Iodine Content Of Salt Research Articles

Availability of adequately iodized in Northwest Ethiopia: a cross-sectional study

BackgroundUniversal salt iodization is the most cost-effective, safe and sustainable strategy to eliminate iodine deficiency disorders. However, little is known about the availability of adequately iodized salt in the northwestern part of Ethiopia. Thus, the aim of this study was to assess the availability of adequately iodized salt at the household level and associated factors in Dabat District, northwest Ethiopia.MethodsA community-based cross-sectional study was conducted from February 21 to March 31, 2016. We included 705 households in the study. A stratified multistage followed by simple random sampling technique was employed to select households. The level of salt iodine content was determined using the rapid field test kit. Accordingly, the value of <15 parts per million (PPM) and ≥15 PPM with the corresponding color chart on the rapid test kit were used to classify the level of iodine content in the sampled salt. A multivariable binary logistic regression model was fitted to identify factors associated with the availability of adequately iodized salt. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association.ResultsThis study indicated that about 33.2% [95% CI: 29.6, 36.7%] of households had adequately iodized salt. Urban residence (AOR = 2.15, 95% CI: 1.23, 3.76), use of packed salt (AOR = 2.23, 95% CI: 1.01, 4.89), and good respondents' knowledge on iodized salt use (AOR = 1.49, 95% CI: 1.08, 2.08) were positively associated with the availability of adequately iodized salt. However, longer distance to buy salt was inversely related with availability of adequately iodized salt (AOR = 0.68, 95% CI: 0.48, 0.99).ConclusionsThe availability of iodized salt is well under the WHO recommendation in Dabat District in spite of the fact that Ethiopia has been implementing universal salt iodization since the last five years. Therefore, intensifying strategies targeting to enhance community awareness on the benefit and handling practice of iodized salt is essential to improve availability of iodized salt. In addition, the focus needs to be on improving accessibility of iodized salt.

The Storage Conditions to Quality of Iodine Content in Salt at the Seller Level that Distributed in Traditional Market at North Denpasar in Year 2017

Introduction : One of the health problems in Indonesian society that has a huge impact on the survival and quality of human resources is GAKI. One of the basic human needs in daily life is widely used as an additional ingredient in food ingredients as food preservatives such as salted fish, mustard greens, pickled fruits, and the basic manufacture of chemical compounds is salt. The research was to determine the effect of storage process and storage time on iodine content in salt. Method : The research was designed as descriptives quantitative study that conducted in traditional market at North Denpasar. The sample collected was 60 branded salt and unbranded salts. The iodine content was tested using iodometri titration method at Laboratorium Analis Kesehatan STIKes Wira Medika Bali. Data of storage condition was collected from direct measurement and interview with the vendor. The data was analyzed descriptively and analytically. Results : The researched results showed that iodine content of 5 branded and unbranded salts in North Denpasar was 58,98 ± 24,41 ppm. While the storage conditions with the average storage duration time at the traders was 13 days with average temperature of 29,760C and 68,82% humidity.

Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys

Background: Household coverage with iodized salt was assessed in 10 countries that implemented Universal Salt Iodization (USI).Objective: The objective of this paper was to summarize household coverage data for iodized salt, including the relation between coverage and residence type and socioeconomic status (SES).Methods: A review was conducted of results from cross-sectional multistage household cluster surveys with the use of stratified probability proportional to size design in Bangladesh, Ethiopia, Ghana, India, Indonesia, Niger, the Philippines, Senegal, Tanzania, and Uganda. Salt iodine content was assessed with quantitative methods in all cases. The primary indicator of coverage was percentage of households that used adequately iodized salt, with an additional indicator for salt with some added iodine. Indicators of risk were SES and residence type. We used 95% CIs to determine significant differences in coverage.Results: National household coverage of adequately iodized salt varied from 6.2% in Niger to 97.0% in Uganda. For salt with some added iodine, coverage varied from 52.4% in the Philippines to 99.5% in Uganda. Coverage with adequately iodized salt was significantly higher in urban than in rural households in Bangladesh (68.9% compared with 44.3%, respectively), India (86.4% compared with 69.8%, respectively), Indonesia (59.3% compared with 51.4%, respectively), the Philippines (31.5% compared with 20.2%, respectively), Senegal (53.3% compared with 19.0%, respectively), and Tanzania (89.2% compared with 57.6%, respectively). In 7 of 8 countries with data, household coverage of adequately iodized salt was significantly higher in high- than in low-SES households in Bangladesh (58.8% compared with 39.7%, respectively), Ghana (36.2% compared with 21.5%, respectively), India (80.6% compared with 70.5%, respectively), Indonesia (59.9% compared with 45.6%, respectively), the Philippines (39.4% compared with 17.3%, respectively), Senegal (50.7% compared with 27.6%, respectively) and Tanzania (80.9% compared with 51.3%, respectively).Conclusions: Uganda has achieved USI. In other countries, access to iodized salt is inequitable. Quality control and regulatory enforcement of salt iodization remain challenging. Notable progress toward USI has been made in Ethiopia and India. Assessing progress toward USI only through household salt does not account for potentially iodized salt consumed through processed foods.

