Adequate Urinary Iodine Concentration among Infants in the Inland Area of Norway
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Ethical Considerations
2.3. Collection of Breast Milk and Urine Samples
2.4. Chemical Analyses
2.5. Infant Iodine Intake from Food and Supplements
2.6. Participant Characteristics and Independent Variables
2.7. Statistical Analyses
3. Results
3.1. General Characteristics
3.2. Dietary Iodine Intake
3.3. Urinary Iodine Concentration
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Zimmermann, M.B. The role of iodine in human growth and development. Semin. Cell Dev. Biol. 2011, 22, 645–652. [Google Scholar] [CrossRef]
- Pearce, E.N.; Lazarus, J.H.; Moreno-Reyes, R.; Zimmermann, M.B. Consequences of iodine deficiency and excess in pregnant women: An overview of current knowns and unknowns. Am. J. Clin. Nutr. 2016, 104 (Suppl. 3), 918s–923s. [Google Scholar] [CrossRef] [Green Version]
- World Health Organization. Iodine and Health, Geneva. 1994. Available online: https://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/WHO_NUT_94.4/en/ (accessed on 2 February 2021).
- Bougma, K.; Aboud, F.E.; Harding, K.B.; Marquis, G.S. Iodine and mental development of children 5 years old and under: A systematic review and meta-analysis. Nutrients 2013, 5, 1384–1416. [Google Scholar] [CrossRef] [Green Version]
- Dineva, M.; Fishpool, H.; Rayman, M.P.; Mendis, J.; Bath, S.C. Systematic review and meta-analysis of the effects of iodine supplementation on thyroid function and child neurodevelopment in mildly-to-moderately iodine-deficient pregnant women. Am. J. Clin. Nutr. 2020, 112, 389–412. [Google Scholar] [CrossRef] [PubMed]
- Nerhus, I.; Markhus, M.W.; Nilsen, B.M.; Øyen, J.; Maage, A.; Ødegård, E.R.; Midtbø, L.K.; Frantzen, S.; Kögel, T.; Graff, I.E.; et al. Iodine content of six fish species, Norwegian dairy products and hen’s egg. Food Nutr. Res. 2018, 62. [Google Scholar] [CrossRef] [Green Version]
- Devold, O.; Batt, F.; Closs, K. En strumaundersøkelse fra Modum. Nor. Mag. Lægevitenskap 1937, 7, 900–937. [Google Scholar]
- Nyström, H.F.; Brantsæter, A.L.; Erlund, I.; Gunnarsdottir, I.; Hulthén, L.; Laurberg, P.; Mattisson, I.; Rasmussen, L.B.; Virtanen, S.; Meltzer, H.M. Iodine status in the Nordic countries—Past and present. Food Nutr. Res. 2016, 60, 31969. [Google Scholar] [CrossRef] [PubMed]
- Brantsæter, A.L.; Knutsen, H.K.; Johansen, N.C.; Nyheim, K.A.; Erlund, I.; Meltzer, H.M.; Henjum, S. Inadequate iodine intake in population groups defined by age, life stage and vegetarian dietary practice in a Norwegian convenience sample. Nutrients 2018, 10, 230. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Brantsæter, A.L.; Abel, M.H.; Haugen, M.; Meltzer, H.M. Risk of suboptimal iodine intake in pregnant Norwegian women. Nutrients 2013, 5, 424–440. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Henjum, S.; Lilleengen, A.M.; Aakre, I.; Dudareva, A.; Gjengedal, E.L.; Meltzer, H.M.; Brantsæter, A.L. suboptimal iodine concentration in breastmilk and inadequate iodine intake among lactating women in Norway. Nutrients 2017, 9, 643. [Google Scholar] [CrossRef] [Green Version]
- Henjum, S.; Brantsæter, A.L.; Kurniasari, A.; Dahl, L.; Aadland, E.K.; Gjengedal, E.L.; Birkeland, S.; Aakre, I. Suboptimal iodine status and low iodine knowledge in young Norwegian women. Nutrients 2018, 10, 941. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dold, S.; Zimmermann, M.B.; Aboussad, A.; Cherkaoui, M.; Jia, Q.; Jukic, T.; Kusic, Z.; Quirino, A.; Sang, Z.; San Luis, T.O. Breast milk iodine concentration is a more accurate biomarker of iodine status than urinary iodine concentration in exclusively breastfeeding women. J. Nutr. 2017, 147, 528–537. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization (WHO); International Council for Control of Iodine Deficiency Disorders (ICCIDD); United Nations International Children’s Emergency Fund (UNICEF). Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers. 2007. Available online: https://apps.who.int/iris/bitstream/handle/10665/43781/9789241595827_eng.pdf (accessed on 10 March 2021).
