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Li S, Wang C, Cheng Y, Li J, Zhang H, Jin Q, Meng Q, Wu W, Wang T, Liu D, Meng X, Guo W, Zhang W. Iodine Metabolism in Urine and Breast Milk among Lactating Women with Adequate Iodine. J Nutr 2024:S0022-3166(24)00271-2. [PMID: 38718924 DOI: 10.1016/j.tjnut.2024.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/24/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND In lactating women, iodine metabolism is regulated and maintained by the kidneys and mammary glands. Limited research exists on how iodine absorbed by lactating women is distributed between the kidneys and breasts. OBJECTIVES This study aimed to accurately evaluate the total iodine intake (TII), urinary iodine excretion (UIE), and breast milk iodine excretion (BMIE) in lactating women and explore the relationship between TII and total iodine excretion (TIE). METHODS A 7-d iodine metabolism study was conducted on 41 lactating women with a mean age of 30 y in Yuncheng and Gaoqing, China, from December 2021 to August 2023. TII and TIE were calculated by measuring the iodine content in food, water, 24-h urine, feces, and breast milk. The urinary iodine excretion rate (UIER), breast milk iodine excretion rate (BMIER), and partitioning of iodine excretion between urine and breast milk were determined. RESULTS Iodine metabolism studies were performed for 285 d. The median TII and TIE values were 255 and 263 μg/d, respectively. With an increase in TII, UIER, and BMIER, the UIE and BMIE to TII ratio exhibited a downward trend. The median UIER, BMIER, and proportion of iodine excreted in urine and breast milk were 51.5%, 38.5%, 52%, and 37%, respectively. When the TII was <120 μg/d, the BMIER decreased with the increase of the TII (β: -0.90; 95% confidence interval: -1.08, -0.72). CONCLUSIONS When maternal iodine intake is low, the proportion in breast milk increases, ensuring sufficient iodine nutrition for infants. In addition, the UIE of lactating women with adequate iodine concentrations is higher than their BMIE. This study was registered at clinicaltrials.gov as NCT04492657.
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Affiliation(s)
- Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chunxi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuangui Cheng
- Department of General Surgery, Gaoqing County People's Hospital, Gaoqing, China
| | - Junjing Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hexi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ting Wang
- Department of Obstetrics, Yuncheng County People's Hospital, Yuncheng, China
| | - Denghai Liu
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, China
| | - Xianglu Meng
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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2
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Arns-Glaser L, Zihlmann R, Gessler S, Verkaik-Kloosterman J, Zandberg L, Assey VD, Rigutto-Farebrother J, Braegger CP, Zimmermann MB, Andersson M. Estimating habitual iodine intake and prevalence of inadequacy from spot urine in cross-sectional studies: a modeling analysis to determine the required sample size. Am J Clin Nutr 2023; 117:1270-1277. [PMID: 37270291 DOI: 10.1016/j.ajcnut.2023.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/08/2023] [Accepted: 03/09/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The habitual/usual iodine intake and the prevalence of iodine inadequacy may be estimated from spot urinary iodine concentrations in cross-sectional studies by collecting a repeat spot urine in a subgroup of the study population and accounting for within-person variability in iodine intake. However, guidance on the required overall sample size (N) and the replicate rate (n) is lacking. OBJECTIVES To determine the sample size (N) and replicate rate (n) needed to estimate the prevalence of iodine inadequacy in cross-sectional studies. METHODS We used data from local observational studies conducted in women 17-49 y old in Switzerland (N = 308), South Africa (N = 154), and Tanzania (N = 190). All participants collected 2 spot urine samples. We calculated the iodine intake using urinary iodine concentrations and accounted for urine volume using urinary creatinine concentration. For each study population, we estimated the habitual iodine intake distribution and determined the prevalence of iodine intake below the average requirement using the Statistical Program to Assess habitual Dietary Exposure (SPADE). We used the obtained model parameters in power analyzes and estimated the prevalence of iodine inadequacy for different sample sizes (N = 400, 600, and 900) and replicate rates (n = 50, 100, 200, 400, 600, and 900). RESULTS The estimated prevalence (95% CI) of inadequate iodine intake was 21% (15, 28%), 5.1% (1.3, 8.7%), and 8.2% (3.4, 13%) for Swiss, South African, and Tanzanian women, respectively. An N of 400 women, with a repeated measure (n) in 100 women, achieved a satisfactory precision of the prevalence estimate in all study populations. Increasing the replicate rate (n) improved the precision more effectively than increasing the N of the study. CONCLUSIONS The sample size for cross-sectional studies aiming to assess the prevalence of inadequate iodine intake depend on the expected prevalence, the overall variance in intake, and the study design. However, an N of 400 participants with a repeated measure of 25% may be used as guidance when planning observational studies applying simple random sampling. This trial was registered at clinicaltrials.gov as NCT03731312.
