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Use of iodized salt in the households improves the iodine status of pregnant women and school-age children in Donetsk, Ukraine: A double-blind randomized controlled trial

https://doi.org/10.14341/ket20117233-42

Abstract

This study analyzed the effect of iodized salt consumption on the iodine status of pregnant women and school children living in the households of Donetsk, Ukraine. 160 households with a healthy pregnant woman and a child aged 6–12 years were assigned in concealed sequence 1 : 1 to the use of either common or iodized salt. Casual urine samples were collected and the consumption of specific foods was obtained verbally from the women and the children during a baseline and a follow-up visit in each household. All the women (age 30 years; pregnancy duration 20 weeks) and the children (age 8.5 years) completed the trial without any adverse event. At the baseline visit, the mean household salt iodine content was 10.2 mg/kg (SD 3.1) and the median urinary iodine (UI) concentration in the women (89 μg/L) and the children (101 μg/L) was not significantly different. The salt iodine content during the trial in the experimental households was 43.3 mg/kg (SD 4.6) and starkly higher (p<0.001) than in comparison house- holds (11.4 mg/kg; SD 5.1). The final UI of the pregnant women (141μg/L; 95% CI: 123–163) in experimental households was lower (p < 0.05) than of the children (169μg/L; 95% CI: 147–194), but the net effect of iodized salt consumption on the UI levels of the women (73μg/L; 95% CI: 66–81) was significantly higher (p<0.01) than that of the children (59μg/L; 95% CI: 53–67). The baseline UI (in both groups), and the consumption of marine fish (both groups) and of dairy products other than cheese (in children) were significant effect modifiers. Introduction of iodized salt in the households of Donetsk was associated with adequate iodine intake in school-age children but it did not realize sufficient iodine intake in pregnant women, despite the greater net effect on the UI concentration in the latter group.

About the Authors

N Firsova

kand. med. nauk, vrach Donetskogo regional'nogo tsentra okhrany materinstva i detstva


der Van

professor Shkoly obshchestvennogo zdorov'ya Universiteta Emori, Atlanta, SShA


T Demina

doktor med. nauk, professor kafedry akusherstva, ginekologii i perinatologii FIPO Donetskiy meditsinskiy universitet


V Chaika

chlen.-korr. AMNU, doktor med. nauk, professor kafedry akusherstva, ginekologii i perinatologii FIPO Donetskiy meditsinskiy universitet


L Ivanova

rukovoditel' proekta, Predstavitel'stvo Detskogo fonda OON (YuNISEF) v Ukraine


O Trush

rukovoditel' proektov po voprosam pitaniya Predstavitel'stva Detskogo fonda OON (YuNISEF) v Ukraine


References

1. Allain P., Mauras Y., Dougé C. et al. Determination of iodine and bromine in plasma and urine by inductively coupled plasma mass spectrometry // Analyst. 1990. V. 115. P. 813–815.

2. Andersson M., de Benoist B., Delange F., Zupan J. (2007). Prevention and control of iodine deficiency in pregnant and lactat- ing women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. WHO Secretariat // Publ. Hlth. Nutr. V. 10 (12A). P. 1606–1611.

3. Berbel P., Obregón M.J., Bernal J. et al. Iodine supplementation during pregnancy: A public health challenge // Trends Endocr. Met. 2007. V. 18. P. 338–343.

4. Biloukha O.O., Utermohlen V. Correlates of food consumption and perceptions of foods in an educated urban population in Ukraine // Food Quality Pref. 2000. V. 11. P. 475–485.

5. Bland J.M., Altman D.G. Comparing methods of measurement: Why plotting difference against standard method is misleading // Lancet. 1995. V. 346. P. 1085–1087.

6. Bland J.M., Altman D.G. Transformations, means, and confidence intervals // Brit. Med. J. 1996. V. 312. P. 1079.

7. Commonwealth of Independent States (CIS) Secretariat. Agreement on the prevention of iodine deficiency disorders in CIS member states, signed by Heads of State of Azerbaijan, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russian Federation, Tajikistan, Uzbekistan and Ukraine. Minsk, CIS Secretariat, 2001.