- Nordic Council of Ministers. Nordic Nutrition Recommendations 2012: Integrating Nutrition and Physical Activity, 5th ed.; Nordisk Ministerråd: Copenhagen, Denmark, 2014; Available online: http://norden.diva-portal.org/smash/get/diva2:704251/FULLTEXT01.pdf (accessed on 3 February 2021).
- The Norwegian Scientific Committee for Food and Environment. Benefit and Risk Assessment of Iodization of Household Salt and Salt Used in Bread and Bakery Products. Opinion of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy of the Norwegian Scientific, VKM Report. 2020. Available online: https://vkm.no/download/18.c32c738172460c3c3d20b0a/1613123110904/Benefit%20and%20risk%20assessment%20of%20iodization%20of%20household%20salt%20and%20salt%20used%20in%20bread%20and%20bakery%20products.pdf (accessed on 5 February 2021).
- Groufh-Jacobsen, S.; Mosand, L.M.; Bakken, K.S.; Solvik, B.S.; Oma, I.; Gjengedal, E.L.; Brantsæter, A.L.; Strand, T.A.; Henjum, S. Mild to moderate iodine deficiency and inadequate iodine intake in lactating women in the inland area of Norway. Nutrients 2020, 12, 630. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bakken, K.S.; Oma, I.; Groufh-Jacobsen, S.; Solvik, B.S.; Mosand, L.M.; Langfjord, M.M.; Gjengedal, E.L.; Henjum, S.; Strand, T.A. The reliability of iodine concentration in diaper-retrieved infant urine using urine collection pads, and in their mothers’ breastmilk. Biomolecules 2020, 10, 295. [Google Scholar] [CrossRef] [Green Version]
- Butte, N.F.; Lopez-Alarcon, M.G.; Garza, C. Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant during the First Six Months of Life; World Health Organization: Geneva, Switzerland, 2002. [Google Scholar]
- Norwegian Food Safety Authority. Matvaretabellen. 2017. Available online: https://www.matvaretabellen.no (accessed on 2 February 2021).
- The Norweigian Directorate of Health. Infant and Toddler Diets—Nationwide Dietary Surveys. 2009. Available online: https://www.helsedirektoratet.no/rapporter/spedkost-og-smabarnskost-landsomfattende-kostholdsundersokelser (accessed on 2 February 2021).
