Public health policy to redress iodine insufficiency in pregnant women may widen sociodemographic disparities

Mallard, Simonette R.; Houghton, Lisa A

doi:10.1017/s1368980013001626

Cited by 15 publications

(29 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We estimated an increase in iodine intake of approximately 31 μg/day from bread reflecting an average consumption of 2 slices per day. This is comparable to the estimated post-fortification increase of iodine intake from bread, of 35 to 37 μg/day in women of childbearing age [14] and in adults aged 18 to 64 years [8], but lower than the modeled estimate of 52 μg/day in children [4]. …”

Section: Discussionsupporting

confidence: 67%

“…For example, older institutionalized adults with renal insufficiency may have lower iodine requirements from decreased excretion of iodine. Therefore, while previous studies have focused on monitoring the effect of the mandatory bread fortification program on the iodine intake or status of younger populations [9,14], it is also important to evaluate the impact of the program on the elderly.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care

et al. 2016

View full text Add to dashboard Cite

In response to the re-emergence of iodine deficiency in New Zealand, in 2009 the government mandated that all commercially made breads be fortified with iodized salt. There has been no evaluation of the impact of the program on iodine status of the elderly, despite this population group being vulnerable to iodine deficiency or excess. The aim of this study was to describe the iodine status of elderly New Zealanders in residential aged-care homes following the implementation of the bread fortification program. A cross-sectional survey was conducted, involving 309 residents (median age 85 years) from 16 aged-care homes throughout NZ. Information on socio-demographic, anthropometric, dietary and health characteristics were collected. Casual spot urine samples were analysed for urinary iodine concentration (UIC). Blood samples were analysed for serum thyroglobulin, thyroglobulin antibodies, and other biochemical indices. The median UIC (MUIC) of the residents was 72 μg/L, indicating mild iodine deficiency, and 29% had a UIC < 50 μg/L. Median thyroglobulin concentration was 18 ng/mL and 26% had elevated thyroglobulin concentration (>40 ng/mL), suggesting iodine insufficiency. Diuretic use was associated with lower MUIC (p = 0.043). Synthetic thyroxine use was associated with lower odds of having a UIC < 50 μg/L (OR 0.32, p = 0.030)) and lower median thyroglobulin (−15.2 ng/mL, p = 0.001), compared with untreated participants. Frailty was associated with elevated thyroglobulin (p = 0.029), whereas anemia was associated with lower thyroglobulin (p = 0.016). Iodine insufficiency persists in New Zealanders residing in residential aged-care homes despite increasing iodine intake from fortified bread. Research is required to establish optimal iodine intake and status in the elderly.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care

et al. 2016

View full text Add to dashboard Cite

show abstract

“…However, UIC in the current study (65 µg/l) represents an increment of only 25% (13 µg/day) compared to the median UIC (52 µg/l) of women in a national study prior to iodine fortification [26]. Although, the estimated iodine intake (130 µg/day) in the present study was twice the intake estimated for women prior to fortification (63 µg/day) in the 2009 New Zealand Total Diet Survey (NZTDS) [29], their urinary iodine status still classified them as iodine-deficient. In addition, the estimated median intake is below the EAR of 160 and 190 µg/day for pregnant and lactating women respectively, thus they would remain at risk of inadequate iodine intake if they became pregnant, despite mandatory fortification.…”

Section: Open Access Fnsmentioning

confidence: 65%

“…It is therefore essential that pregnant and lactating women use the subsidised iodine supplement to ensure sufficient iodine intake during this time. However, a recent observational study in NZ (n = 723) reported low use of iodine containing supplements among pregnant women, especially low income women [29].…”

Section: Open Access Fnsmentioning

confidence: 98%

Iodine and Selenium Intake in a Sample of Women of Childbearing Age in Palmerston North, New Zealand after Mandatory Fortification of Bread with Iodised Salt