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Affiliation(s)
- Leonie Arns-Glaser
- Human Nutrition Laboratory, Institute of Food Nutrition and Health, ETH Zurich, Zurich, Switzerland.
| | - Reto Zihlmann
- Seminar for Statistics, ETH Zurich, Zurich, Switzerland
| | - Sara Gessler
- Human Nutrition Laboratory, Institute of Food Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | | | - Lizelle Zandberg
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Vincent D Assey
- Nutrition Services Section Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | | | - Christian P Braegger
- Nutrition Research Unit, University Children's Hospital Zürich, Zürich, Switzerland
| | - Michael B Zimmermann
- Human Nutrition Laboratory, Institute of Food Nutrition and Health, ETH Zurich, Zurich, Switzerland; Iodine Global Network, Ottawa, ON, Canada
| | - Maria Andersson
- Nutrition Research Unit, University Children's Hospital Zürich, Zürich, Switzerland; Iodine Global Network, Ottawa, ON, Canada
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Novakova G, Bonev P, Duro M, Azevedo R, Couto C, Pinto E, Almeida A. Serum Iodine and Bromine in Chronic Hemodialysis Patients-An Observational Study in a Cohort of Portuguese Patients. TOXICS 2023; 11:247. [PMID: 36977012 PMCID: PMC10053604 DOI: 10.3390/toxics11030247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Background: Patients on chronic hemodialysis therapy are at high risk of disturbances in trace element status due to both the underlying disease and the hemodialysis process itself. Data on iodine and bromine levels in these patients are scarce. Methods: Using an ICP-MS analytical procedure, serum iodine and bromine levels were determined in a cohort (n = 57) of end-stage renal disease patients on chronic hemodialysis. The results were compared with those of a control group (n = 59). Results: Hemodialysis patients presented serum iodine levels within the normal range, slightly lower than in controls, but without reaching a statistically significant difference (67.6 ± 17.1 µg/L vs. 72.2 ± 14.8 µg/L; p = 0.1252). In contrast, serum bromine levels were much lower in patients (1086 ± 244 µg/L vs. 4137 ± 770 µg/L; p < 0.0001), at values only about 26% of the values observed in controls. Conclusions: Hemodialysis patients had normal serum iodine levels, but highly decreased serum bromine levels. The clinical significance of this finding requires further investigation, but it may be associated with sleep disturbances and fatigue that affect hemodialysis patients.
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Affiliation(s)
- Gergana Novakova
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Presian Bonev
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Mary Duro
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- FP-ENAS—Fernando Pessoa Energy, Environment and Health Research Unit, Fernando Pessoa University, 4249-004 Porto, Portugal
- Laboratório de Análises Clínicas Dra. Matilde Sampaio, 5200-216 Mogadouro, Portugal
- Laboratório de Análises Clínicas Vale do Sousa, 4560-547 Penafiel, Portugal
| | - Rui Azevedo
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Cristina Couto
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences, CESPU, 4585-116 Gandra, Portugal
| | - Edgar Pinto
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Department of Environmental Health, ESS, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Agostinho Almeida
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Silva DLF, Crispim SP, Almeida CCB, Schrubbe V, Azevedo FM, de Faria FR, Pizato N, Pereira RJ, Macedo MDS, Franceschini SDCC. Improving Pregnant Women's Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates. Nutrients 2023; 15:nu15040846. [PMID: 36839203 PMCID: PMC9966772 DOI: 10.3390/nu15040846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
(1) Measuring usual iodine intake is a complex task due to the food consumption variability and its natural concentration in food. Therefore, the use of covariates to adjust statistical methods to estimate usual intake could improve the estimates obtained through dietary surveys. This study aims to evaluate the influence of salt and seasoning usage covariates on the estimates of usual iodine intake and the prevalence of its inadequacy. (2) A cross-sectional study was conducted with Brazilian pregnant women's food consumption data obtained with 24-h recall (n = 2247). The usual iodine intake was adjusted for intraindividual variability, supplement use, temporal effects, data collection methods, and sociodemographic characteristics with the tool UCD/NCI SIMPLE in the SAS software. Then, salt and seasoning usage covariates were used to adjust the distribution. The harmonized intake reference values for populations were used to assess intake adequacy. (3) The adjustments for salt and seasoning usage yielded a higher mean of usual iodine intakes. The only exception was the adjustment for the "habit of adding salt to meals after preparing/cooking", which produced a lower mean of usual intake and increased the prevalence of insufficient intake. (4) Salt and seasoning usage covariates affect the estimates evaluated. However, more studies are necessary to evaluate the influence observed.
