Iodine status of UK schoolgirls: a cross-sectional survey

With new evidence that UK schoolgirls are now iodine deficient (1) and in absence of iodine prophylaxis in the UK, women should be made aware of the increased iodine requirement throughout pregnancy, its importance and how to achieve sufficiency. Midwives are crucial in disseminating nutrition and lifestyle recommendations to pregnant women; here, we assessed awareness and knowledge of iodine in the light of current practice among midwives.Sixty NHS midwives were recruited in hospitals around Glasgow from July to September 2011. A short questionnaire, which consisted of three main sections (demographics, dietary and nutrition advice and confidence and awareness) was administered face-to-face.Respondents had spent a median 12.5 years in practice and were based in the community (18 %) or hospital (56 %) with 16 % indicating working in ante-natal clinics and 18 % on the labour wards. Most saw women in the last two trimester of pregnancy (59 %), with 30 % seeing women throughout the pregnancy. A majority advised women routinely on nutrition (50%), with 58 % seeing advising on nutrition as one of their responsibilities.In practice, specific dietary and lifestyle advice was routinely provided for weight management, food safety and specific micronutrients such as iron, vitamin A and folic acid (which may not be mentioned as often as expected due to the majority of the respondents dealing with women in the last two trimester of their pregnancy). Iodine, however, is most often not mentioned (67 %), and if so, mainly upon direct enquiry (23 %). While nearly all respondents reported awareness of the role of folate deficiency in increasing the risk of neural tube defects (97%), few could link iodine deficiency with hampered fetal brain development (20 %) or were aware of the increased iodine requirement during pregnancy (10%). Fish and dairy/milk were correctly mentioned as iodine-rich foods (by 46 and 23 %, respectively). Respondents were "very confident" for knowledge on general nutritional and "confident" regarding knowledge of dietary guideline (modes 7 and 5 on a 7-point likert scale, respectively). They were, however, "unconfident" regarding all aspects iodine in pregnancy (including requirements, implications for fetal health, ways to increase intake and identifying groups at risk). A majority (95 %) indicated a need for further education in this area.Midwives have previously identified a need for further nutritional education (2) . Dietary iodine is fast becoming a public health concern in the UK, and it is essential that health care professionals involved in pregnancy receive adequate information and training. Openlearning materials, which have been shown to increase nutritional knowledge, may be a useful tool to achieve this (3) .

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Sixty NHS midwives were recruited in hospitals around Glasgow from July to September 2011.

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confidence: 99%

Dietary iodine: awareness, knowledge and current practice among midwives

2012

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“…7 A more recent study among schoolgirls in the UK also reported a similarly low UIC suggesting that mild-to-moderate iodine deficiency remains a problem. 23 Such deficiency was probably caused by a poor availability of iodised salt, few UK recommendations for increased iodine intake in pregnancy, and insufficient use of iodine-containing prenatal supplements. The International Council for Control of Iodine Deficiency Disorders global network now places the UK on the list of mildly deficient nations.…”

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confidence: 99%

Moderate iodine deficiency among pregnant women in Hong Kong: revisit the problem after two decades

Tam

Chan

et al. 2017

Hong Kong Med J

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Women were recruited by snowball sampling using advertisements (in social media, relevant websites and places in the community) and word of mouth (May to November 2015).

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confidence: 99%

Dietary guidance during pregnancy and iodine nutrition: a qualitative approach

2016

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Iodine is important for the formation of thyroid hormones and infant neurodevelopment; however iodine intake, knowledge and awareness remain low amongst UK mothers (1)(2)(3) . Using qualitative study design, we aimed to explore mothers' perceptions of nutrition in pregnancy, focussing on points pertinent to iodine nutrition.Women were recruited by snowball sampling using advertisements (in social media, relevant websites and places in the community) and word of mouth (May to November 2015). Inclusion criteria included UK residency, fluent English and being pregnant, having a child (younger than 2 years old) or trying to conceive. All participants were interviewed individually by phone or face-to-face using a topic guide. Interviews were transcribed verbatim and analysed with thematic analysis, using NVivo version 11 (QSR International).Participants (n = 48) were pregnant (38 %), breastfeeding (35 %), planning to conceive (10 %) and 17 % had a baby or toddler. Four main themes emerged from the interviews: i) dietary guidance received; ii) iodine awareness, iii) acceptance of iodine rich products, difficulties and barriers towards consumption and iv) desirable characteristics of dietary guidance.An emerging theme in women with multiple pregnancies (n = 11) was assumption of prior knowledge by health professionals, leading to less information being provided. This is an issue, considering that most participants were unaware of the importance of iodine, its sources and recommended intake, as previously shown (3) . Only women with nutrition/medical backgrounds were aware of the importance of iodine, its sources and recommended intake -information both surprised and concerned women once handed from the researcher. Written dietary advice was received by most during the first antenatal care appointment (around 12-14 weeks gestation), with an overt focus on foods to avoid and supplements ("I had very little directions from [the] doctor so I've been on the internet."). However, a clear theme of trust in the health services emerged, with midwives and general practitioners considered experts in pregnancy nutrition.Attitude to dairy products was generally positive. Milk was recognised to alleviate heartburn symptoms and to be craved for pregnancy. In cases of dislike, women still tried to increase milk consumption via yogurts and/or cheese. The main barriers towards dairy consumption included taste (mainly for milk), (true or perceived) lactose intolerance or health conditions associated to dairy products (e.g. eczema), morning sickness and perceptions of unhealthiness associated with cheese products (fat, processed foods). It was perceived difficult to increase or maintain fish and/or seafood consumption, the main barrier to which was the general dislike of these foods, exacerbated by heartburn, morning sickness and change of taste and smell during pregnancy. Other stated reasons of fish exclusion were partner's and family preferences, lack of cooking skills, cost implications, low availability and habit of not buying/ eatin...

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Iodine status of UK schoolgirls: a cross-sectional survey

Cited by 291 publications

References 24 publications

Dietary iodine: awareness, knowledge and current practice among midwives

Dietary iodine: awareness, knowledge and current practice among midwives

Moderate iodine deficiency among pregnant women in Hong Kong: revisit the problem after two decades

Dietary guidance during pregnancy and iodine nutrition: a qualitative approach

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