The Swiss Iodized Salt Program Provides Adequate Iodine for School Children and Pregnant Women, but Weaning Infants Not Receiving Iodine-Containing Complementary Foods as well as Their Mothers Are Iodine Deficient

Andersson, Maria; Aeberli, Isabelle; Wüst, Nadja; Piacenza, Alberta M.; Bucher, Tamara; Henschen, Isabelle; Haldimann, Max; Zimmermann, Michael

doi:10.1210/jc.2010-0975

Cited by 117 publications

(119 citation statements)

References 27 publications

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“…For example, in developed countries, such as the USA and Switzerland, national median UIC in schoolchildren is 211 and 120 µg/L, respectively (36,37). These UIC levels are lower than in some Latin American countries, and this may be because in the USA and Switzerland, the addition of iodine to salt for direct human consumption or for food industry is not mandatory.…”

Section: Discussionmentioning

confidence: 99%

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index

García‐Solís

Solís-S

García-Gaytán

et al. 2013

Arq Bras Endocrinol Metab

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OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

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Section: Discussionmentioning

confidence: 99%

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index

García‐Solís

Solís-S

García-Gaytán

et al. 2013

Arq Bras Endocrinol Metab

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“…The latter result challenge the general hypothesis that TS could be not required in patients with normal TSH. Remarkably, most eligible studies were from European countries with current or prior iodine deficiency where autonomous nodular goitres are a frequent finding [13,[28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule

Treglia

Trimboli

Verburg

et al. 2015

Eur J Clin Investigation

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Background International guidelines significantly diverge on the effectiveness of thyroid scintigraphy (TS) in the initial work-up of thyroid nodules. In particular, the role of TS to detect or exclude the presence of autonomously functioning thyroid nodules (AFTN) in patients with normal serum thyrotropin (TSH) is still a matter to debate. Here, we aimed to review the literature on the prevalence of normal TSH value among patients with AFTN and meta-analyse data of the retrieved eligible papers.

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“…1 Based on this, the World Health Organization (WHO) and the American Thyroid Association (ATA) recommend a daily iodine intake of 250 µg for pregnant and lactating women. 2,3 Iodine deficiency disorder (IDD) in pregnant women could result in harmful effects, including goiter, cretinism, hypothyroidism, growth retardation, pregnancy loss, and infant mortality. Moreover, inadequate iodine intake during pregnancy may lead to neurodevelopmental deficits in offspring, and iodine deficiency is currently considered the leading preventable cause of intellectual impairment worldwide.…”

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confidence: 99%

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2018

Rev Bras Ginecol Obstet

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Iodine is an essential micronutrient required for the production of thyroid hormones, which are critical for homeostasis and neurodevelopment. Because of increased thyroid hormone production, renal iodine excretion and fetal iodine requirements, dietary iodine requirements are higher in pregnancy than they are for nonpregnant adults. 1 Based on this, the World Health Organization (WHO) and the American Thyroid Association (ATA) recommend a daily iodine intake of 250 µg for pregnant and lactating women. 2,3 Iodine deficiency disorder (IDD) in pregnant women could result in harmful effects, including goiter, cretinism, hypothyroidism, growth retardation, pregnancy loss, and infant mortality. Moreover, inadequate iodine intake during pregnancy may lead to neurodevelopmental deficits in offspring, and iodine deficiency is currently considered the leading preventable cause of intellectual impairment worldwide. 4 On the other hand, the excess of iodine may result in fetal goiter and hypothyroidism. Exposures as minor as the vaginal application of povidone-iodine during delivery or local use of disinfectant in newborns can lead to increased serum TSH concentrations 5 and transient neonatal hypothyroidism. 6 With this information in mind, we read with great interest the 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. 7 Among other topics, the nutritional aspects related to iodine sufficiency are addressed in section IV, and a supplementation with 150 μg of potassium iodine per day is suggested on Recommendation 6 for women, in most regions of the world, who are planning a pregnancy or currently pregnant. This is optimally started 3 months in advance of planned pregnancy (strong recommendation, moderate-quality evidence). Could this recommendation improve the quality of the prenatal care of Brazilian pregnant women?The most efficient method of IDD prevention is salt iodination. Also, ongoing monitoring of population biomarkers, such as urinary iodine concentration, is essential to ensure that population iodine intakes are optimized. In Brazil, the salt iodination is controlled by federal law in partnership with the National Agency for Sanitary Surveillance (Anvisa, in the Portuguese acronym) and the salt productive sector. 8-10 Unfortunately, data on the iodine nutritional status are scarce and contradictory in Brazil. The national project of salt iodination (PNAIsal, in the Portuguese acronym) (which evaluated 477 locations and a total of 18,978 school children) identified Brazil as a country of "more than appropriate" iodine consumption, with a mean urinary iodine excretion (UIE) concentration of 276 µg/L. 11,12 A recent meta-analysis concluded that the majority of the data on this subject are derived from the population in the south/southeast region of Brazil, but the actual overall IDD prevalence is unknown and might still be high in some areas. 13 Regarding the pregnant population, three studies were published prior to Anvis...

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The Swiss Iodized Salt Program Provides Adequate Iodine for School Children and Pregnant Women, but Weaning Infants Not Receiving Iodine-Containing Complementary Foods as well as Their Mothers Are Iodine Deficient

Abstract: In countries in which iodized salt programs supply sufficient iodine to older children and pregnant women, weaning infants, particularly those not receiving iodine-containing IFM, may be at risk of inadequate iodine intakes.

Cited by 117 publications

References 27 publications

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index

Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule

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