Moderate-to-Severe Iodine Deficiency in the “First 1000 Days” Causes More Thyroid Hypofunction in Infants Than in Pregnant or Lactating Women

BackgroundIodine deficiency early in the life cycle—the “first 1000 days”—can cause hypothyroidism and irreversibly impair neuromotor development. However, the relative vulnerability among women and infants during this critical period is unclear, making it difficult for country-based programs with limited resources to prioritize their iodine interventions. ObjectivesOur aim was to determine the prevalence of thyroid hypofunction in women and infants living in an area of moderate-to-severe iodine deficiency. MethodsIn a cross-sectional survey in Morocco, we measured urinary iodine concentrations (UICs) and concentrations of thyroid-stimulating hormone (TSH) and total or free thyroxine (TT4 or fT4, respectively) in women of reproductive age (n = 156), pregnant women (n = 245), and lactating women (n = 239) and their young infants (n = 239). We calculated daily iodine intakes and measured iodine concentrations in breast milk and household salt. We compared the incidence of hypothyroidism between the 3 groups of women and with the infants. ResultsWomen of reproductive age, pregnant women, and lactating women had median (IQR) UICs of 41 (29–63), 32 (17–58), and 35 (19–62) μg/L; and estimated iodine intakes were ∼60%, 22%, and 26% of Recommended Nutrient Intakes (RNIs). The infants' median UIC was 73 (28–157) μg/L, which was greater than for all 3 groups of women (P < 0.001), and their dietary intakes were 27% of the RNI. The prevalence of hypothyroidism was not significantly different between the 4 groups, whereas the prevalence of hypothyroxinemia was higher in infants (40%) than in the 3 groups of women (11–14%) (P < 0.001). The median breast-milk iodine concentration was 42 (26–81) μg/L. Only 6% of salt samples were adequately iodized to a concentration of ≥15 ppm; 54% were inadequately iodized and 40% contained no measurable iodine. ConclusionsIn an area of moderate-to-severe iodine deficiency, the prevalence of thyroid hypofunction is ∼4-fold higher in young infants compared with the 3 groups of women, suggesting that, in the “first 1000 days,” infants are more vulnerable than their mothers and that programs should prioritize iodine prophylaxis for this group.

Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies.

BackgroundAlthough several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported.MethodWe conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081).Results50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies.ConclusionAlthough universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.

The Impact of Various Iodized Salt Doses Intervention on Iodine Status and Thyroid Function on Primary School Children

Background. There were some debate regarding iodized salt dosages (SNI>30 ppm) indicating excess of iodine in some areas in Indonesia. Previous studies have not yet define appropriate and effective iodine content in salt that ensure safe iodine status for the community. Objective. This study aims to define iodized dosage in salt that can effectively guarantee the urine iodine levels and normal thyroid function in elementary school children. Method. The study was conducted in Kepil Subdistrict,Wonosobo District for ten months. The subjects were 176 children aged 6-12 years chosen using randomized block design with eight blocks. This is a population based double-blind RCT. Each intervention groups given iodized salt dosage of 15-25 ppm; 25-35 ppm; 35-45 ppm; 45-55 ppm KIO3 respectivelly for four months. Research variables were urinary iodine excretion (24-hours urine samples), thyroid function, nutritional status, iodine sources food consumption, goitrogenic and iodized salt consumption. Results. The median value of urinary iodine excretion (UIE) was still within the optimal limits (100-300 ug/l): 222 ug/l (pre study) and 238 ug/l (post study). The median value of UIE and TSH levels were not significantly different between groups or between pre and post study. The risk of iodine deficiency and excess of 8.0% and 26.7% respectivelly at pre study; to 7.4% and 31.2% post study. Subjects with high TSH and low TSH level was found after four months of intervention. Thyroid function based on the assessment of TSH and FT4 levels simultaneously not found the incidence of overt overt hypothyroidism and overt hyperthyroidism. There were no overt hypothyroidism and overt hyperthyroidism, however, there were 4% subclinic hypothyroid and 1.7% subclinic hyperthyroidism in post study. Conclusion. Iodized salt (KIO3) intervention of 15-55 ppm for four months was generally able to provide normal urine iodine and thyroid function on elementary school children.

