Improved iodine status in Tasmanian schoolchildren after fortification of bread: a recipe for national success

DePaoli, Kate M; Seal, Judy; Burgess, John; Taylor, Roscoe

doi:10.5694/mja12.11356

Cited by 11 publications

(9 citation statements)

References 14 publications

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“…This is expected, as the intervention added iodine to a dietary component that is not eaten in the same amounts each day. A similar phenomenon was observed in Tasmania during the voluntary iodine fortification program . Signs of iodine deficiency, such as intellectual impairment, are generally not evident in people with a mild deficiency.…”

Section: Discussionsupporting

confidence: 66%

Iodine status of Indigenous and non‐Indigenous young adults in the Top End, before and after mandatory fortification

Singh

Davison

Gary

et al. 2018

Medical Journal of Australia

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Objective To assess the median urine iodine concentration (UIC) of young adults in the Top End of Northern Territory, before and after fortification of bread with iodised salt became mandatory. Design, setting Analysis of cross‐sectional data from two longitudinal studies, the Aboriginal Birth Cohort and the non‐Indigenous Top End Cohort, pre‐ (Indigenous participants: 2006–2007; non‐Indigenous participants: 2007–2009) and post‐fortification (2013–15). Participants Indigenous and non‐Indigenous Australian young adults (mean age: pre‐fortification, 17.9 years (standard deviation [SD], 1.20 years); post‐fortification, 24.9 years (SD, 1.34 years). Main outcome measure Median UIC (spot urine samples analysed by a reference laboratory), by Indigenous status, remoteness of residence, and sex. Results Among the 368 participants assessed both pre‐ and post‐fortification, the median UIC increased from 58 μg/L (interquartile range [IQR], 35–83 μg/L) pre‐fortification to 101 μg/L (IQR, 66–163 μg/L) post‐fortification (P < 0.001). Urban Indigenous (median IUC, 127 μg/L; IQR, 94–203 μg/L) and non‐Indigenous adults (117 μg/L; IQR, 65–160 μg/L) were both iodine‐replete post‐fortification. The median UIC of remote Indigenous residents increased from 53 μg/L (IQR, 28–75 μg/L) to 94 μg/L (IQR, 63–152 μg/L; p < 0.001); that is, still mildly iodine‐deficient. The pre‐fortification median UIC for 22 pregnant women was 48 μg/L (IQR, 36–67 μg/L), the post‐fortification median UIC for 24 pregnant women 93 μg/L (IQR, 62–171 μg/L); both values were considerably lower than the recommended minimum of 150 μg/L for pregnant women. Conclusions The median UIC of young NT adults increased following mandatory fortification of bread with iodised salt. The median UIC of pregnant Indigenous women in remote locations, however, remains low, and targeted interventions are needed to ensure healthy fetal development.

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Section: Discussionsupporting

confidence: 66%

Iodine status of Indigenous and non‐Indigenous young adults in the Top End, before and after mandatory fortification

Singh

Davison

Gary

et al. 2018

Medical Journal of Australia

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“…The article by Hynes and colleagues in this issue of the Journal 2 corroborates earlier data that support the benefit of replacing a voluntary iodine bread fortification program in Tasmania with a mandatory program 3 . The authors note that iodine nutrition is considered adequate when the median urinary iodine concentration (UIC) of the population is 100–200 μg/L and fewer than 20% of tested samples have values below 50 μg/L 2 .…”

supporting

confidence: 67%

The value of food fortification as a public health intervention

Harvey

Diug

2018

Medical Journal of Australia

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“…Are the deleterious impacts of in utero iodine insufficiency long-lasting and can they be ameliorated by adequate iodine nutrition in childhood? We are uniquely placed to examine these questions, having a cohort whose gestation occurred during a documented period of mild ID (median UICs 72 to 75 μg/L between 1998 and 2000) [ 8 ] in the Tasmanian population, with the children subsequently growing up in an iodine replete environment (median UICs 105 to 130 μg/L, between 2003 and 2016) [ 9 , 10 ], following population iodine prophylaxis via fortification of bread with iodized salt in late 2001 [ 11 , 12 ]. In this follow-up of the Gestational Iodine Cohort we investigate whether our previously observed association between mild GID and reduced educational outcomes in literacy, at age 9-years [ 4 ], persists into adolescence.…”

Section: Introductionmentioning

confidence: 99%

Reduced Educational Outcomes Persist into Adolescence Following Mild Iodine Deficiency in Utero, Despite Adequacy in Childhood: 15-Year Follow-Up of the Gestational Iodine Cohort Investigating Auditory Processing Speed and Working Memory

et al. 2017

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There is increasing evidence that even mild gestational iodine deficiency (GID) results in adverse neurocognitive impacts on offspring. It’s unclear, however, if these persist long-term and whether they can be ameliorated by iodine sufficiency in childhood. We followed a unique cohort (Gestational Iodine Cohort, n = 266) where gestation occurred during a period of mild population iodine deficiency, with children subsequently growing-up in an iodine replete environment. We investigated whether associations between mild GID and reductions in literacy outcomes, observed at age 9-years, persisted into adolescence. Comparisons were made between offspring of mothers with gestational urinary iodine concentrations (UICs) ≥ 150 μg/L and < 150 μg/L. Educational outcomes were measured using Australian National Assessment Program—Literacy and Numeracy (NAPLAN) tests. Children whose mothers had UICs < 150 μg/L exhibited persistent reductions in spelling from Year 3 (10%, −41.4 points (95% Confidence Interval −65.1 to −17.6, p = 0.001)) to Year 9 (5.6%, −31.6 (−57.0 to −6.2, p = 0.015)) compared to children whose mothers had UICs ≥ 150 μg/L. Associations remained after adjustment for biological factors, socioeconomic status and adolescent UIC. Results support the hypothesis that mild GID may impact working memory and auditory processing speed. The findings have important public health implications for management of iodine nutrition in pregnancy.

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Improved iodine status in Tasmanian schoolchildren after fortification of bread: a recipe for national success

Cited by 11 publications

References 14 publications

Iodine status of Indigenous and non‐Indigenous young adults in the Top End, before and after mandatory fortification

Iodine status of Indigenous and non‐Indigenous young adults in the Top End, before and after mandatory fortification

The value of food fortification as a public health intervention

Reduced Educational Outcomes Persist into Adolescence Following Mild Iodine Deficiency in Utero, Despite Adequacy in Childhood: 15-Year Follow-Up of the Gestational Iodine Cohort Investigating Auditory Processing Speed and Working Memory

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