [ 7 , 8 ]. Indeed, concern is emerging that mild iodine deficiency might be prevalent in Norway, even though Norway has been considered iodine replete for six decades [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Suboptimal Iodine Status among Pregnant Women in the Oslo Area, Norway

et al. 2018

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Norway has been considered iodine replete for decades; however, recent studies indicate reemergence of inadequate iodine status in different population groups. We assessed iodine status in pregnant women based on urinary iodine concentration (UIC), urinary iodine excretion (UIE), and iodine intake from food and supplements. In 804 pregnant women, 24-h iodine intakes from iodine-rich foods and iodine-containing supplements were calculated. In 777 women, iodine concentration was measured in spot urine samples by inductively coupled plasma/mass spectrometry (ICP-MS). In addition, 49 of the women collected a 24-h urine sample for assessment of UIE and iodine intake from food frequency questionnaire (FFQ). Median UIC was 92 µg/L. Fifty-five percent had a calculated iodine intake below estimated average requirement (EAR) (160 µg/day). Iodine intake from food alone did not provide the amount of iodine required to meet maternal and fetal needs during pregnancy. In multiple regression models, hypothyroidism, supplemental iodine and maternal age were positively associated with UIC, while gestational age and smoking were negatively associated, explaining 11% of the variance. This study clearly shows that pregnant women in the Oslo area are mild to moderate iodine deficient and public health strategies are needed to improve and secure adequate iodine status.

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“…Both iodine deficiency and iodine excess are known to interfere with thyroid hormone synthesis [ 5 – 8 ]. While severe iodine deficiency has been eliminated, the number of countries with iodine excess has increased over the past decade [ 9 – 12 ]. Fetuses and newborn children are particularly vulnerable to iodine excess, since their immature thyroid gland is unable to escape from the Wolff-Chaikoff effect [ 13 – 15 ], which may lead to long-term thyroid dysfunction [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between thyroid dysfunction and developmental status in children with excessive iodine status

et al. 2017

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Background and objectiveAdequate iodine status and normal thyroid hormone synthesis are important for optimal child development. In this study, we explored whether young children’s developmental status is associated with thyroid dysfunction in an area of chronic excessive iodine exposure.MethodsWe included 298 children between 18 and 48 months of age residing in Algerian refugee camps. Early child development was measured using the Ages and Stages Questionnaires, third edition (ASQ-3), consisting of five domains: Communication, Gross Motor, Fine Motor, Problem Solving and Personal-Social. Due to poor discriminatory ability in the Gross Motor domain, the total ASQ-3 scores were calculated both including and excluding this domain. Urinary iodine concentration (UIC), thyroid hormones (TSH, FT3 and FT4), thyroid antibodies and serum thyroglobulin (Tg) were measured.ResultsThe median UIC was 451.6 μg/L, and approximately 72% of the children had a UIC above 300 μg/L. Furthermore, 14% had thyroid disturbances, of whom 10% had TSH outside the reference range. Children with thyroid disturbances and TSH outside the reference ranges had lower odds of being among the 66% highest total ASQ scores, with adjusted odds ratios (95% CI) of 0.46 (0.23, 0.93) and 0.42 (0.19, 0.94), respectively.ConclusionWe found an association between thyroid dysfunction and poorer developmental status among children with excessive iodine intake. The high iodine intake may have caused the thyroid dysfunction and hence the delayed developmental status; however, other influential factors cannot be excluded. Optimal child development is important for a sustainable future. With iodine excess being an increasing problem globally, this subject should be further explored.

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Epidemiology of Iodine Deficiency

Cited by 21 publications

References 36 publications

Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample

Suboptimal Iodine Status among Pregnant Women in the Oslo Area, Norway

Associations between thyroid dysfunction and developmental status in children with excessive iodine status

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