Guidance on the monitoring of salt iodization programmes and determination of population iodine status: Russian language version

Over the last two decades, there has been remarkable progress towards eliminating iodine deficiency (ID). While there has been remarkable success, there have been several notable changes in the way that salt iodization programs have been designed and monitored, as well as the general landscape in which salt iodization is being implemented. This article is based on the “Guidance on the monitoring of salt iodization programmes and determination of population iodine status”. It summarizes important lessons learned on how to better track the performance of and refine salt iodization programs. The adequacy of iodine intakes should be examined among different subsets of the population (not only school-aged children), especially among groups vulnerable to deficiency (such as pregnant women). The acceptable range of ‘adequate’ iodine intake among school-age children can be widened from 100–199 µg/L to 100–299 µg/L eliminating the range of 200–299 µg/L that previously indicates ‘more than adequate’ iodine intake. The interpretation of mUIC of ≥ 300 µg/L as ‘excessive iodine intake’ remains unchanged. With currently available methods, the mUIC can only be used to define population iodine status and not to quantify the proportion of the population with iodine deficiency or iodine excess. National salt iodization programmes should monitor the use of iodized salt in processed foods. If the salt contained in such foods is well iodized, it can be an important source of iodine and may help explain iodine sufficiency in settings where household iodized salt coverage is low.

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Assessment of iodine intake and deficiency in school-age children in Morocco

Nutrition & Food Science ◽

10.1108/nfs-03-2018-0069 ◽

2018 ◽

Vol 48 (6) ◽

pp. 873-885

Author(s):

Naima Saeid ◽

Anass Rami ◽

Samir Mounach ◽

Abdeslam Hamrani ◽

Asmaa El Hamdouchi ◽

...

Keyword(s):

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Intake ◽

School Age Children ◽

School Age ◽

Content Type ◽

Iodine Status ◽

School Aged Children ◽

Salt Iodization ◽

Significant Difference

Purpose Iodine deficiency has several adverse effects on human growth and development and it is categorized collectively as iodine deficiency disorders (IDDs). Recent estimations showed that 29.8 per cent of school-age children have insufficient iodine intake. Salt iodization is widely accepted as the best method for increasing iodine intake. In 1995, Morocco adopted the universal salt iodization strategy to reduce iodine deficiency and consequently prevent and control IDDs. This study aims to determine the benefit of this strategy on schoolchildren and adolescent by assessing iodine intake and evaluating iodine deficiency. Design/methodology/approach This transversal study was conducted on 131 children and adolescents. Iodine intake was assessed using a food frequency questionnaire. Iodine status was evaluated on 24-h urine samples and the creatinine excretion was used to validate completeness of urine collection. Findings The medians of urinary iodine excretion and concentration were 77 µg/day and 96 µg/L, respectively. Overall, 72.5 per cent are deficient, so mild and moderate iodine deficiencies were reported in 58 per cent and 14.5 per cent, respectively, and no child exhibited severe deficiency. A significant difference was reported between iodine deficiency and, sex and age; iodine deficiency was more pronounced in boys and children under eight years. In this study, iodine status in deficient children does not change with the consumption pattern of dairy products and eggs, and results showed no significant association (p > 0.05). However, fish consumption was significantly associated to urinary iodine concentration = 100 µg/L (p = 0.044). Average UIC in school-aged children is still inadequate and consumption of foods high in iodine remains very insufficient. Therefore, additional efforts must focus on nutritional education of Moroccan school-aged children. Originality/value In the author’s knowledge, this is the first study evaluating schoolchildren iodine status by 24-h iodine collection; the study reported association of iodine deficiency with dietary habit concerning sources of food rich on iodine.

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Indicators of Iodine Status in Pregnancy and Postpartum in a Group of Pregnant Women from Perimarine Area of Romania

ARS Medica Tomitana ◽

10.2478/arsm-2020-0013 ◽

2020 ◽

Vol 26 (2) ◽

pp. 63-69

Author(s):

Scrinic Olesea ◽

Delia Corina Elena ◽

Toma Geanina Mirela ◽

Circo Eduard

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Iodine Intake ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Urinary Creatinine ◽