Shukri¹,

Coad²,

Weber³

et al. 2014

FNS

View full text Add to dashboard Cite

Iodine deficiency is a worldwide public health problem, which has long been observed in many parts of the world, including New Zealand (NZ). The aim of this study was to assess iodine and selenium intake among women of childbearing age in Palmerston North, New Zealand post mandatory fortification of bread with iodised salt. Fifty women of childbearing age completed a researcher-led questionnaire, including a semi-quantitative food frequency questionnaire. Iodine and selenium were analysed in 24-hour urine samples. The median urinary iodine concentration (UIC) was 65 µg/l with 30% below 50 µg/l; representing mild iodine deficiency according to the World Health Organization. The estimated median daily iodine intake (130 µg/day) was higher than the Estimated Average Requirement (100 µg/day) and higher than seen in women prior to fortification. The median excretion of selenium (32 µg/day) was slightly above level suggested as adequate (30 µg/day) and estimated median intake (57 µg/day) was higher than Estimated Average Requirement (50 µg/day). Selenium and iodine excretion were significantly correlated (Spearman's rank order; r(50) = 0.547, p < 0.001). The major contributors to iodine intake were milk (36%), bread (25%) and fish/seafood (15%). Participants had a mean intake of 2.5 slices of bread/day, which contributed approximately 14 to 20 µg of iodine. The majority of participants (74%) had iodised salt at home, but less than half (48%) used iodised salt exclusively. In conclusion, despite the mandatory fortification of bread with iodised salt in NZ, UIC of the study population indicates iodine deficiency although their estimated dietary intakes appear adequate. It is essential that government initiatives to improve iodine status are evaluated for their efficacy.

show abstract

“…While the etiology of the observed disparities have not been fully elucidated [55], evolving research has begun to focus on prenatal maternal nutritional status [36, 39] with a few studies documenting sociodemographic disparities in both dietary and supplement intakes in pregnant women and women of child-bearing age [15, 18]. Methods are needed among pregnant minorities in order to ensure the success of accurately measuring prenatal intake.…”

Section: Introductionmentioning

confidence: 99%

Validation of a Food Frequency Questionnaire for Estimating Micronutrient Intakes in an Urban US Sample of Multi-Ethnic Pregnant Women

Brunst

Kannan

et al. 2015

Matern Child Health J

View full text Add to dashboard Cite

Objective(s) To validate the Block98 food frequency questionnaire (FFQ) for estimating antioxidant, methyl-nutrient and polyunsaturated fatty acids (PUFA) intakes in a pregnant sample of ethnic/racial minority women in the United States (US). Methods Participants (n = 42) were from the Programming of Intergenerational Stress Mechanisms study. Total micronutrient intakes from food and supplements was ascertained using the modified Block98 FFQ and two 24-h dietary recalls collected at random on nonconsecutive days subsequent to completion of the FFQ in mid-pregnancy. Correlation coefficients (r) corrected for attenuation from within-person variation in the recalls were calculated for antioxidants (n = 7), methyl-nutrients (n = 8), and PUFAs (n = 2). Result(s) The sample was largely ethnic minorities (38 % Black, 33 % Hispanic) with 21 % being foreign born and 41 % having less than or equal to a high school degree. Significant and adequate deattenuated correlations (r ≥ 0.40) for total dietary intakes of antioxidants were observed for vitamin C, vitamin E, magnesium, and zinc. Reasonable deattenuated correlations were also observed for methyl-nutrient intakes of vitamin B6, betaine, iron, and n:6 PUFAs; however, they did not reach significance. Most women were classified into the same or adjacent quartiles (≥70 %) for total (dietary + supplements) estimates of antioxidants (5 out of 7) and methyl-nutrients (4 out of 5). Conclusions The Block98 FFQ is an appropriate dietary method for evaluating antioxidants in pregnant ethnic/minorities in the US; it may be less efficient in measuring methyl-nutrient and PUFA intakes.

show abstract

Public health policy to redress iodine insufficiency in pregnant women may widen sociodemographic disparities

Cited by 15 publications

References 26 publications

Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care

Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care

Iodine and Selenium Intake in a Sample of Women of Childbearing Age in Palmerston North, New Zealand after Mandatory Fortification of Bread with Iodised Salt

Validation of a Food Frequency Questionnaire for Estimating Micronutrient Intakes in an Urban US Sample of Multi-Ethnic Pregnant Women

Contact Info

Product

Resources

About