The Prevalence and Risk Factors Associated with Iodine Deficiency in Canadian Adults

Abstract

Iodine is a trace micronutrient that is critical for normal thyroid function and human health. Inadequate dietary intake is associated with cognitive impairment, infertility, growth retardation and iodine deficiency disorders in affected populations. Herein, we examined the prevalence of iodine deficiency in adults (median age of 61 years) based on the analysis of 24 h urine samples collected from 800 participants in four clinical sites across Canada in the Prospective Urban and Rural Epidemiological (PURE) study. Urinary iodide together with thiocyanate and nitrate were measured using a validated capillary electrophoresis assay. Protective/risk factors associated with iodine deficiency were identified using a binary logistic regression model, whereas daily urinary iodine concentration (24 h UIC, μg/L) and urinary iodine excretion (24 h UIE, μg/day) were compared using complementary statistical methods with covariate adjustments. Overall, our Canadian adult cohort had adequate iodine status as reflected by a median UIC of 111 μg/L with 11.9% of the population <50 μg/L categorized as having moderate to severe iodine deficiency. Iodine adequacy was also evident with a median 24 h UIE of 226 μg/day as a more robust metric of iodine status with an estimated average requirement (EAR) of 7.1% (< 95 μg/day) and a tolerable upper level (UL) of 1.8% (≥1100 μg/day) based on Canadian dietary reference intake values. Participants taking iodine supplements (OR = 0.18; p = 6.35 × 10−5), had greater 24 h urine volume (OR = 0.69; p = 4.07 × 10−4), excreted higher daily urinary sodium (OR = 0.71; p = 3.03 × 10−5), and/or were prescribed thyroxine (OR = 0.33; p = 1.20 × 10−2) had lower risk for iodine deficiency. Self-reported intake of dairy products was most strongly associated with iodine status (r = 0.24; p = 2.38 × 10−9) after excluding for iodine supplementation and T4 use. Participants residing in Quebec City (OR = 2.58; p = 1.74 × 10−4) and Vancouver (OR = 2.54; p = 3.57 × 10−4) were more susceptible to iodine deficiency than Hamilton or Ottawa. Also, greater exposure to abundant iodine uptake inhibitors from tobacco smoking and intake of specific goitrogenic foods corresponded to elevated urinary thiocyanate and nitrate, which were found for residents from Quebec City as compared to other clinical sites. Recent public health policies that advocate for salt restriction and lower dairy intake may inadvertently reduce iodine nutrition of Canadians, and further exacerbate regional variations in iodine deficiency risk.

Prevalence of iodine deficiency and associated factors among school-age children in Ethiopia: a systematic review and meta-analysis

“…According to several systematic reviews and meta-analyses, females were found highly likely to develop iodine deficiency compared to males [ 20 , 21 ]. Regarding the other main factor, goitrogenic food consumption, studies conducted elsewhere showed that the burden of iodine deficiency is significantly higher among those who consume goitrogenic foods compared to those who never consumed it [ 22 , 23 ].…”

Estado nutricional de iodo e fatores associados, socioecônomicos, demográficos, de saúde e nutricionais em agricultores familiares da região geográfica imediata de Viçosa-MG

“…Além de fatores relacionados ao consumo alimentar, como utilização ou não de sal iodado, temperos caseiros e industrializados são também associados ao estado nutricional de iodo características socioeconômicas e demográficas, uma vez que determinantes como renda, escolaridade, condições de moradia podem influenciar de forma indireta o estado nutricional de iodo, assim como hábitos e estilo de vida, a exemplo o tabagismo MATHIAPARANAM et al, 2022).…”