Use Of Iodized Salt Research Articles

Trends of risk factors associated with childhood stunting and anaemia in Ghana: evidence from the Demographic Health Survey and Multiple Indicator Cluster Survey (2003-2017).

This study investigated the trend of effect estimates of the key risk factors of childhood stunting and anaemia between 2003 and 2017. A secondary analysis of the Demographic Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) data for the Ghanaian population between 2003 and 2017. Associations of selected socio-demographic (child age and gender; maternal age and education), economic (household wealth), environmental, dietary (minimum dietary diversity and iodine use) and health system (place of delivery and vaccination) factors were explored using the Poisson regression model. Trend analysis was explored using a fitted linear regression line on a time series plot. Ghana. Children under 5 years. The results showed a reduction in the prevalence of stunting and anaemia over the 15-year duration. These health outcomes were found to be negatively associated with a wide array of socio-demographic (child age and gender, maternal age and education, residency), economic (household wealth), dietary (iodised salt use) and health service (place of delivery and vaccination) factors; however, the most consistent statistically significant association was observed between child's age and belonging to the poor wealth quintile. In order to prevent these indicators of child malnutrition, key consideration must be given to the early developmental stages of life. Child health policies must focus on addressing the key contextual factors of child malnutrition.

Bridging the Knowledge Gap: Discerning the Association between Adequately Iodized Salt Coverage and Household Knowledge, Attitudes and Practices in Madagascar

Background: Iodine deficiency disorders are one of Madagascar's public health issues regarding the low level of iodine concentration in the population as assessed in 2015. Since then, the national salt iodization program has been revitalized. Therefore, this study aimed to estimate the coverage of households' adequately iodized salt in Madagascar and assess their level of Knowledge, Attitudes, and Practices regarding iodized salt use and associated factors. Materials and Methods: A cross-sectional population-based study using a multistage random sampling was conducted in 2020 in 4410 households in Madagascar. After informed consent, a pre-tested questionnaire on iodized salt was administered to the households, followed by a table, or cooking salt sample collected for iodine content testing using the iodometric titration technique. In addition, bivariate and multivariate analyses were conducted at 95% confidence level to identify associated factors. Results: The study results estimated the coverage of adequately iodized salt (15-60 ppm) nationwide at 41.1% (CI95%: 39.7%-42.2%) with significant differences between provinces. In addition, 36.8% of women had a “good” knowledge, 45.0% “good” practice of iodized salt, and 24.4% had a “positive” attitude towards iodized salt. Finally, the study identified the following associated factors to adequately iodized salt: attitude or perception towards iodized salt, household size, residence, economic status, and education level. Conclusion: Household coverage of adequately iodized salt has improved since 2015 but remains below WHO recommendations. Thus, the Ministry of Health and its partners could reinforce nutrition education efforts on household attitudes toward iodized salt and other associated factors to maintain coverage progress. Keywords: Coverage, iodine deficiency disorders, iodized salt, supplementation.

Iodized household salt utilization and associated factors among households in East Africa: a multilevel modelling analysis using recent national health surveys