Iodine Status ◽

In Pregnancy

Abstract Objective: Assessment of iodine nutritional status in pregnant women in the perimarine area of Romania, a region without iodine deficiency. Adequate iodine intake is the main source for normal thyroid function, ensuring the need for maternal thyroid hormones during pregnancy, but also for the development and growth of children in the fetal and postpartum period. Material and method: Prospective study performed on 74 pregnant women in the first 2 trimesters of pregnancy, originating from the perimarin area. The following indicators of iodine status were analyzed: urinary iodine concentration (UIC), the ratio between urinary iodine concentration and urinary creatinine (UIC/UCr), the prevalence of maternal goiter and the value of neonatal TSH (thyroid stimulating hormone). Results: The mean gestational age was 11 weeks. The ways of iodine intake are: iodized salt - 59.4%, iodized salt and iodine supplements- 23%, only iodine supplements -10.8% and 6.8% consume only non-iodized salt. The median of UIC was 133.03 mcg/l considered insufficient iodine intake (normal in pregnancy UIC >150 mcg/l), but the adjustment of UIC to urinary creatinine reveals a median of 152.83 mcg/g, a value that reflects an adequate iodine intake. The prevalence of goiter was 25.6% characteristic for a moderate iodine deficiency. The prevalence of neonatal TSH >5 mIU/L was registered in 18.8% characteristic of mild iodine deficiency. Conclusions: Monitoring of the iodine nutritional status is recommended for the prevention of disorders due to iodine deficiency under the conditions of universal salt iodization. Perimarine areas considered sufficient in iodine may show variations in iodine status in subpopulations under certain physiological conditions, such as pregnancy. An indicator of iodine status of the population is UIC, but the UIC/UCr ratio may be a more optimal indicator for pregnant women, to avoid possible overestimated results of iodine deficiency in pregnancy.

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Iodine status five years after the adjustment of universal salt iodization: a cross-sectional study in Fujian Province, China

Nutrition Journal ◽

10.1186/s12937-021-00676-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yixuan Lin ◽

Diqun Chen ◽

Jiani Wu ◽

Zhihui Chen

Keyword(s):

Pregnant Women ◽

Urinary Iodine ◽

Interquartile Range ◽

Iodized Salt ◽

School Age Children ◽

Fujian Province ◽

Cross Sectional ◽

Lactating Women ◽

Iodine Status ◽

Salt Iodization

Abstract Background Universal salt iodization program was introduced to China to eliminate iodine deficiency disorders in 1995. In 2012, Fujian Province decreased the concentration of iodized table salt according to the national unified requirement. This study aimed to assess the effect on iodine status after the adjustment, providing evidence for further adjustment in Fujian Province. Methods Sampling units were selected by multistage cluster sampling method. In each sampling unit, table salt was collected from 30 households. A total of 2,471 people in 2009 and 4,806 people in 2017 provided urine samples and were included in this cross-sectional analysis. Median iodized salt concentration and median urine iodine concentration were present by median and interquartile range. Results Median iodized salt decreased from 29.8 mg/kg in 2009 to 23.9 mg/kg in 2017. The median urinary iodine concentrations for school-age children in 2017 in coastal urban area, non-coastal urban area, coastal rural area and non-coastal rural area were 163.6µg/L (interquartile range = 100.1–252.0µg/L), 198.9µg/L (interquartile range = 128.0-294.0µg/L), 181.8µg/L (interquartile range = 114.1–257.0µg/L) and 218.2µg/L (interquartile range = 148.1-306.5µg/L), respectively. The median urinary iodine concentrations for adults in 2017 in these areas were 151.1µg/L (interquartile range = 98.3-231.7µg/L), 168.7µg/L (interquartile range = 109.6–242.0µg/L), 167.7µg/L (interquartile range = 105.7-245.7µg/L) and 182.7µg/L (interquartile range = 117.1-258.9µg/L). The median urinary iodine concentrations for pregnant women in 2017 in these areas were 157.7µg/L (interquartile range = 106.9-223.8µg/L), 141.5µg/L (interquartile range = 97.7-207.6µg/L), 127.3µg/L (interquartile range = 90.0-184.5µg/L) and 144.8µg/L (interquartile range = 99.9-184.5µg/L). The median urinary iodine concentrations for lactating women in 2017 in these areas were 122.7µg/L (interquartile range = 84.1–172.0µg/L), 123.7µg/L (interquartile range = 70.7-184.7µg/L), 105.8µg/L (interquartile range = 67.1-152.3µg/L) and 110.2µg/L (interquartile range = 74.1-170.3µg/L). Conclusions The overall urinary iodine concentrations among school-age children, adults and lactating women dramatically decreased after implementing the new standard. Almost all of them were iodine adequate, suggesting we reached the expected aim of iodized salt adjustment. However, pregnant women were iodine insufficient after adjustment. Therefore, we should continue the surveillance of iodine status of populations and focus on the additional iodine supplement strategies for pregnant women.

