Short-term effectiveness of mandatory iodization of table salt, at an elevated iodine concentration, on the iodine and goiter status of schoolchildren with endemic goiter

Jooste, P. L.; Weight, M.J.; Lombard, Carl

doi:10.1093/ajcn/71.1.75

Cited by 68 publications

(45 citation statements)

References 13 publications

(13 reference statements)

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“…37 As a consequence a dramatic shift occurred, also within one year, in the distribution of urinary iodine values from deficient to sufficient concentrations in four communities in the Langkloof area. 12 The goitre rates in these children, measured by palpation, remained unchanged after a year, confirming the slow regression of the thyroid size after increasing the iodine intake observed in the Ivory Coast. 3 This data also indicated that goitres measured by palpation may not be appropriate in the short-term evaluation of changes in salt iodisation programmes.…”

Section: Impact Of Mandatory Iodisation Of Saltsupporting

confidence: 59%

“…The cut-off levels and interpretation of iodine status are provided in Table II. 2 The thyroid size of children aged 6 to 12 years has been used as biological marker of iodine deficiency for many years, but its usefulness is limited because the thyroid size regresses slowly after increasing the iodine intake in salt iodisation programmes, 12,13 and results need to be interpreted cautiously. Thyroid size determined by palpation is graded as Grade 0 when the thyroid is not palpable, Grade 1 when it is palpable but not visible and the size of the lobe is bigger than the size of the end digit of the thumb of the Overall, iodine deficiency produces subtle but widespread adverse effects in a population, including decreased educability, apathy, and reduced work productivity, resulting in impaired social and economic development.…”

Section: Assessment Of Iodine Statusmentioning

confidence: 99%

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Progress towards eliminating iodine deficiency in South Africa

Jooste¹,

Zimmermann

2008

South African Journal of Clinical Nutrition

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Section: Impact Of Mandatory Iodisation Of Saltsupporting

confidence: 59%

Section: Assessment Of Iodine Statusmentioning

confidence: 99%

Progress towards eliminating iodine deficiency in South Africa

Jooste¹,

Zimmermann

2008

South African Journal of Clinical Nutrition

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“…Legislations to controls the tobacco exposure [93] and fortification of salt with iodine [94] are some examples of this approach.…”

Section: Population Approachmentioning

confidence: 99%

Review on Cardiovascular Risk Prediction

Ruwanpathirana

Owen

Reid

2015

Cardiovascular Therapeutics

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SUMMARYThe objectives were to review the currently available and widely used cardiovascular risk assessment models and to examine the evidence available on new biomarkers and the nonclinical measures in improving the risk prediction in the population level. Identification of individuals at risk of cardiovascular disease (CVD), to better target prevention and treatment, has become a top research priority. Cardiovascular risk prediction has progressed with the development and refinement of risk prediction models based upon established clinical factors, and the discovery of novel biomarkers, lifestyle, and social factors may offer additional information on the risk of disease. However, a significant proportion of individuals who have a myocardial infarction still are categorized as low risk by many of the available methods. Although novel biomarkers can improve risk prediction, including B-type natriuretic peptides which have shown the best predictive capacity per unit cost, there is concern that the use of risk prediction strategies which rely upon new/or expensive biomarkers could further broaden social inequalities in CVD. In contrast, nonclinical factors such as work stress, social isolation, and early childhood experience also appear to be associated with cardiovascular risk and have the potential to be utilized for the baseline risk stratification at the population level. A stepwise approach of nonclinical methods followed by risk scores consisting of clinical risk factors may offer a better option for initial and subsequent screening, preserving more specialized approaches including novel biomarkers for enhanced risk stratification at population level in a cost-effective manner.

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“…There is therefore no further need to add iodine to a fortified biscuit distributed in South African schools. The effectiveness of the mandatory salt iodisation programme in South Africa was evaluated by Jooste et al 20 and shown to be effective in virtually eradicating iodine deficiency, as measured by urinary iodine excretion, in a group of school children within one year.…”

mentioning

confidence: 99%

Long-term evaluation of a micronutrient-fortified biscuit used for addressing micronutrient deficiencies in primary school children

Stuijvenberg

Dhansay

Smuts

et al. 2001

Public Health Nutr.

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Objective: To evaluate the long-term effect on micronutrient status of a b-carotene-, iron-and iodine-fortified biscuit given to primary school children as school feeding. Design: Children receiving the fortified biscuit were followed in a longitudinal study for 2.5 years n 108; in addition, cross-sectional data from three subsequent surveys conducted in the same school are reported. Setting: A rural community in KwaZulu-Natal, South Africa. Subjects: Children aged 6±11 years attending the primary school where the biscuit was distributed.Results: There was a significant improvement in serum retinol, serum ferritin, haemoglobin, transferrin saturation and urinary iodine during the first 12 months of the biscuit intervention. However, when the school reopened after the summer holidays, all variables, except urinary iodine, returned to pre-intervention levels. Serum retinol increased again during the next 9 months, but was significantly lower in a subsequent cross-sectional survey carried out directly after the summer holidays; this pattern was repeated in two further cross-sectional surveys. Haemoglobin gradually deteriorated at each subsequent assessment, as did serum ferritin (apart from a slight increase at the 42-month assessment at the end of the school year). Conclusions: This study has shown that fortification of a biscuit with b-carotene at a level of 50% of the Recommended Dietary Allowance (RDA) was enough to maintain serum retinol concentrations from day to day, but not enough to sustain levels during the long school holiday break. Other long-term solutions, such as local food production programmes combined with nutrition education, should also be examined. The choice of the iron compound used as fortificant in the biscuit needs further investigation.

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Short-term effectiveness of mandatory iodization of table salt, at an elevated iodine concentration, on the iodine and goiter status of schoolchildren with endemic goiter

Abstract: Mandatory iodization of salt virtually eradicated iodine deficiency within 1 y in South African schoolchildren, but the goiter rate in these children did not decline. Measurement of goiters by palpation may not be appropriate in short-term evaluations of mandatory iodization programs.

Cited by 68 publications

References 13 publications

Progress towards eliminating iodine deficiency in South Africa

Progress towards eliminating iodine deficiency in South Africa

Review on Cardiovascular Risk Prediction

Long-term evaluation of a micronutrient-fortified biscuit used for addressing micronutrient deficiencies in primary school children

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