Abstract
A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007–2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification) and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%–62%). A low intake of fish and seafood resulted in this food group contributing only 3%–8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring.
Highlights
Iodine deficiency is one of the most common nutrient deficiencies in the world, with almost one billion people affected
This paper explores whether the knowledge and practices related to iodine nutrition have changed since these two public health strategies were introduced, and investigates dietary intakes of iodine, in an attempt to better understand the need for nutritional and supplementation advice targeting these groups
We have previously reported data from the current study sample that 1–2 years following introduction of the mandatory iodine fortification programme of salt used in bread-making in Australia, median urinary iodine concentrations of both pregnant and lactating women indicated sufficiency only in those who were taking iodine-containing supplements [23,24]
Summary
Iodine deficiency is one of the most common nutrient deficiencies in the world, with almost one billion people affected. Inadequate iodine intake during pregnancy is of particular concern as, depending on the severity of deficiency, it can result in miscarriages, stillbirths, cretinism, irreversible mental retardation, impaired psychomotor development, and behavioural problems [1,2,3]. Iodine requirements are increased from an RDI value of 150 μg/day in adolescents and adulthood, to 220 and. Meta-analyses indicate that moderate to severe iodine deficiency without supplementation may result in a population-level loss of intelligence in children of around 10–13.5 IQ points [5,6]. Implications of mild iodine deficiency are less well defined, developmental gains have been demonstrated in New Zealand children aged 10–13 years following correction of iodine deficiency through supplementation with 150 μg iodine per day [7] Increased requirements are due to (1) an increase in the production of thyroxine (T4) by the mother to maintain her euthyroid state and transfer of thyroid hormone to the foetus, (2) transfer of iodine from mother to foetus and (3) an increased renal iodine clearance by the mother [1].
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