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A cross-sectional research of iodine status of pregnant women in Chongqing, south-west China

Public Health Nutrition ◽

10.1017/s1368980019003434 ◽

2020 ◽

Vol 23 (5) ◽

pp. 769-775 ◽

Cited By ~ 1

Author(s):

Ning Yao ◽

Chunbei Zhou ◽

Jun Xie ◽

Shuang Zhou

Keyword(s):

Nutritional Status ◽

Pregnant Women ◽

Iodine Deficiency ◽

Dietary Habits ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Table Salt ◽

Cross Sectional ◽

Iodine Status ◽

Salt Iodization

AbstractObjective:To investigate whether implementation of a universal salt iodization (USI) programme has sufficient effects on pregnant women in Chongqing, the present study evaluated the iodine nutritional status of pregnant women living in Chongqing by spot urinary iodine concentration (UIC), to provide scientific suggestions to better meet the specific iodine needs of this vulnerable group.Design:Cross-sectional design.Setting:A random spot urine sample and household table salt sample were provided by each participant.Participants:A total of 2607 pregnant women from twenty-six of thirty-nine districts/counties in Chongqing participated.Results:The overall median UIC of pregnant women was 171·80 μg/l (interquartile range (IQR) = 113·85–247·00 μg/l) and 40·97 % (n 1057) of participants were iodine insufficient. The median iodine in table salt samples was 25·40 mg/kg (IQR = 23·10–28·30 mg/kg); 93·26 % (n 2406) of samples examined were found to be adequately iodized. Iodine nutritional status was not significantly different according to table salt iodization category. Trimester was identified to be statistically associated with UIC (P < 0·01). Seven districts/counties had median UIC below 150 μg/l and one district had median UIC of 277·40 μg/l.Conclusions:The USI programme in Chongqing prevents iodine deficiency generally, but does not maintain iodine status within adequate and recommended ranges throughout pregnancy. Usage of non-iodized or unqualified iodized salt and the slight change of dietary habits of iodized salt in Chongqing may present a substantial challenge to fight iodine-deficiency disorders; more efforts are needed to ensure adequate iodine intake during pregnancy besides the USI programme.

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THE SITUATION OF URINARY IODINE CONCENTRATION (UIC) AMONG SCHOOL AGE CHILDREN, WOMEN AT REPRODUCTIVE AGE AND PREGNANT WOMEN IN INDONESIA: THE ANALYSIS OF RISKESDAS 2013

GIZI INDONESIA ◽

10.36457/gizindo.v39i1.207 ◽

2017 ◽

Vol 39 (1) ◽

pp. 49

Author(s):

Djoko Kartono ◽

Atmarita Atmarita ◽

Abas B Jahari ◽

Soekirman Soekirman ◽

Doddy Izwardy

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Iodized Salt ◽

Reproductive Age ◽

School Age Children ◽

Urinary Iodine Concentration ◽

Iodine Status ◽

Iodine Level

Iodine Deficiency Disorders (IDD) are the leading cause of goiter, cretinism, developmental delays and other health problems. Iodine deficiency is an important public health issue as it is a preventable cause of intellectual disability. While elimination of iodine deficiency is imperative, it should be noted that excessive intake of iodine can also lead to adverse health effects. This paper analyzed the iodine status using median urinary iodine concentration (MUIC) of school age children (SAC), women of reproductive age (WRA), and pregnant women (PW) who live in the same household from Riskesdas 2013. The total number of households included in the analysis was 13,811 households, from which 6,149 SAC (aged 6 – 12 years), 13,218 WRA (aged 15-49 years), and 578 PW (aged 15-49 years) were enumerated. The national MUIC of SAC, WRA and PWwas in the normal range indicated that the iodine status was adequate using WHO epidemiological criteria. Iodine status in some sub-populations indicated deficiency, however, in terms of geographic characteristics people who live in the urban has better iodine status compared to rural areas. Similarly, populations in richer economic quintiles had better iodine status. Only pregnant women in the 1st and 2nd quintile were deficient. Almost all regions in Indonesia showed the MUIC was in the normal adequate range, except NTT-NTB, Maluku-Papua, and East Java for pregnant women who tend to have lower MUIC (<150 µg/L). The status of iodized salt at the household was detected using both Rapid Test Kit/RTK as well as Titration. The result demonstrated a strong association between salt iodine level and iodine status. The MUIC for all three groups were lower when the iodine level in salt was lower, then increased when the levels of iodine content in salt increased. The iodine status of pregnant women consuming non-iodized salt was inadequate. The detrimental effect of iodine deficiency on the mental and physical development of children as well as on the women of reproductive age has been recognized. Indonesia still needs the salt iodization program to keep the iodine status in the normal range. In particular coverage with adequately iodized salt needs to be improved in order to improve the iodine status of pregnant women. For the prevention of Iodine disorders (insufficient), monitoring should be undertaken in regular basis to assess the MUIC, especially for pregnant women.