KADAR IODIUM DALAM GARAM PADA DAERAH DENGAN KASUS HIPOTIROID DAN HIPERTIROID TINGGI

Background. Iodized salt is universal effort to eliminate iodine deficiency disorders (IDD). Iodine consentration in iodized salt needs to be evaluated due to many cases of hypothyroid and hyperthyroidism. Objective. The purpose of this study was to describe whether iodized salt consumed by peoples contributes to hypothyroidism and hyperthyroidism cases. Method. This was a descriptive study in area with the highest cases of hypothyroidism and hyperthyroidism based on data from Klinik Litbang GAKI Magelang 2005-2012. Samples were taken using purposive sampling with a sample size of 90 households per area. Area with the highest case of hyperthyroidism is Mertoyudan Sub District while area with the highest case of hypothyroidism is Salaman Sub Districts, both in Magelang District. Iodine content in salt was by taking sample of salt from households which used for daily consumption. Statistic analysed used were independent sample t test and Chi Square. Result. The results showed that salt consumed in both areas already contains iodine. Salt iodine content level in area with the highest hyperthyroidism (55.1±23.84 ppm) was higher than in the area with the highest hypothyroidism (49.79±39.28 ppm). According to the category of iodine content in salt, iodine content below standards ( 80 ppm) is higher in area with the highest hyperthyroidism (13.2 percent). However iodine content in both areas showed no significant difference (p=0.27). Conclusion. Iodized salt consumption does not contribute to the high case of hypothyroidism or hyperthyroidism. Salt consumed in area with the highest cases of hypothyroidism and hyperthyroidism already contains iodine as standard. It is possible that there are other factors that cause high incidence of hypothyroidism and hyperthyroidism in those areas that needs further research. Keywords: hyperthyroidism, hypothyroidism, iodine, salt

FAKTOR SOSIAL EKONOMI YANG BERHUBUNGAN DENGAN KADAR IODIUM DALAM GARAM RUMAH TANGGA

Background. Iodine deficiency has multiple adverse effects on human growthand development. WHO (2007) recommends the use of iodized salt for IDDprevention, because is easily obtained, cheap, and all levels of society consumedit.The identification of social, economy, knowledge, attitude, and practice thatinfluence the used to iodized salt is essential. It would allow us to formulate betterintervention measures. Objective. To understand the relationship between socialeconomic factor, knowledge and attitude about iodized salt, together with practice inhousehold. Methods. This is a cross sectional study to 211 child bearing age 15-45years old. Samples selected by random sampling from 3 villages in Ngombol district,Purworejo area. Results. Age, education, income, knowledge, attitude, and practicein utilizing iodized salt had significant relationship with iodized salt in household (R2 =0.078 ; p<0.05). Practice (beta 0.197 p = 0.007) in utilizing iodized salt was the mostdominant factor that could influence iodized salt content in household. Conclusion.Practice in utilizing iodized salt was the most dominant factor that could influenceiodized salt content in household. The better practice in utilizing iodized salt thehigher the iodine content in household salt. Keywords: attitude, economic, knowledge, practice, social

Can an Educational Intervention Improve Iodine Nutrition Status in Pregnant Women? A Randomized Controlled Trial.