- Garnweidner-Holme, L.; Aakre, I.; Lilleengen, A.M.; Brantsæter, A.L.; Henjum, S. Knowledge about iodine in pregnant and lactating women in the Oslo area, Norway. Nutrients 2017, 9, 493. [Google Scholar] [CrossRef] [Green Version]
- Dold, S.; Zimmermann, M.B.; Baumgartner, J.; Davaz, T.; Galetti, V.; Braegger, C.; Andersson, M. A Dose-response crossover iodine balance study to determine iodine requirements in early infancy. Am. J. Clin. Nutr. 2016, 104, 620–628. [Google Scholar] [CrossRef] [Green Version]
- Zimmermann, M.B.; Aeberli, I.; Andersson, M.; Assey, V.; Yorg, J.A.; Jooste, P.; Jukić, T.; Kartono, D.; Kusić, Z.; Pretell, E.; et al. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100–299 mug/L: A UNICEF/ICCIDD study group report. J. Clin. Endocrinol. Metab. 2013, 98, 1271–1280. [Google Scholar] [CrossRef]
- Zimmermann, M.B. Are weaning infants at risk of iodine deficiency even in countries with established iodized salt programs? Nestle Nutr. Instit. Workshop Ser. 2012, 70, 137–146. [Google Scholar]
- Völzke, H. The Krakow Declaration on iodine: Tasks and responsibilities for prevention programs targeting iodine deficiency disorders. Eur. Thyroid J. 2018, 7, 201–204. [Google Scholar] [CrossRef]
- Thomassen, R.A.; Kvammen, J.A.; Eskerud, M.B.; Júlíusson, P.B.; Henriksen, C.; Rugtveit, J. Iodine status and growth in 0–2-year-old infants with cow’s milk protein allergy. J. Pediatr. Gastroenterol. Nutr. 2017, 64, 806–811. [Google Scholar] [CrossRef]
- Aakre, I.; Markhus, M.W.; Kjellevold, M.; Moe, V.; Smith, L.; Dahl, L. Sufficient iodine status among Norwegian toddlers 18 months of age—Cross-sectional data from the Little in Norway study. Food Nutr. Res. 2018, 62. [Google Scholar] [CrossRef]
- Astrup, H.; Myhre, J.B.; Andersson, N.; Kristiansen, A.L. Småbarnskost 3. Landsomfattende Undersøkelse av Kostholdet Blant 2-Åringer i Norge. Folkehelseinstituttet og Universitetet i Oslo. Available online: https://www.fhi.no/globalassets/dokumenterfiler/rapporter/2020/kostholdsundersokelser/smabarnskost-3---barn-2-ars-alder.pdf (accessed on 15 March 2021).
- The Norwegian National Council of Nutrition. Anbefaling om Berikning Med Jod for å sikre et Tilstrekkelig Jodinntak i Befolkningen. 2021. Available online: https://www.helsedirektoratet.no/om-oss/organisasjon/rad-og-utvalg/nasjonalt-rad-for-ernaering/Anbefaling%20om%20beriking%20med%20jod%20for%20å%20sikre%20et%20tilstrekkelig%20jodinntak%20i%20befolkningen,%20Nasjonalt%20råd%20for%20ernæring,%20februar%202021.pdf/_/attachment/inline/bae79a56-041d-4ccf-8b29-eb75b7e69d05:667ba7fee811d9232d4bea9634744de99190b543/Anbfaling%20om%20beriking%20med%20jod%20for%20å%20sikre%20et%20tilstrekkelig%20jodinntak%20i%20befolkningen,%20Nasjonalt%20råd%20for%20ernæring,%20feruar%202021.pdf (accessed on 15 March 2021).