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Iodine Status of School Age Children 6-12 Years in Umuahia South LGA of Abia State, Nigeria

Engineering and Scientific International Journal ◽

10.30726/esij/v8.i2.2021.82014 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

A.D. Oguizu ◽

J.O. Nwagwu

Keyword(s):

Nutrition Education ◽

Iodine Deficiency ◽

School Children ◽

Urinary Iodine ◽

Food Habit ◽

Iodized Salt ◽

School Age Children ◽

Urinary Iodine Concentration ◽

School Age ◽

Iodine Status

Background: Iodine deficiency disorders have continued to be a significant health problem in some Nigerian communities despite universal salt iodization. Objective: This study was designed to assess the iodine status of school age children (6-12 years) in Umuahia South LGA of Abia State, Nigeria. Methods: A total of 414 school children were studied. Urine samples were obtained from 84 school children, 30 males and 54 females. The background and socio-economic information, food habit and dietary intake of the respondents were determined using validated questionnaires. Urinary iodine concentration analysis, using Sandell-Kolthoff reaction was used to determine the iodine status of the children. Chi-square was used to determine the relationship between urinary iodine status of the children and the socio-economic characteristics of their parents. Results: More than half (58.7%) of the children were females while 40.5% were males. About a quarter of the children (40.1%) were 9-10 years, 23.4% were 11-12 years while 36.5% were 6-8 years. Most of the respondents (72.2%) were aware of iodized salt; 14.3% heard about iodized salt from friends, 41.8% heard from the media while 13% heard about iodized salt from the market. Majority of the respondents (94.4%) claimed they consume iodized salt while 4.9% said they use salts that were measured in cups which was not iodized salt. The study revealed that 54.3% of the school children had optimal iodine status while 35.7% had mild iodine deficiency which was higher in males (46.7%) than in females (29.6%). About 5.6% of the respondents had grade 1 goiter. There was a significant association (p< 0.05) between urinary iodine status of the school children and educational status of their fathers’, mothers’, parents’ occupation and income level of fathers. Conclusion: Nutrition education should be aimed at mothers, caregivers, and school children to promote consumption of iodine rich foods.

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Flaws of universal salt iodization programmes in nutrition transition contexts: is there a risk of a double burden of inadequate iodine intake and excess adiposity? A case study in Tunisia

10.21203/rs.3.rs-40301/v1 ◽

2020 ◽

Author(s):

Radhouene DOGGUI ◽

Myriam El Ati-Hellal ◽

Jalila El Ati ◽

Pierre Traissac

Keyword(s):

Iodine Deficiency ◽

Nutrition Transition ◽

Iodine Intake ◽

School Age Children ◽

School Age ◽

Mena Region ◽

Double Burden ◽

Salt Iodization ◽

Excess Iodine ◽

Excess Adiposity

Abstract Background In the Middle East and North Africa (MENA) region, universal salt iodization (USI) programs defaults were sometimes shown to increase the risk of iodine excess. Also, the nutrition transition which underlies the obesity epidemic in the MENA region is characterized by salt-rich diets, so that there could be a cumulative effect with respect to iodine status. We assess the within-subject co-existence of overweight and inadequate iodine intake, and associated factors.Methods A national cross-sectional study used a stratified, clustered random sample and conducted among Tunisian school-age children aged from 6 to 12 y. (n = 1560). Overweight (Ow) was body mass index (BMI)-for-age ≥ + 1z. Iodine deficiency was UIC (Urinary Iodine Content) < 100 µg/L and iodine intake above requirements (IAR) UIC ≥ 200 µg/L. Association of covariables with the within-subject double burden Ow–IAR was assessed by multinomial regression.Results The prevalences of Ow-ID or Obe-ID were marginal, but not so for excess adiposity and IAR as for example prevalence of Ow-IAR was 9.8% (95% CI:[7.7–12.3]). OW and IAR were found to co-occur independently (P = 0.29). Socio-economic patterning of Ow-IAR was mild. Nevertheless, prevalence were the lowest among children of mother with no formal schooling and in the South-East region. Beyond school-age children, we estimated that this double burden of overweight and excess iodine could concern a third of Tunisian adults (all the more for women).Conclusions Among Tunisian children, iodine deficiency coupled with excess adiposity was quite marginal. Coexistence of overweight and excess iodine may affect a tenth of these children. More data would be needed to document a possibly even higher rate among adults. Cumulative effects of unhealthy lifestyle due to the nutrition transition interacting with metabolic pathways may be involved in this potential overweight-high iodine intake double burden. In the MENA region, obesity and salt reduction policies should continue to be monitored.