IntroductionIodine deficiency disorders (IDDs) are a significant global public health issue that affects the physical and mental development of every age group, with children and nursing mothers being the most vulnerable. Approximately 50 million of approximately 2 billion people with iodine deficiency (ID) globally exhibit clinical symptoms. Identifying iodine levels using various techniques is important when considering treatment choices. Screening programs and early ID diagnostics are crucial for the follow-up of pregnant women, especially in iodine-deficient nations. There have been calls for universal salt iodization programs, but only approximately 71% of people have access to them. The problem is more common in developing nations; however, there is a shortage of literature on the individual-, family-, and community-level factors influencing iodized salt use in East Africa. This study aimed to investigate individual- and community-level factors of household iodized salt usage in East Africa.MethodsUsing Stata 17, this study used the most recent demographic and health survey datasets from twelve East African countries. The survey included a weighted sample of 154,980 households. To assess factors related to iodized salt use in the region, bivariable and multivariable multilevel logistic regressions were used. P values less than or equal to 0.2, and < 0.05 were used in the binary regression, and to deem variables statistically significant in the final model respectively.ResultsAbout 87.73% (95% CI = 87.56,87.89) households have utilized iodized household salt. Secondary and above education (AOR = 1.23, 95% CI = 1.17–1.30), household heads with ages of 25–35 years, 36–45 years (AOR = 1.20, 95% CI = 1.12,1.28), 36–45 years (AOR = 1.16, 95% CI = 1.09,1.24), and more than 45 years (AOR = 1.18, 95% CI = 1.11,1.25), lower and middle wealth (AOR = 0.89, 95% CI = 0.76,0.89) and (AOR = 0.97, 95% CI = 0.81,0.93), media exposure (AOR = 1.10, 95% CI = 1.07–1.14), female household leaders (AOR = 1.08, 95% CI = 1.04–1.12), access to improved drinking water and better toilet facility (AOR = 2.26, 95% CI = 2.18–2.35) and (AOR = 1.50, 95% CI = 1.44,1.56), larger than five family members (AOR = 0.96, 95% CI = 0.93–0.99), high community level wealth (AOR = 1.54, 95% CI = 1.27–1.87), and low community education(AOR = 0.40, 95% CI = 0.33,0.49) were statistically associated with utilization of iodized household salt in East Africa respectively.ConclusionIn East Africa, household salt iodization is moderately good. To expand the use of iodized salt in the region, access to improved drinking water and toilet facilities, participating family leaders, using the opportunity of family planning services, media sources, and the improvement of the community’s socioeconomic level are all needed.

Prevalence of adequately iodised salt and associated factors among households in Gambela district, Southwest Ethiopia: a cross-sectional study

BackgroundIodine deficiency disorders (IDDs) are among the major public health problems for populations worldwide. Although the recommended strategy for the prevention of IDD is universal salt iodisation, little is known...

Impact of stopping the use of iron fortified iodised salt on Hb levels

Background: Research studies have shown that use of iron fortified iodised salt (DFS) improved Hb in women, children and men. There are no publications on impact of stopping DFS on Hb levels. Methods: A community-based randomised study to assess the impact of DFS use on Hb was being carried out in Delhi. Between April-September 2020 salt could not be supplied and families were requested to purchase iodised salt (IS) from the market and use it. Blood samples from persons from these families were collected to assess impact of not using DFS for 6 months on Hb. Results: Comparison of mean Hb after 12 months use of the allocated salt and Hb after six-month use of IS by all three groups showed that: (1) there was a small reduction in Hb in all three groups after using IS for 6 months; fall was statistically significant in women in group 3; (2) women who had earlier used DFS had higher mean Hb and ferritin as compared to those who had used IS, both after 12 months of use of DFS and after 6 months of use of IS; (3) changes in ferritin varied and were not consistent. Conclusions: DFS users continued to have a higher mean Hb as compared to IS users even after discontinuing use of DFS for 6 months. The impact of this higher Hb when they restart using DFS for further 12 months has to be investigated.

Introduction to the programme guidance for the use of iodised salt in processed foods and its pilot implementation, strengthening strategies to improve iodine status.

Efforts to achieve optimal iodine intake through salt iodisation have focussed primarily on iodisation of household salt. However, there is strong evidence that in most regions of the world, industrially processed foods and condiments are an increasingly important source of dietary salt. In this context The Iodine Global Network (IGN) and partners developed programme guidance to help national programme managers assess the potential contribution of widely consumed industrially processed foods and condiments to iodine intake. The programme guidance additionally aimed to facilitate better understanding of iodised salt use by the processed food industry, review existing salt iodisation legislation for inclusion of food industry salt, and investigate how regulatory monitoring of food industry practices could be strengthened if needed. To evaluate the utility of the guidance in practice and identify areas where it could be improved, the IGN requested expressions of interest to pilot test implementation. Five pilots were implemented in Kenya, North Macedonia, The Republic of Moldova, Sri Lanka and Thailand, with remote technical support from IGN. The pilots demonstrated how evidence from implementation could be used to strengthen existing salt iodisation initiatives. In particular, how modelling existing processed food intake data enhanced understanding of potential or actual iodised salt intake and provided an evidence base for strategic change, as well as encouraging alignment with salt reduction programmes. In summary, the guidance provided a useful framework for national teams to conduct a relatively rapid assessment of the existing programme for achieving optimal iodine nutrition and opportunities to strengthen it. National teams involved with the pilot implementation were highly engaged and motivated by the outcomes. The pilot implementation process resulted in the development of strategic recommendations nationally and provided invaluable feedback to IGN on the utility of the guidance, facilitating development of an improved version.

