Establishment of a Regional Iodine Resource Laboratory and External Quality Assessment Program at the Kazakh Academy of Nutrition.

Objectives: The need for and lack of iodine resource laboratories in Central and Eastern Europe led to an agreement between the Centers for Disease Control and Prevention (CDC) and UNICEF for developing a regional iodine reference laboratory at the Kazakh Academy of Nutrition (KAN). Objectives included conducting reliable iodine measurements, KAN capacity strengthening, operating an external quality assurance (EQA) program, and self-sustainability. An underlying aim was ensuring quality laboratory data for management and decision-making of iodine disorder elimination programs. Methods: Creation of the laboratory at KAN was undertaken through technical support, training, funding, and material resources from CDC and UNICEF. Initial activities included building a fully-functioning laboratory, developing partnerships, and creating and operating a website and EQA program. Later activities included a landscape analysis, harmonized guidelines, an inaugural workshop attended by 17 regional laboratories, and a business sustainability plan. Results: The KAN reference laboratory was established and an operational plan is being implemented that will ensure sustainability. The plan includes contracts with the Kazakh government for multiple micronutrient analyses in four surveys, and fee-based trainings and assessments for regional laboratories as provided for Serbia, Kyrgyzstan, and Moldova. Participation in at least one EQA round by 78% of regional laboratories and consistent participation from 11/18 labs indicates that KAN assistance was well received. Conclusions: An up-to-date, high-quality reference laboratory and resource center for iodine assessments, led by technical experts capable of managing reliable iodine measurements in salt and urine and coordinating an EQA service for national iodine laboratories, has been established in the region.

The CDC Model for Biomonitoring of Iodine Status in Pregnant Women in the National Health and Nutrition Examination Survey.

Objectives: Iodine is a trace element involved in the metabolism of thyroid hormones, important for development and normal physiological function. Adequate iodine intake during pregnancy and lactation is especially critical to normal brain development in the fetus. Strategies to combat the prevalence of iodine deficiency disorders focus on ensuring adequate dietary intake.Dairy, grain, seafood, and to a lesser degree, iodized salt are the major dietary sources of iodine in the United States.Since 1971, National Health and Nutrition’s Examination Survey (NHANES) has measure urinary iodine in the United State population. A sizable decrease in urinary iodine concentrations (UIC) was detected between (1988-1994). This decline may have been due to the dairy industry’s effort in the mid-1980s to reduce the iodine residue in milk. Methods: NHANES is a program of studies designed to assess the health and nutrition status of adults and children in the United States. Results: CDC hasbeen continuously monitoring US iodine level since 2000. NHANES data indicates that the U.S. median UIC been relatively stable since the initial drop that had occurred from NHANES I to NHANES III. However some findings indicate that some pregnant women in the US do not appear to have an adequate iodine intake. Conclusions: Our iodine data supports the continued need to monitor the iodine status in the population because changes in patterns of dietary habit and iodine content in the food supply maynegatively affect populations at risk for iodine deficiency disorders.