8. Costeira M.J., Olivera P., Ares S. et al. Iodine status of pregnant women and their progeny in the Minho region of Portugal // Thyroid. 2009. V. 19. P.157–163.

9. Daly L.E. Confidence intervals and sample sizes / Ed. Altman D.G., Machin D., Bryant T.N., Gardner M.J, Statistics with confidence. 2nd ed. / Books Brit. Med. J. Bristol, 2000. P. 139–152.

10. Delange F. Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition // Publ. Hlth. Nutr. 2007. V. 10(12A). P. 1571–1580.

11. Food Standards Australia New Zealand. Proposal 1003: Mandatory iodine fortification for Australia assessment report. Canberra, Food Standards Australia – New Zealand, 2008.

12. Gerasimov G. Iodine deficiency disorders (IDD) in the Russian Federation. A review of policies toward IDD prevention and control and trends in IDD epidemiology (1950–2002). Moscow: UNICEF, 2002.

13. Glinoer D. The regulation of thyroid function during pregnancy: Pathways of endocrine adaptation from physiology to pathology // Endocr. Rev. 1997. V. 18 (3). P. 404–431.

14. Glinoer D. The regulation of thyroid function during normal pregnancy: Importance of the iodine nutrition status // Best. Pract. Res. Clin. Endocrinol. Met. 2004. V. 18. P. 133–152.

15. Glinoer D., Rovet J. Gestational hypothyroxinemia and the beneficial effects of early dietary iodine fortification // Thyroid. 2009. V. 19. P. 431–434.

16. Health Council of the Netherlands. Towards maintaining an optimum iodine intake. The Hague, Health Council of the Netherlands; publication no. 2008/14E.

17. Institute of Medicine, Academy of Sciences, USA. Dietary reference intakes of vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. Washington, DC: National Academy Press, 2001.

18. James W.P., Ralph A., Sanchez'Castillo C.P. The dominance of salt in manufactured food in the sodium intake of affluent societies // Lancet. 1987. V. 1 (8530). P. 426–429.

19. Jooste P.L., Weight M.J., Lombard C.J. Short-term effectiveness of mandatory iodization of table salt, at elevated iodine concentration, on the iodine and goiter status of schoolchildren with endem- ic goiter // Am. J. Clin. Nutr. 2000. V. 71. P. 75–80.

20. Kelly F.C., Snedden W.W. Prevalence and geographical distribution of endemic goitre. In: Endemic Goitre. Geneva, World Health Organization. WHO Monogr., 1960. Ser. 44. P. 27–233.

21. Kravchenko V.I., Karakashyan A.N., Lubyanova I.P., Kalachova I.V. Report of the national micronutrient survey Ukraine. Kiev: Acad. Med. Sci. Ukraine, 2004.

22. Leung A.M., Pearce E.N., Braverman L.E. Iodine content of prenatal multivitamins in the United States // N. Engl. J. Med. 2009. V. 60(9). P. 939–940.

23. Limbert E., Prazeres S., São P.M. et. al. and Thyroid Study Group of the Portuguese Endocrine Society. Iodine intake in Portuguese pregnant women: Results of a countrywide study // Eur. J. Endocr. 2010. V. 163. P. 631–635.

24. Marchioni E., Fumarola A., Calvanese A. et al. Iodine deficiency in pregnant women in an area with adequate iodine intake // Nutr. 2008. V. 24. P. 458–461.

25. Moleti M., Pio Lo Presti P., Campolo C. et al. Iodine prophylaxis using iodized salt and risk of maternal thyroid failure in conditions of mild iodine deficiency // J. Clin. Endocr. Met. 2009. V. 93(7). P. 2616–2621.

26. de Escobar M.G., Obregón M.J., Escobar del R.F. Role of thyroid hormone during early brain development // Eur. J. Endocr. 2004. V. 151. P. U25–U37.

27. de Escobar M.G., Obregón M.J., Escobar del R.F. Iodine deficiency and brain development in the first half of pregnancy // Publ. Hlth. Nutr. 2007. V. 10 (12A). P. 1554–1570.