Strengthening the strategy to sustain optimal iodine status in the Republic of Moldova: Assessing the use of iodized salt in industrially processed foods.

Although national legislation in the Republic of Moldova includes the use of iodized salt in processed food industry as well as household (cooking and table) salt, little is known of the actual use of iodized salt in the food industry and its contribution to the overall iodine intake of the population. This study has helped to address the gap in understanding about how much iodized salt is used in the production of different foods and to identify where more information is still required in order to more fully characterize the contribution of food industry salt to population iodine intake. Using the available food consumption and production data, the assessment introduces a novel modelling technique, based on the methodology of the IGN Programme Guidance to assess the use of iodized salt in industrially produced foods (IPF). The method included the identification of key salt containing IPF and modelling of the salt and potential iodine intake in two groups of the population, non-pregnant adults and pregnant women. The findings were synthetized to develop a list of recommendations for adjustment or strengthening the existing salt iodization strategy. In RM, the salt used for industrially produced bread and household use provide almost 80% of all salt intake for adults. The intake from iodized salt at household level and the 8 key salt- containing IPF is estimated to currently meet 89% and 53% of the recommended nutrient for adults and pregnant women, respectively. If all salt used at household level and industrial bread baking would be iodized, then, potentially, it could ensure 181% and 109%, respectively, of the required iodine intake. Use of iodized salt in the processed food industry is of growing significance and universal use of iodized salt at household level and in bread production could result in a desirable increase in iodine intake. The national salt iodization strategy should include strengthened regulatory monitoring of iodized salt use in the bread baking industry.

Assessing of iodine consumption with iodized salt in organized nutrition of children of preschool and school age in the Tyumen region

The territory of the Tyumen region is an endemic region with insufficient iodine content in the environment, in which, since the early 1990s, active preventive measures have been taken to increase the use of iodized salt (IS) in households, catering and the food industry. The purpose of the research was to assess the consumption of iodine with IS used in the organized nutrition of children in the Tyumen region. Material and methods. The assessment of iodine intake was carried out in preschool institutions and schools randomly selected the city of Tyumen and rural areas (village of Isetskoye). Modeling of iodine consumption in organized groups was carried out for children aged 1-3, 3-7, 7-11 and 12 years and older in urban and rural areas, respectively, using a standard menu and a technological map of dishes. Iodine intake was estimated based on the content of 40 μg of iodine in 1 g of salt and its 30% loss during cooking. Model 1 assumed the mandatory use of IS in the preparation of all salt-containing meals for preschoolers and schoolchildren. Model 2, in addition to the mandatory use of IS in school and preschool meals accounted the consumption of iodine with bakery products (BP) produced with IS. Results. The modeling showed that the average intake of iodine with meals (model 1) in preschool institutions in Tyumen was 89±16 μg/day for children aged 1-3 years. When BP with IS were included in the menu (model 2), iodine intake increased to 101±14 μg/day. In children aged 4-7 years iodine intake was 115±18 and 126±18 μg/day, respectively. In rural areas, iodine intake was lower: in children aged 1-3 years, under model 1, iodine intake was 66±3 μg/day, under model 2 - 76±4 μg/day. In children aged 4-7 years, these figures were 83±3 and 92±4 μg/day, respectively. Iodine consumption in a school in Tyumen under model 1 in children 7-11 years old was 24±5 μg/day, and in children 12 years and older - 27±6 μg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 32±5 μg/day in children 7-11 years old and to 39±6 μg/day in children 12 years of age and older. In rural areas, when using model 1, iodine intake in children aged 7-11 years was 37±15 μg/day, in children aged 12 and over 40±21 μg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 44±15 μg/day in children aged 7-11 years and to 50±21 μg/day in children 12 years of age and older. Conclusion. The use of IS in the preparation of salt-containing meals in preschool educational institutions of the Tyumen region fully covered the iodine requirements of preschool children, which confirms the effectiveness of the chosen strategy for the prevention of iodine deficiency and can be considered as an important part of the concept of universal salt iodization. The use of IS in preparation of school breakfast meals provides 23.5-36.9% of the recommended nutrient intake for iodine in rural schools and 15.4-26.4% of the recommended nutrient intake in urban schools, which can be a significant contribution to the total intake of this micronutrient.