Because of their increased need for iodine, pregnant women are among the high-risk groups for iodine deficiency. The purpose of this study was to evaluate the effectiveness of an educational program on the iodine nutrition status of pregnant women. In this randomized controlled trial, 100 pregnant women were randomly selected from five healthcare centers in the southern region of Tehran, the capital of Iran. In the intervention group, pregnant women received a four-month educational program, which included two face-to-face educational sessions, using a researcher-designed educational pamphlet in the second and third trimesters, and two follow-up telephone calls. Knowledge, attitude, and practice (KAP) scores, urinary iodine concentration (UIC), and salt iodine content were assessed at baseline and four months after the intervention. At baseline, there were significant associations between knowledge and attitude (r = 0.38, p = 0.03) between practice and UIC (r = 0.28, p = 0.01) and between UIC and iodine content of salt (r = 0.24, p = 0.009). Although a significant difference was found in mean KAP scores between the two groups after the educational intervention, scores were significantly higher in the intervention group compared with controls (p < 0.01). There were no significant differences in UIC and iodine content of salt between the two groups at follow-up. Despite educational intervention increasing KAP among women regarding the importance of iodine and iodized salt consumption during pregnancy, their iodine status did not improve. Considering the main socio-environmental determinants of iodine deficiency, in particular, the monitoring of salt fortification, prescribing iodine containing supplements as well as improving health literacy in pregnant women seem essential strategies.

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

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 (&lt;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.

Poor dietary diversity, wealth status and use of un-iodized salt are associated with goiter among school children: a cross-sectional study in Ethiopia

BackgroundGlobally, more than two billion people are at risk of iodine deficiency disorders, 32% of which are school children. Iodine deficiency has been recognized as a severe public health concern in Ethiopia, however little is known about the problem. Therefore, this study aimed to assess the prevalence of goiter and associated factors among school children (6 to 12 years) in Dabat District, northwest Ethiopia.MethodsA school-based cross-sectional study was conducted from February 21 to March 31, 2016. A total of 735 school children were included in the study. A stratified multistage sampling followed by systematic sampling technique was employed to select the study participants. Thyroid physical examination was done and classified according to the World Health Organization recommendations as grade 0, grade 1, and grade 2. The level of salt iodine content was determined using the rapid field test kit. The value 0 parts per million (PPM), <15 PPM and ≥15 PPM with the corresponding color chart on the rapid test kit were used to classify the level of iodine in the sampled salt. A multivariable logistic regression analysis was employed to identify factors associated with goiter. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was calculated to show the strength of association. In multivariable analysis, variables with a P-value of <0.05 were considered statistically significant.ResultsIn this community, the overall prevalence of goiter was 29.1% [95% CI: 25.9, 32.6], in which about 22.4 and 6.7% had goiter grade 1 and grade 2, respectively. The age of children (AOR = 1.13; 95% CI: 1.01, 1.26), being housewife mother (AOR = 1.49; 95% CI: 1.08, 2.15), use of unprotected well water source for drinking (AOR = 6.25; 95% CI: 2.50, 15.66), medium household wealth status (AOR = 1.78; 95% CI: 1.18, 2.92), use of inadequately iodized salt (AOR = 2.79; 95% CI: 1.86, 4.19), poor dietary diversity score of the child (AOR = 1.92;95% CI: 1.06, 3.48) and medium maternal knowledge (AOR = 0.65; 95% CI: 0.42, 0.94) were significantly associated with goiter.ConclusionsThe prevalence of goiter is higher in Dabat District, which confirmed a moderate public health problem. Therefore, regular monitoring of household salt iodine content, improving access to safe water, promoting the importance of diversified food for children is recommended to address the higher burden of iodine deficiency.

Comparing the Quality of Iodine in Edible Salt in Iranian Households Living in the Southern Province of Khorasan-e-Razavi Using WHO Standards (Years 2010–2015)

Iodine deficiency disorder among Iranians is a major health-related issue. The aim of this study was to determine iodine concentration in household salt. To sample the iodized salt products, the authors visited all wholesale warehouses of two cities of Bajestan and Gonabad in Khorasan-Razavi, Iran, and randomly purchased three packages of each brand of factory salt distributed through those centers. The sampling procedure was continued over the course of five years (2010–2015). In the 5-year study period, 82 samples of 23 different brands of factory salt were sampled. The most frequent samples were classified into three groups based on their iodine content (ppm = mg iodine per kg of salt): under standard limit (&lt;20 ppm); allowable standard limit (20–50 ppm); over standard limit (&gt;50 ppm). The tests showed that 67% of samples maintained a good level, 26.8% possessed an acceptable level, and 6% had unacceptable levels of iodine. Mean and standard deviation of the salt iodine content were 24.7 and 13.7, respectively. According to the results, the iodine content of samples showed significant differences with international standards (40 ppm), and this highlights the necessity of stricter monitoring of the salt production.

