Iodine and Pregnancy—A Qualitative Study Focusing on Dietary Guidance and Information

Abstract

Iodine is essential for thyroid hormones synthesis and normal neurodevelopment; however, ~60% of pregnant women do not meet the WHO (World Health Organization) recommended intake. Using a qualitative design, we explored the perceptions, awareness, and experiences of pregnancy nutrition, focusing on iodine. Women in the perinatal period (n = 48) were interviewed and filled in a food frequency questionnaire for iodine. Almost all participants achieved the recommended 150 μg/day intake for non-pregnant adults (99%), but only 81% met the increased demands of pregnancy (250 μg/day). Most were unaware of the importance, sources of iodine, and recommendations for iodine intake. Attitudes toward dairy products consumption were positive (e.g., helps with heartburn; easy to increase). Increased fish consumption was considered less achievable, with barriers around taste, smell, heartburn, and morning sickness. Community midwives were the main recognised provider of dietary advice. The dietary advice received focused most often on multivitamin supplements rather than food sources. Analysis highlighted a clear theme of commitment to change behaviour, motivated by pregnancy, with a desired focus on user-friendly documentation and continued involvement of the health services. The study highlights the importance of redirecting advice on dietary requirements in pregnancy and offers practical suggestions from women in the perinatal period as the main stakeholder group.

Got Mylk? The Emerging Role of Australian Plant-Based Milk Alternatives as A Cow’s Milk Substitute

“…Similarly, although the iodine status of Australians has generally improved following the mandatory use of iodised salt in flour for bread making [76], disparities in intake still exist between populations [72,73]. Iodine is imperative in thyroid hormone production and neurodevelopment, and its deficiency is a risk factor for mental impairment and birth defects [77]. In the current analysis, we were unable to identify products fortified with iodine apart from one product, indicating that there is only endogenous iodine present from the characterising ingredient.…”

An antenatal wish list: A qualitative systematic review and thematic synthesis of UK dietary advice for weight management and food borne illness

“…"That put a lot of pressure and a lot of guilt on me, but the second time round I decided to be a bit more relaxed and trust my body a bit more." (Bouga, Lean and Combet, 2018) Several participants felt able to exercise self-control throughout their pregnancy, through physical activity and dietary choices. These women believed that it was possible to maintain their weight and relished the resulting empowerment (Arden, Duxbury and Soltani, 2014;Denison et al, 2015;Heslehurst et al, 2013).…”

“…Back pain and fatigue prevented women maintaining their regular activity levels and had a subsequent effect on weight management (Draffin et al, 2016;Swift et al, 2017). Furthermore, consuming a healthy diet was compromised by nausea, heartburn and food cravings (Arden, Duxbury and Soltani, 2014;Bouga, Lean and Combet, 2018;Denison et al, 2015;Swift et al, 2017). Healthy foods were described as 'bland' or 'undesirable' with women prioritising comfort foods high in fat and sugar (Swift et al, 2017).…”

“…Women lacked time to cook the food they knew they should be eating and resorted to convenient options such as frozen food (McMillan et al, 2018;Padmanabhan, Summerbell and Heslehurst, 2015). Some women struggled to cook a healthy meal to please the whole family and one participant lacked the knowledge on how to cook fish (Bouga, Lean and Combet, 2018;Jarvie, 2017). Time pressures further affected physical activity, with women feeling too exhausted after a long working day (Denison et al, 2015;Weir et al, 2010).…”

Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort

“…The predicted estimates in this study may also be amplified amongst those with several risk factors for smallerbirthweight babies. The majority of women of reproductive age are likely unaware of their iodine status or good dietary sources, as only 23% of women who were pregnant or of reproductive age in the UK had heard of iodine, compared to 100% for folic acid [36]. Given the presence of these at-risk groups, and evidence of a continuing decrease in iodine consumption amongst UK women of childbearing age [35], our finding of an association between lower iodine status and increased risk of lower birthweight is highly relevant for the UK population.…”