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Affiliation(s)
- Débora L. F. Silva
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
- Correspondence: ; Tel.: +55-41-9-9845-9490
| | - Sandra P. Crispim
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Claudia C. B. Almeida
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Vanessa Schrubbe
- Departamento de Nutrição, Universidade Federal do Paraná, Curitiba 80210-170, Paraná, Brazil
| | - Francilene M. Azevedo
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
| | - Franciane R. de Faria
- Faculdade de Ciências da Saúde, Universidade Federal de Rondonópolis, Rondonópolis 78736-900, Mato Grosso, Brazil
| | - Nathalia Pizato
- Departamento de Nutrição, Universidade de Brasília, Brasília 70970-000, Distrito Federal, Brazil
| | - Renata J. Pereira
- Curso de Graduação em Nutrição, Universidade Federal do Tocantins, Palmas 77001-090, Tocantins, Brazil
| | - Mariana de S. Macedo
- Departamento de Nutrição, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina 39100-000, Minas Gerais, Brazil
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Guo W, Wu W, Gao M, Yang Y, Pearce EN, Li S, Ren Z, Zhang N, Zhang K, Pan Z, Zhang W. Characteristics and predictors of breast milk iodine in exclusively breastfed infants: Results from a repeated-measures study of iodine metabolism. Front Nutr 2022; 9:1017744. [PMID: 36438740 PMCID: PMC9682142 DOI: 10.3389/fnut.2022.1017744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background The iodine supply of exclusively breastfed infants entirely depends upon breast milk. Changes in breast milk iodine affect infants’ iodine nutritional status. This study aimed to comprehensively assess the characteristics and predictors of breast milk iodine concentration (BMIC). Materials and methods This 7-day iodine metabolism experiment was conducted in 25 exclusively breastfed mother-infant pairs. The duplicate portion method was used to measure the mother’s daily iodine intake from foods and water, and maternal 24-h urine excretion was assessed. We recorded the number of breastfeeds per mother per day and collected breast milk samples before and after each feeding. Results The median [quartile (Q)1–Q3 range] of BMIC was 115 (86.7, 172) μg/L. The BMIC before breastfeeding was generally higher than that after breastfeeding. Time-sequential analysis found that morning BMIC was most highly correlated with the prior day’s iodine intake. Breast milk samples taken in the afternoon or after midnight are closer to the median level of BMIC throughout the day. The number of breast milk samples needed to estimate the iodine level with 95% CI within precision ranges of ± 20% was 83 for a population, 9 for an individual, and 2 for an individual’s single day. Maternal total iodine intake (TII) and urine iodine were significantly associated with BMIC. 24-h urinary iodine excretion (24-h UIE) was found to be the best predictive indicator for the BMIC (β = 0.71, 95% CI: 0.64, 0.79). Conclusion BMIC is a constantly changing indicator and trended downward during each breastfeeding. Breast milk samples taken in the afternoon or after midnight are most representative. BMIC was significantly associated with recent iodine intake. Maternal 24-h UIE was the best predictor of BMIC.