Status of Iodine Nutrition among Pregnant Women Attending Antenatal Clinic of a Secondary Care Hospital: A Cross-sectional Study from Northern India.

Background:Daily requirement of iodine increases during pregnancy making pregnant women a high-risk group for iodine deficiency disorders. The limited available literature shows that even in iodine sufficient population, pregnant women are iodine deficient.Objective:The objective of this study is to assess the current iodine nutrition status among pregnant women in Ballabgarh, district Faridabad, Haryana.Materials and Methods:Pregnant women were recruited from antenatal clinic (ANC) of subdistrict hospital (SDH), Ballabgarh, Haryana. Consecutive sampling strategy was followed to recruit pregnant women, and women of all trimesters were included in the study. Urinary iodine estimation was done using simple microplate method, and salt iodine was estimated using iodometric titration. The study was approved by Institute Ethics Committee, All India Institute of Medical Sciences (AIIMS), New Delhi.Results:Out of the total 1031 pregnant women, 90.9% were using adequately iodized salt. Median (interquartile range [IQR]) salt consumption by the pregnant women was 8.3 (6.7, 11.1) g/day. Median (IQR) urinary iodine concentration (UIC) for the pregnant women was 260 (199, 323) μg/L. Only 13.5% of pregnant women had insufficient iodine intake (UIC <150 μg/L). There was no significant difference in median UIC values by household salt iodine content and across three trimesters of pregnancy.Conclusion:Iodine nutrition status of the pregnant women attending ANC clinic of SDH Ballabgarh was adequate with attainment of universal salt iodization goal of >90% adequately iodized salt coverage in the study population.

Adequacy Assessment of a Universal Salt Iodization Program Two Decades after Its Implementation: A National Cross-Sectional Study of Iodine Status among School-Age Children in Tunisia.

In the framework of a worldwide policy to eliminate iodine deficiency (ID) disorders, universal salt iodization was adopted in Tunisia two decades ago. The present study aims to evaluate this strategy, using both performance and impact indicators. A total of 1560 children, aged 6–12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. Urinary iodine concentration (UIC) of the subjects, and household salt iodine content, were analyzed. The national median UIC was 220 µg/L (95% confidence interval (CI): 199–241), indicating an acceptable iodine status at the population level. Only 11.4% (95% CI: 8.6–14.9) of the children had UIC <100 µg/L, but with large regional disparities (4.3% to 25.5%, p < 0.01); however, more than a quarter of the subjects were at risk of adverse health consequences due to iodine excess. Children from households of low socio-economic levels were more prone to inadequate UIC. The national median iodine concentration of household salt was 22 mg/kg (95% CI: 21–23). Only half of the households used adequately iodized salt (15–25 ppm), with large regional disparities. National ID rates are now well below the target criteria of WHO (World Health Organization) certification (<20% of children with UIC <50 µg/L and <50% with UIC <100 µg/L). The coverage of adequately iodized salt fell short in meeting the goals of USI (Universal Salt Iodization), i.e., >90% of households. Regular monitoring of iodized salt production lines must be strengthened with involvement by producers.

Yoduria y concentración de yodo en sal de consumo en escolares peruanos del nivel primario

To determine the ioduria and iodine concentration in table salt in Peruvian elementary schoolchildren. A cross-sectional study was performed. A total of 8,023 elementary schoolchildren, who voluntarily participated, were included. Multistage stratified probability sampling was performed, and the sample was obtained by systematic selection. Ioduria was determined via spectrophotometry (Sandell-Kolthoff method), and the amount of iodine in salt was evaluated volumetrically. The data were processed by means of analysis for complex samples with a weighting factor. Medians, percentiles, and confidence intervals were calculated, and the Mann-Whitney U and Kruskal-Wallis H tests were used, where appropriate. Nationwide, the median ioduria in schoolchildren was 258.53 ug/L, being higher in boys (265.90 ug/L) than in girls (250.77 ug/L). The median ioduria in urban areas was higher (289.89 ug/L) than that in rural areas (199.67 ug/L), while it was 315.48 ug/L in private schools and 241.56 ug/L in public schools (p<0.001). The median iodine concentration in table salt was 28.69 mg/kg. Of the total salt samples, 23.1% contained less than 15 mg/kg of iodine. The median ioduria in elementary schoolchildren exceeded normal levels, according to the criteria of the World Health Organization, with differences between urban and rural areas and public and private schools.