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Prevalence of goiter and iodine status among 6-12 years school age children in district Kohat, Pakistan

South East Asia Journal of Public Health ◽

10.3329/seajph.v4i2.23694 ◽

2015 ◽

Vol 4 (2) ◽

pp. 42-46 ◽

Cited By ~ 3

Author(s):

Fazli Subhan ◽

Muhammad Jahangir ◽

Saira Saira ◽

Rehman Mehmood Khattak ◽

Muhammad Shahab ◽

...

Keyword(s):

Iodine Deficiency ◽

School Children ◽

Urinary Iodine ◽

Iodine Content ◽

Iodine Concentration ◽

Iodized Salt ◽

School Age Children ◽

Urinary Iodine Concentration ◽

Iodine Status ◽

Mountainous Regions

Pakistan is considered to be one of the most severely iodine deficient countries in the region. A decade earlier, 70% of the population was estimated to be at risk of iodine deficiency. However, the recent use of iodized salt has reduced the intensity of the problem. Earlier studies regarding iodine deficiency in Pakistan were restricted to the northern mountainous regions, but have now been extended to the sub-Himalaya areas and the plains of Punjab. The aim of the present study was to investigate the prevalence of goiter and iodine status among school children in district Kohat, Pakistan. The 30 cluster approach was adopted for the study. From each cluster, 40 samples were collected from school going children. The palpation method was used to measure goiter grade, whereas, for urinary iodine estimation, the wet digestion method was used. The prevalence of goiter in the district was found to be 35% (37.16% in boys and 33% in girls). The median urinary iodine concentration was found to be 56±31.19?g/L. Estimation of iodine content in salt illustrated that 56.8% people were consuming non-iodized salt and 43.5% were using iodized salt. The current study suggests a severe iodine deficiency in school children of district Kohat and regular iodine supplementation is required on an instant basis.South East Asia Journal of Public Health Vol.4(2) 2014: 42-46

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Determinants of iodine deficiency among school age children in Guraghe Zone, Southwest Ethiopia

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v9i2.20387 ◽

2020 ◽

Vol 9 (2) ◽

pp. 90

Author(s):

Berhanu Abebaw ◽

Abdu Oumer

Keyword(s):

Iodine Deficiency ◽

Child Death ◽

Sampling Technique ◽

Cross Sectional Study ◽

Iodine Intake ◽

Iodized Salt ◽

School Age Children ◽

P Value ◽

School Age ◽

Cross Sectional

Globally, insufficient iodine intake is found to be the most common preventable cause of mental retardation that results in diminished immunity, decreased school performance and infant and young child death. Ethiopia is the first of the top iodine deficient countries in the world. About 12 million children (school age) get inadequate iodine. Community based cross sectional study was conducted on 792 school age children in Guraghe Zone, Ethiopia to assess the determinants of iodine deficiency. Multistage sampling technique was used to select the study subjects. Data were collected by using pretested questionnaire. Clinical examinations were taken following standard procedures. The collected data were entered into Epi-data and exported to SPSS for analysis. Descriptive statistics was calculated and presented accordingly. Bivariate and multivariable Logistic regression with odds ratios along with the 95% confidence interval was computed and interpreted accordingly. A P-value <0.05 was declared as statistically significant association. Total goiter rate was 8.7%. Factors that had significant association with goiter were: School age children who utilized non iodized salt (AOR=3.12, 95% CI=1.73-5.63), those who consumed cabbage >2 times per week (AOR=1.94, 95% CI=1.10-3.52), and children who got elder (AOR=1.22, 95% CI=1.10-1.41). The study area had mild iodine deficiency disorder. Non iodized salt utilization; frequent cabbage consumption and increased age of children were found to be predictors of goiter. Thus, Interventions should focus on universal salt iodization, besides familiarizing goiterogens to the community at large.

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