Оценка йодной обеспеченности детей-вегетарианцев

Objective. To study the iodine supply of children on a vegetarian diet and to evaluate the effectiveness of iodized salt for the prevention of iodine deficiency. Methods. 65 vegetarian children( from 7 to 11 years) were examined. The control group included 40 healthy children of the same age which had no any dietary restrictions. All children lived in the Donetsk Republic. The study of iodine supply was carried out by determining the median of ioduria in the group. Taking into account the identified changes in the iodine supply of children of the surveyed groups, we prescribed them the prevention of iodine deficiency using iodised salt. The effectiveness was evaluated in 6 months. Results. In the main group, the median iodine was 68.4 μg/L, which is mild iodine deficiency. At the same time, 33.9% of children of the main group had a level of ioduria &lt;50 μg / l. In the control group, the median iodine was 97.1 μg/L. Ioduria &lt;50 μg/L had 25.0% of children. In 6 months from the beginning of iodised salt use in the main group, the median iodine was 107.8 μg/L, which is normal iodine supply, and the proportion of children with an iodine concentration in the urine &lt;50 μg/L was 16.9%. In turn, in the control group, after preventive use, the median iodine was 122.5 μg/L, and the proportion of children with ioduria &lt;50 μg/L decreased to 12.5%. Conclusion. The children living in the Donbass have a mild iodine deficiency. Vegetarianism without the use of iodised salt leads to an even more pronounced iodine deficiency. The received data allows to consider that vegetarian children have a risk of iodine deficiency. Regular iodized salt use is an effective prevention of iodine deficiency not only in traditionally fed children, but also in vegetarian children. Key words: vegetarianism, iodine, iodine deficiency, children, iodised salt

Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort.

After a recommendation for iodine supplementation in pregnancy has been issued in 2013 in Portugal, there were no studies covering iodine status in pregnancy in the country. The aim of this study was to assess iodine status in pregnant women in Porto region and its association with iodine supplementation. A cross-sectional study was conducted at Centro Hospitalar Universitário São João, Porto, from April 2018 to April 2019. Pregnant women attending the 1st trimester ultrasound scan were invited to participate. Exclusion criteria were levothyroxine use, gestational age < 10 and ≥ 14weeks, non-evolutive pregnancy at recruitment and non-signing of informed consent. Urinary iodine concentration (UIC) was measured in random spot urine by inductively coupled plasma-mass spectrometry. Median UIC was 104μg/L (IQR 62-189) in the overall population (n = 481) of which 19% had UIC < 50µg/L. Forty three percent (n = 206) were not taking an iodine-containing supplement (ICS) and median UIC values were 146µg/L (IQR 81-260) and 74µg/L (IQR 42-113) in ICS users and non-users, respectively (p < 0.001). Not using an ICS was an independent risk factor for iodine insufficiency [adjusted OR (95% CI) = 6.00 (2.74, 13.16); p < 0.001]. Iodised salt use was associated with increased median iodine-to-creatinine ratio (p < 0.014). A low compliance to iodine supplementation recommendation in pregnancy accounted for a mild-to-moderately iodine deficiency. Our results evidence the need to support iodine supplementation among pregnant women in countries with low household coverage of iodised salt. Trial registration number NCT04010708, registered on the 8th July 2019.