Breast-Milk Iodine Concentrations, Iodine Status, and Thyroid Function of Breastfed Infants Aged 2-4 Months and Their Mothers Residing in a South African Township.

Objective:Lactating women and their infants are susceptible to iodine deficiency and iodine excess. In South Africa, no data exist on the iodine status and thyroid function of these vulnerable groups.Methods:In a cross-sectional study, urinary iodine concentrations (UIC), thyroid function, and breast-milk iodine concentrations (BMIC) were assessed in 100 lactating women from a South African township and their 2-4-month-old breastfed infants. Potential predictors of UIC, thyroid function, and BMIC, including household salt iodine concentrations (SIC) and maternal sodium excretion, were also investigated.Results:The median (25th-75th percentile) UIC was 373 (202-627) μg/L in infants and 118 (67-179) μg/L in mothers. Median household SIC was 44 (27-63) ppm. Household SIC and maternal urinary sodium excretion predicted UIC of lactating mothers. Median BMIC was 179 (126-269) μg/L. Age of infants, SIC, and maternal UIC predicted BMIC. In turn, infant age and BMIC predicted UIC of infants. Forty-two percent of SIC values were within the South African recommended salt iodine fortification level at production of 35-65 ppm, whilst 21% of SIC were >65 ppm. Thyroid-stimulating hormone, total thyroxine, and thyroglobulin concentrations in the dried whole blood spot specimens from the infants were 1.3 (0.8-1.9) mU/L, 128±33 mmol/L, and 77.1 (56.3-105.7) μg/L, respectively, and did not correlate with infant UIC or BMIC.Conclusion:Our results suggest that the salt fortification program in South Africa provides adequate iodine to lactating women and indirectly to their infants via breast milk. However, monitoring of salt iodine content of the mandatory salt iodization program in South Africa is important to avoid over-iodization of salt.

More than two-thirds of dietary iodine in children in northern Ghana is obtained from bouillon cubes containing iodized salt.

Bouillon cubes are widely consumed by poor households in sub-Saharan Africa. Because their main ingredient is salt, bouillon cubes could be a good source of iodine if iodized salt is used in their production and if their consumption by target groups is high. Our objective was to measure the iodine content of bouillon cubes, estimate their daily intake in school-aged children and evaluate their potential contribution to iodine intakes. In a cross-sectional study, we measured urinary iodine concentrations (UIC) and estimated total daily iodine intakes. We administered a questionnaire on usage of bouillon cubes. We measured the iodine content of bouillon cubes, household salt, drinking-water and milk products. Primary schools in northern Ghana. Schoolchildren aged 6-13 years. Among school-aged children (n 250), median (interquartile range) UIC and estimated iodine intake were 242 (163-365) µg/l and 129 (85-221) µg/d, indicating adequate iodine status. Median household salt iodine concentration (n 100) was only 2·0 (0·83-7·4) µg/g; 72 % of samples contained <5 µg iodine/g. Iodine concentrations in drinking-water and milk-based drinks were negligible. Median iodine content of bouillon cubes was 31·8 (26·8-43·7) µg/g, with large differences between brands. Estimated median per capita consumption of bouillon cubes was 2·4 (1·5-3·3) g/d and median iodine intake from bouillon cubes was 88 (51-110) µg/d. Despite low household coverage with iodized salt, iodine nutrition in school-aged children is adequate and an estimated two-thirds of their dietary iodine is obtained from bouillon cubes.

Relationship between Iodine Content in Household Iodized Salt and Thyroid Volume Distribution in Children