28. Pino S., Fang S.L., Braverman L.E. Ammonium persulphate: A safe alternative oxidizing reagent for measuring urinary iodine // Clin. Chem. 1996. V. 42. P. 239–243.

29. Rasmussen L.B., Ovesen L., Christensen T.E. Iodine content in bread and salt in Denmark after iodization and the influence on iodine intake // Int. J. Sci. Nutr. 2007. V. 58. P. 231–239.

30. Restani P., Persico A., Ballabio C. et al. Analysis of food supplements containing iodine: A survey of Italian market // Clin. Toxicol. 2008. V. 46. P. 282–286.

31. Ristic'Medic D., Piskackova Z., Hooper L. et al. Methods of assessment of iodine status in humans: A systematic review // Am. J. Clin. Nutr. 2009. V. 89. P. 2052S–2069S.

32. Stanbury J.B. The Damaged Brain of Iodine Deficiency. New York: Cognizant Communication Corporation, 1994.

33. Vila L., Legaz G., Barrionuevo C. et al. Iodine status and thyroid volume changes during pregnancy: Results of a survey in Aran Valley (Catalan Pyrenees) // J. Endocr. Invest. 2008. V. 31. P. 851–855.

34. World Health Organization. Iodine status worldwide: WHO global database on iodine deficiency. Geneva: World Health Organization, 2004.

35. World Health Organization, UNICEF, International Council for Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. 3rd ed. Geneva: World Health Organization, 2007.

36. Wu T., Liu G.J., Li P., Clar C. Iodised salt for preventing iodine deficiency disorders (Review) // Cochr. Databas. Systemat. Rev. 2002. V. 3. P. 1–23.

37. Zhao J., Xu F., Zhang Q. et al. Randomized clinical trial comparing different iodine interventions in school children // Public. Healt. Nutr. 1999. V. 2. P. 173–178.

38. Zimmermann M.B., Moretti D., Chaouki N., Torresani T. Development of a dried whole-blood spot thyroglobulin assay and its evaluation as an indicator of thyroid status in goitrous children receiving iodized salt // Am. J. Clin. Nutr. 2003. V. 77. P. 1453–1458.

39. Zimmermann M., Delange F. Iodine supplementation of pregnant women in Europe: A review and recommendations // Eur. J. Clin. Nutr. 2004. V. 58. P. 979–984.

40. Zimmermann M.B., Aeberli I., Torresani T., Bürgi H. Increasing the iodine concentration in the Swiss iodized salt program markedly improved iodine status in pregnant women and children: A 5-y prospective national study // Am. J. Clin. Nutr. 2005. V. 82. P. 388–392.

41. Zimmermann M.B., de Benoist B., Corigliano S. et al. Assessment of iodine status using dried blood spot thyroglobulin: Development of reference material and establishment of an international reference range in iodine-sufficient children // J. Clin. Endocr. Met. 2006. V. 91. P. 4881–4887.

42. Zimmermann M.B. The impact of iodised salt or iodine supplements on iodine status during pregnancy, lactation and infancy // Publ. Hlth. Nutr. 2007. V. 10 (12A). P. 1584–1595.

43. Zimmermann M.B., Jooste P.L., Pandav C.S. Iodine-deficiency disorders // Lancet. 2008. V. 372. P. 1251–1262.

44. Zimmermann M.B. Iodine deficiency // Endocr. Rev. 2009. V. 30. P. 376–408.

45. Качан В. и др. “Стратегия устранения йодного дефицита в Республике Беларусь: оценка результатов 10-летней работы” // Клиническая и экспериментальная тиреоидология. 2010. Т. 6. №3. С. 30.


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 ,  ,  ,  ,  ,   Use of iodized salt in the households improves the iodine status of pregnant women and school-age children in Donetsk, Ukraine: A double-blind randomized controlled trial. Clinical and experimental thyroidology. 2011;7(2):33-42. (In Russ.) https://doi.org/10.14341/ket20117233-42

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