Factors Associated with Household Iodised Salt Use and Iodine Deficiency Among Nepalese School Children Aged 6-9 Years

Iodine deficiency is one of the world’s leading causes of delay in cognitive growth of children, and remains a public health problem, particularly in low-income countries including Nepal. This current study used cross-sectional data to examine factors associated with iodine deficiency and household iodised salt among Nepalese children. The source of data was the 2016 Nepal National Micronutrient Status Survey (NNMSS). Household iodised salt and urinary iodine were examined (by using and multivariate statistical models that adjust for clustering and sampling weights) against a set of non-biological and eating habits factors of 1153 Nepalese children aged 6-9 years. The mean household salt iodine concentrations (in ppm) in the Eastern, Central, Western, Mid-Western and Far-Western were 1.15 ± 1.6, 9.6 ± 2.6, 43.5 ± 12.9, 69.1 ± 3.7 and 85.6 ± 3.9 respectively. The corresponding median iron status of the children (and interquartile range IQR) in μg/l were 299 (177.6-569.2), 387.8 (197-604.8), 357.7 (203.8-566.7), 239.2 (140.3-493.1) and 238.5 (114.1-397.5) respectively. The likelihood of iodine deficiency was significantly higher among children from the Mountain ecological zone compared with those from the Terai zone [adjusted odds ratio (AOR): 0.02; 95% confidence interval (CI): (1.03, 1.49)]. Children who consumed dark green leafy vegetables were significantly less predisposed to iodine deficiency compared with those who did not [AOR: 0.87; 95% CI: (0.77, 0.99)]. The likelihood of household iodised salt use was significantly lower among children from the Far-Western region compared with those from the Eastern region [AOR: 0.81; 95% CI: (0.68, 0.97)]. The use of iodised salt was significantly more likely among children from rich households compared with those from poor households [AOR: 1.19; 95% CI: (1.06, 1.33)]. The likelihood of iodised salt use was significantly higher among households where children consumed meat compared with those in which children did not consume meat [AOR: 1.07; 95% CI: (1.01, 1.15)]. Among the development regions, it is only the Mid-Western region where household iodine concentration among the children was less than 75%. Appropriate interventions should be put in place to improve this situation. Interventions to improve household iodised salt use should target should also target children from poor households and those from households where children did not consume meat.

Iodine status of pregnant women residing in the urban Free State Province of South Africa is borderline adequate: The NuEMI study

Adequate iodine nutrition during pregnancy is essential for optimal fetal development and neonatal outcomes. In South Africa, the iodine status of pregnant women, who have increased iodine requirements, is under-researched. We hypothesized that the iodine status of pregnant women in the Free State Province would be inadequate and may differ between urban and rural areas. This cross-sectional study included 430 urban and 187 rural pregnant women visiting antenatal clinics in the Free State. Urinary iodine concentration (UIC) was determined using the modified Sandell‐Kolthoff reaction method, and serum thyroglobulin (Tg) was measured using the Q-Plex™ Human Micronutrient Array. Data on self-reported iodized salt use were collected using a questionnaire. Median (IQR) UIC was 155 (96-248) µg/L; 150 (94-235) µg/L in urban and 161 (106-256) µg/L in rural participants (P= 0.27), indicative of adequate iodine status. Median (IQR) Tg was 11.5 (7.1-20.4) µg/L, and was not significantly associated with UIC, even after controlling for maternal age and gestational age (urban P= 0.14; rural P= 0.48). The proportions of pregnant women who reported to use iodized household salt were 81% in urban and 70% in rural areas. Our results show that despite the widespread use of iodized salt, the median UIC of pregnant women residing in the urban Free State Province indicates only borderline adequate iodine status. A national iodine survey including pregnant women is recommended to determine the effectiveness of the South African salt iodization program in light of the current salt reduction policy.