ObjectiveTo assess the effect of different levels of salt iodine content on thyroid volume (ThV) distribution using data from the 1999, 2011, and 2014 Chinese national iodine deficiency disorder (IDD) surveys. MethodsProbability proportion to size (PPS) sampling method was used to obtain a representative national sample of 34,547, 38,932, and 47,188 Chinese children aged 8-10 years in 1999, 2011, and 2014 Chinese national IDD surveys, respectively. The iodine content in household iodized salt and urinary iodine concentration were measured and thyroid ultrasound examination was performed. The data were analyzed by SAS software using histograms and box plots. The skewness and kurtosis were calculated for testing the normality of ThV. ResultsThe median iodine content in household iodized salt dropped from 42.30 mg/kg in 1999 to 25.00 mg/kg in 2014. The median urinary iodine concentration of children aged 8-10 years decreased from 306.0 μg/L in 1999 to 197.9 μg/L in 2014. The median and interquartile range (IQR) of ThV in 1999, 2011, and 2014 surveys were 3.44 mL and 1.50 mL, 2.60 mL and 1.37 mL, 2.63 mL and 1.25 mL, respectively. The skewness and kurtosis of ThV distribution in 1999, 2011, and 2014 surveys were 1.34 and 5.84, 0.98 and 3.54, 1.27 and 5.49, respectively. ConclusionWith reduced salt iodization levels, the median urinary iodine concentration and median ThV of children decreased significantly, and the symmetry of the ThV distribution improved.

Iodine content in the marketed products of iodized salt: a descriptive study in southern Sri Lanka

Background: Monitoring of the iodization programmes is crucial not only to ensure that the salt contains sufficient amount of iodine but not excessive amounts that lead to adverse health consequences. Countries usually recommend minimum standards for the iodine content of salt at the production level, but less frequently establish standards at the consumer level. Sri Lankan standards recommended salt should have 15.0-30.0 ppm of fortified iodine at the retail level. Objective: To assess the iodide content in crystal and table (powder) salt preparations for the human consumption in Southern Sri Lanka. Methods: Commercially available packets of both crystal and table salt were purchased from randomly selected permanent (57 retail shops and 24 supermarkets) and temporary (8, weekly fairs) shops and analyzed for the iodine content. Information on the storage conditions, the shelf life of the samples was also recorded. Results: There was a total of 89 packets of salt which comprising of crystal (n=30) and powder (n=59) packets belonged to 42 different brands (15 and 27 brands for crystal powder salts respectively). Over 74% of packets had one year and the remainder (26%) had 18 to 24 months of shelf life. The median iodide level of the total sample was 20.40 ppm (range 0.0 to 73.81 ppm) whereas the median iodide level of crystal salt was 18.89 ppm (range 3.70 to 73.81 ppm) and table salt was 21.63 ppm (range 0.0 to 41.24). It was revealed that 21(23.6%) packets of salt (11 crystal and 10 table salts respectively) had iodide levels below 15.0 ppm and 11(12.4%) packets of salt (4 crystal and 7 table) had iodine level above the recommended range of 30.0 ppm. Altogether 22 (52.4%) brands did not have iodine levels within the recommendations and in fact, one powder salt packet did not contain a detectable amount of iodide. Conclusions: Establishing a precise sustainable monitoring system of salt iodization at the production level is important in maintaining iodine nutrition at the optimum level.

Epidemiological trends of iodine-related thyroid disorders: an example from Slovenia.

The epidemiology of thyroid disorders is significantly associated with iodine supply. In 1999, Slovenia increased iodine content in kitchen salt from 10 mg to 25 mg of potassium iodide per kg of salt. According to the WHO criteria, Slovenia shifted from a mildly iodine-deficient country to a country with adequate iodine intake. Ten years after the increase in iodine intake, the incidence of diffuse goitre and thyroid autonomy decreased. Now patients with diffuse goitre and thyroid autonomy reach older age than the patients before the increase in iodine intake. In addition, patients with thyroid autonomy are less frequently hyperthyroid than ten years ago and iodine-induced hyperthyroidism is less severe. The incidence of highly malignant thyroid carcinoma has also dropped. However, the incidence of Hashimoto's thyroiditis increased, most probably in genetically predisposed individuals. Over the last ten years, many animal and in vitro studies evaluated the effects of endocrine disrupting chemicals (EDC) on various aspects of the thyroid function. They mostly studied the effects of polychlorinated biphenyls (PCBs) and dioxins, brominated flame retardants, phthalates, bisphenol A, perfluorinated chemicals, and perchlorate. However, human studies on the effects of EDCs on the thyroid function are very scarce, especially the long-term ones. What they do suggest is that PCBs and dioxins interfere with the transport of thyroid hormones and adversely affect the thyroid function. Many authors agree that iodine deficiency predisposes the thyroid gland to harmful effects of EDCs. Therefore the effects of EDCs in iodine-deficient areas could be more severe than in areas with adequate iodine intake.