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Affiliation(s)
- Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ying Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Elizabeth N. Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, United States
| | - Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhiyuan Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Naifan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kexin Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- The Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- *Correspondence: Wanqi Zhang,
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Fuse Y, Tsukada N, Urakawa Y, Yokoyama J, Matsuzaki M, Shishiba Y, Irie M. Studies on urinary excretion and variability of dietary iodine in healthy Japanese adults. Endocr J 2022; 69:427-440. [PMID: 34789603 DOI: 10.1507/endocrj.ej21-0486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The daily consumption of iodine in Japan is higher than in most countries, and there are few reports on iodine metabolism and variance of habitual iodine ingestion in an iodine-sufficient area. To elucidate the patterns of short-term urinary iodine excretion (UIE) and long-term variability of habitual iodine intake, the urinary iodine excretion process after a high dietary iodine load of 3 mg was observed in eight Japanese adults under strict supervision with complete urine collections for three days. In addition, estimated UIE and dietary iodine intake (DII) were assessed in 24 university students using repeated spot urine samples of ten consecutive days and a food frequency questionnaire in each of the four seasons. Approximately 50, 75 and 90% of orally ingested iodine was excreted into the urine at 8, 13 and 22 hours after ingestion, respectively. Almost an equal amount of ingested iodine in meals was cleared within 33.5 h after eating with a maximum excretion rate at 3-4 h. There was a high fluctuation in the UIE and DII in the university students. The intra- and inter-individual crude coefficients of variation were 123 or 294.7% for UIE, and 58.3 or 88.7% for DII, respectively, indicating a higher variance of habitual iodine intake than in other countries. The frequency of occurrence for UIE above 3 mg was every 43 days. Rapid renal clearance of iodine and high variability as well as low frequency of dietary iodine intake might prevent people from being exposed to an excess iodine intake over the long term in Japan.
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Affiliation(s)
- Yozen Fuse
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Nobu Tsukada
- Kagawa Nutrition University, Institute of Nutrition Sciences, Saitama 350-0288, Japan
| | | | | | | | - Yoshimasa Shishiba
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Minoru Irie
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
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Liu Z, Lin Y, Wu J, Chen D, Wu X, Lan Y, Chen Z. Is the urinary iodine/creatinine ratio applicable to assess short term individual iodine status in Chinese adults? Comparison of iodine estimates from 24-h urine and timed-spot urine samples in different periods of the day. Nutr Metab (Lond) 2022; 19:27. [PMID: 35392953 PMCID: PMC8991982 DOI: 10.1186/s12986-022-00656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Urinary iodine concentration (UIC) is routinely used to evaluate the population iodine status while the uniform method for the individual level assessment is uncertain. Objectives To explore the 24-h urinary iodine excretion (UIE) in five different periods of the day and the corresponding prediction equations respect by the use of creatinine-corrected UIC. Methods We collected 24-h, spot and fasting urine in five periods of the day to estimate 24-h UIE by the six different prediction equations. We compared the estimated creatinine-corrected UIC to the collected 24-h UIE and identified the most suitable equations in each period of the day. Results Among the six different prediction equations, the equation of Kawasaki T was the best to estimate the 24-h UIE by fasting urine among Chinese adults. Among the five periods of time, the equation of Knudsen N was the best to estimate the 24-h UIE in the non-morning period. Conclusion Urinary iodine status at the individual level could be estimated by different creatinine-based equations at different periods of the day.
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Affiliation(s)
- Zhuan Liu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China.,The Department of Disease Control and Prevention, The First Hospital of Quanzhou Affiliated to Fujian Medical University, No.248-252, Dongjie Road, Quanzhou, 362000, Fujian, People's Republic of China
| | - Yixuan Lin
- School of Public Health, Fujian Medical University, University of New Area, No.1 Xueyuan Road, Fuzhou, 350122, Fujian, People's Republic of China
| | - Jiani Wu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Diqun Chen
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Xiaoyan Wu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Ying Lan
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Zhihui Chen
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China. .,School of Public Health, Fujian Medical University, University of New Area, No.1 Xueyuan Road, Fuzhou, 350122, Fujian, People's Republic of China.