Knowledge and Utilization of Iodized Salt and Associated Factors among Households of Fitche Town, Central Ethiopia, 2020: A Community based Cross-Sectional Study

Adequate knowledge and proper utilization of iodized salt in the household is a significant factor in the prevention of iodine deficiency disorders. This study was aimed at assessing knowledge and utilization of iodized salt and associated factors among the Fitche town community. A total of 470 individuals in the household were participated. About 58.6% of the respondents had good knowledge of iodized salt use and 52.6% use adequately iodized salt. Having higher monthly income [adjusted odds ratio (AOR)=2.97, 95%confidence interval (CI):1.05-8.42], having family health insurance [AOR=2.57, 95%CI:1.15-5.74] and being aware of iodine deficiency consequences [AOR=1.88, 95%CI:1.03-3.40)] were significantly associated with proper utilization of iodized salt. Besides, acquiring health advice on iodized salt [AOR=2.20, 95%CI:1.10-4.40] and educational status [AOR=0.14, 95%CI:0.03-0.56] were shown significant association with the knowledge of respondents on iodized salt use. Even though knowledge of iodized salt use in the study area is higher as compared to other findings, the coverage of proper iodized salt utilization is less than the world health organization recommendation of iodized salt use in households. Therefore, promoting the knowledge and utilization of iodized salt should be strengthened. Additionally, routine testing and monitoring for iodine levels in salt sold in the markets and used by households have enormous benefits.

Iodine Deficiency Disorders: Current State of the Problem in the Republic of Crimea

Background: The article presents the results of a control and epidemiological study conducted in September 2020 by specialists of the Federal State Budgetary Institution «NMIC of Endocrinology» of the Ministry of Health of Russia, aimed at assessing the current state of iodine provision in the population of the Republic of Crimea. The study in Crimea is part of a number of activities and work carried out on behalf of the Ministry of Health of the Russian Federation within the framework of state assignments «Scientific assessment of the need for additional regulatory legal and other measures to eliminate iodine deficiency in pilot regions with severe iodine deficiency» and «Epidemiological and molecular-cellular characteristics of tumor, autoimmune and iodine deficiency thyropathies as a basis for prevention of complications and personalization of treatment.The data obtained reflect the state of the problem of iodine consumption on the territory of the Crimean Peninsula and indicate the relevance of the adoption of a regional preventive program aimed at eliminating iodine deficiency in the diet of the population and related diseases.Aim: Assessment of iodine supply of the population of the Republic of CrimeaMaterials and methods: The research was carried out in secondary schools of four districts of the Republic of Crimea — in the years. Simferopol, Belogorsk, Bakhchisarai and Saki.The volume of the study — 356 schoolchildren of 8-10 years old, all were completed: taking anamnesis and anthropometric parameters (height, weight), examination by an endocrinologist with palpation of the thyroid gland (thyroid gland), ultrasound examination of the thyroid gland (thyroid ultrasound), obtaining single portions of urine and samples of table salt (5-10 grams), which is used daily in the diet in their families. The measurements of the height and weight of the children by the standard method were carried out during the examination by a specialist. Thyroid ultrasound was performed in the supine position using a portable LOGIQe ultrasound machine (China) with a 10-15 MHz multifrequency linear transducer. All urine samples (n = 356) in disposable Eppendorf microtubes were immediately frozen at a temperature of minus 20-25°! for further determination of the concentration of iodine in urine using the cerium-arsenite method (based on the clinical diagnostic laboratory of the Federal State Budgetary Institution NMITs endocrinology «of the Ministry of Health of Russia). A qualitative study for the presence of potassium iodate in food table salt samples (n = 203) was carried out on site by the express method.Informed consent was obtained from all parents / guardians of children for the examination and processing of personal data. The permission of the local ethical committee of the Federal State Budgetary Institution «NMIC of Endocrinology» of the Ministry of Health of Russia was received on March 25, 2020, No. 5.Results: According to the results of a survey of 356 children of primary school age, the median concentration of iodine in urine (mCIM) is 97 pg / l and varies from 78 to 98 pg / l in the surveyed areas, the proportion of urine samples with a reduced iodine concentration was 51.2%. The share of iodized salt use in the families of schoolchildren was 12.3% (values range from 10% to 15%). The average incidence of goiter in children according to ultrasound data is 9.5% (range of values from 1.7% to 16.3%).Conclusion.The indicator of the median concentration of iodine in urine indicates an insufficient iodine supply of the population of the Republic of Crimea.The prevalence of goiter in children of primary school age according to the ultrasound examination of the thyroid gland corresponds to the mild severity of iodine deficiency in the mild degree of goiter endemic in the region.The share of households using iodized salt is extremely low and amounts to 12.3%, which does not meet the WHO recommendations for regions with natural iodine deficiency (from 90% or more).

Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia

BackgroundIodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia.MethodsA systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger’s test.ResultsOne thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21–82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87–88.99) and in Amhara region is 60.93% (95% CI: 57.39–64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08–0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47–0.99) were found to have a significant association with iodine deficiency.ConclusionsThe prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem.

Modeling of iodine consumption with industrial processed foods made with iodized salt in the adults and pregnant in Armenia and Moldova

In recent years, significant progress has been made at the global level in eliminating of iodine deficiency. However, until recently, there has been a gap in methods for estimating iodine intake with industrially processed foods (IPF) produced with iodized salt (IS). The aim of this work was to study the iodine consumption with IPF and kitchen salt by the adult population and pregnant women in Armenia and Moldova. Material and methods. For modeling iodine consumption, a special matrix based on MS Excel spreadsheets was used, into which data on the average per capita daily consumption of the main IPF, salt content in IPF, the share of IPF produced with IS in the total volume of their consumption, percentage of households using IS, and the iodine content in salt according to the national standard were entered. Results and discussion. The estimated average daily salt consumption per capita of the adult population of Armenia was 10.6 g. Due to the use of IS in 93% of households and in the production of 82% of bakery products, 7% of cheese, 83% of meat products, 44% of canned vegetables and 5% of pasta, iodine intake in adults was 149% of the recommended daily allowance (RDA). Bakery products and iodized kitchen salt were the main sources of iodine (66 and 70% of the RDA respectively), and the share of other IPF did not exceed 13%. In Moldova, salt consumption was 11.9 g per day. Due to the use of IS for the production of 50% bakery products, 12% of canned vegetables and 20% of pasta, iodine consumption in adults in Moldova amounted to 74% of RDA almost entirely due to bakery products and kitchen salt (37 and 35% of the RDA respectively). The median urinary iodine concentration indicated adequate iodine intake in both countries and was significantly higher in Armenia (242 μg/L) than in Moldova (136 μg/L). A planned 30% reduction in salt intake may lead to an inadequate reduction in iodine intake in pregnant women. Conclusion. Adequate iodine intake among the adult population of Armenia and Moldova is ensured mainly through the use of IS in households and in the production of bakery products.

TSH Mediated the Effect of Iodized Salt on Child Cognition in a Randomized Clinical Trial.

Objectives:This study examines the hormonal mediators of the effect of iodized salt in pregnancy on child cognition.Methods:Sixty districts across 6 zones in the Amhara region of Ethiopia were randomly allocated to a control or intervention arm of early market access to iodized salt. Twenty-two villages per arm were randomly selected for this sub-study. A total of 1220 pregnant women who conceived after the intervention began were enrolled and assessed for their iodine and iron status. Data were collected once on the household socio-demographic status and iodized salt use, and maternal urinary iodine during pregnancy. Then, infants’ diet, urinary iodine level, cognitive development (Bayley III), serum hormonal levels, iron status, and inflammation markers were measured between 2 and 13 months of age.Results:The median maternal urinary iodine concentration was adequate and significantly higher in the intervention mothers than that of the controls (163 vs 121 µg/L, P < .0001). Intervention children compared to the control children had lower thyroid-stimulating hormone (TSH) (mean: 2.4 ± 1.0 µIU/mL vs 2.7 ± 1.0 µIU/mL, effect size = 0.18, P < .01) and thyroglobulin (Tg) (41.6 ± 1.0 ng/mL vs 45.1 ± 1.0 ng/mL, effect size = 0.14, P < .05). There was an interaction between the intervention and iron stores such that cognition was higher with iron (effect size = 0.28, 100 vs 94 IQ points). TSH was a partial mediator (12%) of the effect of the intervention on child cognition (Sobel z-score = 2.1 ± 0.06, P < .05).Conclusion:TSH partially mediated the effect of the iodized salt intervention on child cognition.