- Andersen, L.F.; Lande, B.; Trygg, K.; Hay, G. Validation of a semi-quantitative food-frequency questionnaire used among 2-year-old Norwegian children. Public Health Nutr. 2004, 7, 757–764. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Azizi, F.; Smyth, P. Breastfeeding and maternal and infant iodine nutrition. Clin. Endocrinol. 2009, 70, 803–809. [Google Scholar] [CrossRef] [PubMed]
- Burrows, T.L.; Ho, Y.Y.; Rollo, M.E.; Collins, C.E. Validity of dietary assessment methods when compared to the method of doubly labeled water: A systematic review in adults. Front. Endocrinol. 2019, 10, 850. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Characteristic | Categories | n (%) a |
---|---|---|
Maternal age, mean (SD) | 31.5 (4.6) | |
Maternal educational level | <12 years | 6 (5) |
12 years | 17 (13) | |
1–4 years college/university | 52 (40) | |
>4 years college/university | 55 (42) | |
Maternal BMI, kg/m2 | <18.5 (Underweight) | 4 (3) |
18.5–24.9 (Normal weight) | 81 (62) | |
25–29.9 (Overweight) | 30 (23) | |
>30 (Obese) | 15 (12) | |
Maternal iodine knowledge score | Poor (0–5) | 10 (8) |
Low (6–11) | 17 (13) | |
Medium (12–19) | 69 (53) | |
High (20–26) | 34 (26) | |
Maternal use of iodine-containing supplement last 24-h | Yes | 30 (23) |
Infant age in weeks, median (min–max) | 22 (1–5) | |
Infant gender | Boy | 69 (53) |
Breastfeeding status b | Weaned | 28 (22) |
Partially | 46 (35) | |
Exclusively | 56 (43) |
Total n = 130 | Exclusively Breastfed n = 56 | Partially Breastfed n = 46 | Weaned n = 28 | |
---|---|---|---|---|
Infant urinary iodine concentration, µg/L | 146 (93, 250) | 130 (78, 210) | 135 (89, 250) | 210 (130, 330) |
Total habitual iodine intake, µg/day | - | - | 21 (6, 37) a | 34 (14, 87) |
Total 24-h iodine intake, µg/day | 50 (31, 78) | 66 (44, 107) | 57 (35, 77) | 25 (13, 39) |
Independent Variables | ß and 95% CI a | |
---|---|---|
Maternal age in Years | 3.7 | −1.2, 9.3 |
Maternal educational level | ||
<12 years | Reference | |
12 years | 0.0 | −1.3, 0.9 |
1–4 years college/university | 0.2 | −1.9, 2.4 |
>4 years college/university | 0.3 | −1.6, 2.1 |
Maternal BMI, kg/m2 | ||
18.5–24.9 (Normal weight) | Reference | |
<18.5 (Underweight) | 3.6 | −2.1, 9.4 |
25–29.9 (Overweight) | −1.2 | −10.4, 7.8 |
>30 (Obese) | 1.9 | −3.7, 6.8 |
Maternal iodine knowledge score | ||
Poor (0–5) | Reference | |
Low (6–11) | 4.7 | −2.1, 13.8 |
Medium (12–19) | −3.2 | −10.2, 5.4 |
High (20–26) | 4.7 | −2.1, 10.8 |
Maternal use of supplement last 24 h, yes | −0.3 | −7.7, 6.9 |
Infant age in weeks | 1.4 | −0.2, 2.7 |
Infant gender, boy | 3.1 | −7.7, 13.2 |
Breastfeeding status | ||
Weaned | Reference | |
Partially | −70.2 | −121.8, −24.5 |
Exclusively | −79.6 | −141.6, −36.5 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bakken, K.S.; Aarsland, T.E.; Groufh-Jacobsen, S.; Solvik, B.S.; Gjengedal, E.L.F.; Henjum, S.; Strand, T.A. Adequate Urinary Iodine Concentration among Infants in the Inland Area of Norway. Nutrients 2021, 13, 1826. https://doi.org/10.3390/nu13061826
Bakken KS, Aarsland TE, Groufh-Jacobsen S, Solvik BS, Gjengedal ELF, Henjum S, Strand TA. Adequate Urinary Iodine Concentration among Infants in the Inland Area of Norway. Nutrients. 2021; 13(6):1826. https://doi.org/10.3390/nu13061826
Chicago/Turabian StyleBakken, Kjersti Sletten, Tonje Eiane Aarsland, Synne Groufh-Jacobsen, Beate Stokke Solvik, Elin Lovise Folven Gjengedal, Sigrun Henjum, and Tor Arne Strand. 2021. "Adequate Urinary Iodine Concentration among Infants in the Inland Area of Norway" Nutrients 13, no. 6: 1826. https://doi.org/10.3390/nu13061826