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8
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Arns-Glaser L, Zandberg L, Assey VD, Baumgartner J, Abdallah F, Galetti V, Dary O, Zimmermann MB, Andersson M. Seasonal effects on urinary iodine concentrations in women of reproductive age: An observational study in Tanzania and South Africa. Am J Clin Nutr 2022; 115:298-309. [PMID: 34601579 DOI: 10.1093/ajcn/nqab327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Iodine intake in populations is usually assessed by measuring urinary iodine concentrations (UICs) in spot samples. Hot climate conditions may reduce urine volume, thus leading to overestimations of UIC and thereby masking inadequate iodine intake. OBJECTIVES We investigated the effects of season on UICs in 2 populations exposed to high-temperature climates. METHODS In this observational study, we examined women (18-49 years) in Tanzania (ncold = 206; nhot = 179) and South Africa (ncold = 157; nhot = 126) during cold and hot seasons. From each woman in both seasons, we obtained two 24-hour urine collections and 2 spot urine samples, as well as salt, water, and cow's milk samples. We measured the urine volume, UIC, and urinary creatinine concentration (UCC). The 24-hour urinary iodine excretion (UIE) was calculated and used to estimate the iodine intake. We used linear mixed-effects models to test for differences between seasons. RESULTS In Tanzanian women, we observed no seasonal effect on the urine volume, 24-hour UIE, 24-hour UIC, spot UIC, spot UIC:UCC ratio, or salt iodine concentration. In South African women, the median 24-hour urine volume was 1.40 L (IQR, 0.96-2.05 L) in the winter and 15% lower in the summer (P < 0.001). The median 24-hour UIE was 184 µg/day (IQR, 109-267 µg/day) in the winter and 34% lower in the summer (P < 0.001), indicating a lower iodine intake. As a result, UICs did not significantly differ between seasons in 24-hour collections and spot samples, whereas the spot UIC:UCC ratio differed by 21% (P < 0.001) and reflected the lower iodine intake. In both study populations, the within- and between-person variabilities in urine volume, 24-hour UICs, and spot UICs were higher than the variability between seasons. CONCLUSIONS Spot UIC may slightly overestimate the iodine intake in hot temperatures due to concentrated urine, and methods to correct for urine volume may be considered. Local seasonal differences in iodine intakes may also occur in some populations. This trial was registered at http://www.clinicaltrials.gov as NCT03215680.
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Affiliation(s)
- Leonie Arns-Glaser
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Vincent D Assey
- Nutrition Services Section Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania.,Iodine Global Network, Ottawa, Canada
| | - Jeannine Baumgartner
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.,Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Fatma Abdallah
- Iodine Global Network, Ottawa, Canada.,Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Valeria Galetti
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Omar Dary
- Division of Nutrition and Environmental Health, Office of Maternal and Child Health and Nutrition, Bureau for Global Health, United States Agency for International Development, Washington, DC, USA
| | - Michael B Zimmermann
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.,Iodine Global Network, Ottawa, Canada
| | - Maria Andersson
- Iodine Global Network, Ottawa, Canada.,Nutrition Research Unit, Children's Research Centre, University Children's Hospital Zurich, Zürich, Switzerland
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9
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Caprio AM, Umano GR, Luongo C, Aiello F, Dello Iacono I, Palumbo S, Miraglia del Giudice E, Grandone A. Case report: Goiter and overt hypothyroidism in an iodine-deficient toddler on soy milk and hypoallergenic diet. Front Endocrinol (Lausanne) 2022; 13:927726. [PMID: 36034464 PMCID: PMC9402931 DOI: 10.3389/fendo.2022.927726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Soy-based infant formulas (SFs) are often consumed by cow's milk allergic children. However, some concerns have risen since soy intake may adversely affect thyroid function in iodine-deficient or subclinical hypothyroid individuals. We report the first Italian case of SF induced goiter and hypothyroidism registered in our country since National Iodine program has been instituted. Finally, we review cases previously reported in literature. A 22-month-old toddler with a previous diagnosis of cow's milk protein allergy came to clinical attention for important goiter and overt hypothyroidism. Detailed dietary anamnesis revealed that he was on a restrictive dietary regimen based on soymilk since 12 months of age. A temporary levothyroxine substitution was instituted to avoid hypothyroidism complications. Adequate iodine supplementation and diet diversification completely reversed SF-induced hypothyroidism and goiter, confirming the diagnostic suspicion of soymilk-induced thyroid dysfunction in a iodine-deficient toddler. This case report demonstrates the importance of careful dietary habits investigation and adequate micronutrients supplementation in children on a restrictive diet due to multiple food allergies in order to prevent nutritional deficits.
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Affiliation(s)
- Angela Maria Caprio
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppina Rosaria Umano
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Caterina Luongo
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Aiello
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
- *Correspondence: Francesca Aiello,
| | - Iride Dello Iacono
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - Stefania Palumbo
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Emanuele Miraglia del Giudice
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Anna Grandone
- Department of the Woman, The Child, of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
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10
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Gibson S, Gray J. Evaluating current egg consumption patterns: Associations with diet quality, nutrition and health status in the UK National Diet and Nutrition Survey. NUTR BULL 2020. [DOI: 10.1111/nbu.12462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S. Gibson
- Registered Nutritionist Sig‐Nurture Ltd. Southampton UK
| | - J. Gray
- Registered Nutritionist London UK
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Letter to the Editor in response to: Intra-individual and inter-individual variations in iodine intake and excretion in adult women: implications for sampling. Br J Nutr 2020; 124:478. [DOI: 10.1017/s0007114520000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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