Indicators of iodine status among adults. Dutch Nutrition Surveillance System

[Critical analysis of the indicators of the nutritional status of iodine in individuals and populations: a systematic review]

The scope of this article is to evaluate the potentialities of indicators of the nutritional status of iodine in individuals or populations. The review was based on PRISMA. The search for articles occurred in January 2019, in the Pubmed, Scopus and LILACS databases, using the key words: indicators AND nutritional status AND iodine. The selection followed the stages of excluding the duplicates, reading the titles, abstracts and analyses in full. The methodological quality of the studies was evaluated by the Downs and Black instrument. A total of 178 studies were identified and 20 were included. Urinary Iodine Concentration (UIC) was analyzed in 65% of the studies and was considered the best indicator to evaluate the nutritional status of iodine in the population. Thyroglobulin was determined in 20% of the studies and reflected the pre-existing state of iodine. Thyroid stimulating hormone was verified in 45% of the articles and was important for the surveillance of iodine deficiency among newborns. Only one study evaluated capillary iodine, useful for analyzing long-term dietary intake. In the evaluation of methodological quality, the lowest score was 12 and the highest 16, in 17 possible points. The use of UIC is recommended for the diagnosis of deficiency and excess of iodine in the population.

Dietary assessment methods for intakes of iron, calcium, selenium, zinc and iodine

The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is working towards developing aligned micronutrient recommendations across Europe. The purpose of the present study was to conduct a review of methods used in validation studies carried out in adults assessing dietary intake of EURRECA priority minerals. A search strategy and inclusion criteria were defined and a scoring system was developed to rate the quality of each validation study that produced a quality index with possible scores obtained ranging from 0.5 to 7. A MEDLINE and EMBASE literature review was conducted. Articles/validation studies meeting the inclusion criteria included: 79/88 for Fe; 95/104 for Ca; 13/15 for Se; 29/30 for Zn; 7/9 for iodine. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24 h recalls were the most used reference methods. The correlation coefficients (CC) between study mineral intakes estimated by FFQ and the reference method were weighted according to the study's quality index and obtained acceptable to good ratings, ranging from 0.36 to 0.60 when the reference method was DR and from 0.41 to 0.58 when the reference was 24 h recalls. A minority of studies (n 9) used biomarkers for validation and among these, five included iodine obtaining a CC of 0.47. The FFQ was seen as a valid method for assessing mineral intake, particularly for Ca and, to a lower extent, for iodine and Zn. Se and Fe showed only acceptable correlations. The present review provides new insights regarding the characteristics that assessment methods for dietary mineral intakes should fulfil.

Lifestyle factors related to iodine intakes in French adults

Objective

To assess dietary iodine intakes among adults and to investigate the relationships of dietary, lifestyle, demographic and geographical characteristics with dietary iodine status. Adequacy of iodine intakes was also assessed.

Design

Cross-sectional study. Linear regression analyses and logistic regression modelling were used to determine correlates of iodine intakes. Usual iodine mean intake was calculated by averaging six 24 h dietary records completed over a 2-year period.

Subjects

Females aged 35–60 years (n2962) and males aged 45–60 years (n2117) living in France and who participated in the SU.VI.MAX study.

Results

Iodine intakes ranged from 30·0 to 446·3 μg/d. The median iodine intake was 150·7 μg/d for males and 131·4 μg/d for females. High-level (97·5th percentile) intakes were 273·4 μg/d for males and 245·0 μg/d for females. Overall, 8·5 % of males and 20·3 % of females had intakes <100 μg/d (P< 0·001). Alcohol drinkers and smokers tended to have lower iodine intakes than abstainers or non-smokers. Regular physical activity and both intermediate and high education levels were associated with a lower risk of iodine intake of <150 μg/d. For both males and females there were significant overall regional differences (P< 0·001) in multivariate-adjusted iodine intakes, with higher adjusted iodine intakes in Brittany and Normandy than in the north-eastern region.

Conclusions

Our data show a borderline low iodine intake in this middle-aged French population. However, differences in iodine intakes may contribute to explaining only a small part of the effects of sex and age on thyroid disease incidence.

An evaluation of urinary measures of iodine and selenium status

The aim of this study was to establish methodology for a survey of the iodine and selenium status of New Zealand residents, more specifically to investigate the correlation between fasting or random casual urine samples and 24 hour urines for iodine and selenium excretion. Sixty-two (31 M, 31 F) adults collected casual, fasting and 24 hour urine samples for analysis of iodide, selenium and creatinine. Plasma and serum samples were collected for analysis of selenium and glutathione peroxidase activity. Results indicated that fasting urine samples, but not casual urines, may give a reasonable estimate of urinary output of iodine and selenium on a population basis, but that 24 hour urines are necessary for diagnosis of iodine deficiency in an individual and for research purposes. The results for iodine also give no support for expressing iodine as the iodide-creatinine ratio, although there was some indication that the selenium-creatinine ratio might be useful. Significant correlations between total daily excretion of selenium and iodine and also for urinary concentrations of the two trace elements in fasting and in 24 hour urine specimens may reflect a relationship of selenium and iodine to body size which may have implications for dietary requirements of these trace elements. Alternatively the correlations may reflect a relationship between dietary intake of the two trace elements in a country in which food concentrations are low, and this needs further investigation.