A study on the iodised salt use pattern amongst the slum dwellers in Kolkata

Background: Iodine deficiency disorders (IDD) are most important causes of preventable brain damage all over the world. Iodization of salt is used as a weapon to prevent IDD through national iodine deficiency disorders control programme and food safety and standards act, 2006 and regulations, 2011. Climatic condition, knowledge about storage and culinary practices pose a problem in maintaining adequate iodine level in salt at the consumer level.Methods: An observational, cross-sectional, descriptive study was carried out in the slum of Baghbazar under the service area of urban health and training centre, R.G. Kar medical college and hospital, Kolkata from 18 April to 30 April 2018. Households were chosen using simple random sampling and one adult representative from each household was interviewed with pre-designed pre-tested schedule.Results: 100% of the households were found to use iodised salt. 19.2% were aware that they were using iodised form of salt. 96.2% people keep the salt in covered container but only 7.7% of them knew that if kept uncovered iodine vaporises from salt. Moreover 40.4% of the respondents were found to keep salt open close to the oven during cooking with 86.5% of them not believing that this practice can have effect on the quality of the salt.Conclusions: Awareness regarding the effect of iodised salt on health, proper storage and use pattern should be initiated for desired sustainable change in practice and strict enforcement of law for curbing sale of non-iodised salt must be implemented so that IDD cease to be a serious public health problem.

Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population

(1) Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on the perinatal outcome. Aim: to assess the changes occurring in dietary iodine intake, potassium iodide supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). (2) Methods: Between 2009–2011, an observational study included a cohort of women whose pregnancies were monitored in the public health system in the Central and North Metropolitan areas of Catalonia. Women received individual educational counseling, a dietary questionnaire was completed, and a urine sample was collected for iodine determination at each trimester visit. (3) Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (≥150 μg/L) increased from the first to the second trimester and remained stable in the third (57.3%, 68.9%, 68%; p < 0.001). Analysis of the relationship between UIC ≥ 150 μg/L and the women’s dietary habits showed that the percentage with UIC ≥ 150 μg/L increased with greater consumption of milk in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. (4) Conclusion: During pregnancy, increased intake of milk, iodized salt, and iodine supplements were associated with an increase in the UIC.

Is iodized salt efficient to overcome iodine deficiency in pregnants?

Objective:Iodine is a trace element that synthesizes thyroid hormones necessary for optimal human growth and development. The relationship between dietary iodine intake and spot urinary iodine excretion in pregnant women has not been previously evaluated in Trabzon city, which is an endemic area of iodine deficiency in the Black Sea region of Turkey. This study aimed to evaluate the relationship between dietary iodine intake and urine iodine excretion in pregnant women.Materials and Methods:This study enrolled 150 pregnant women aged between 19 and 45 years who applied to Clinic of Gynecology and Obstetrics in Trabzon. Spot urine specimens were taken, and dietary iodine intake data were collected using a food frequency questionnaire (FFQ) and 24-hours dietary recall (24-h DR) method.Results:The median urinary iodine concentration (UIC) in the general specimen was 100.6 μg/L. Of the pregnant women, 80.0% had insufficient and 20.0% had sufficient iodine levels, according to UIC. Although total iodine-rich food intake determined by FFQ was sufficient in 20.7% (n=31) of participants, 24-h DR iodine intake was sufficient only 10.7% (n=16). A significant association between urinary iodine excretion and iodine intake was observed in both 24-h DR and FFQ intake estimates (p<0.05). The iodine intake values obtained in both 24-h DR and FFQ and the iodized salt effect were correlated with UIC in all models (p<0.05). Even though 96.0% of pregnant women used iodized salt, its effect on UIC was 15.2%.Conclusion:Both methods indicate that the iodine intake of pregnant women might be insufficient in Trabzon area. Also, although iodized salt use is high in pregnant women in Trabzon, it is not enough to prevent iodine deficiency.