Impact of use of iron fortified iodised salt beyond 12 months on haemoglobin levels

Background: Use of iron fortified iodised salt (IS) for 12 months, resulted in improvement in haemoglobin (Hb) in women, children and men. There is no published data on impact of DFS use beyond 12 months on Hb levels. Methods: A community based open randomised study to assess impact of use of DFS on Hb was discontinued after 12 months due to COVID 19 related lockdown. These families used IS for six months during lockdown; they were willing to continue using the salt provided for further one year. These families were re-randomized into three groups and given the assigned salt for further 12 months and Hb, ferritin and C-reactive protein (CRP) were estimated at 12 months. Results: Improvement in the mean Hb was 0.5 g/dl in women who had used IS earlier and DFS under second randomisation and 0.3 g/dl in those who had used DFS under first and second randomisation. Mean Hb at 30 months was higher in those who had used DFS for 24 months as compared to those who had used IS for 18 months and DFS for 12 months. The deterioration in mean Hb following discontinuation of DFS for 6 and 18 months was small. Conclusions: DFS use for the second year resulted in a further increase in Hb in those who had used DFS earlier. The relatively small deterioration in mean Hb following discontinuation of DFS might at least be in part due to the impact of nutrition and health education and access to health and nutrition services.

Impact of the use of iron-fortified iodized salt on hemoglobin levels: a community based open randomized trial

Background: In India prevalence of iron deficiency and anemia is high across all age, sex and physiological groups because of inadequate iron intake and poor bioavailability of iron from habitual Indian diets. Research studies in school-age children have shown that use of iron-fortified iodized salt (DFS) resulted in small improvement in Hb level; there are very few studies reporting impact of DFS use in women and men. Methods: A community-based open three arm randomised study was carried out to assess the impact of DFS use on Hb in women, men and children. The control group received iodised salt and two intervention groups received two formulations of DFS. Results: Socio-demographic and nutrition profile of the families, mean Hb, ferritin and C reactive protein levels of women, men and children at enrolment were comparable in all three groups. The DFS use for 12 months resulted in improvement in mean Hb in children (0.8 gm/dl) women (0.4 gm/dl) and men (0.3 gm/dl). Improvement in Hb was higher in anemic women, men and children. There was no change in mean Hb in non-anemic persons. There was a small improvement in ferritin in women who have low ferritin but no change in ferritin in women and men with normal ferritin. Conclusions: DFS may be a safe, feasible, affordable, and sustainable method for improving the iron intake and Hb status and accelerating India抯 progress towards the SDG goal of 50% reduction in prevalence of anemia.

Factors affecting to neonatal thyroid hormone deficiency in the era of the COVID-19 pandemic, Akat Amnuai district, Sakon Nakhon Province

Background: In the spread of COVID-19 Less exposure to iodine affects the health of the pregnant woman and fetus, causing miscarriages and premature births. low birth weight, anemia and hypothyroidism in newborns. Changes in levels of thyroid-stimulating hormone besides genetics, and many environmental factors can also affect thyroid function. This research aims to study the impact of environmental factors on thyroid-stimulating hormone in newborns.Methods: The sample consisted of 134 postpartum women randomly selected by simple method from 807 postpartum women in 2020-2022. The data were collected between June-July 2022 by interviewing social, environment, and household economy. Lifestyle, Iodine salt intake, drugs, iodine supplements and quality antenatal care correlation with Thyroid-stimulating hormone were determined by multiple logistic regression, adjusted odd ratio (ORadj), and 95%Confidence Interval (95% CI) were presented.Results: The results revealed that 67.7% were pregnant aged 20-34 years, 50.7% took iodized salt before pregnancy, 67.2% consumed during pregnancy, 45.5% received salt during antenatal care, 30.6% took folate(B9) before pregnancy,53.0%took antenatal care qualitatively and took iodine supplementation (57.5% daily intake, 29.9% intake 4-6 days/week, 11.9% intake 2-3 days/week). Most of them consume high iodine foods not variety and not frequent enough. High iodine supplements/diet intake, household income, COVID-19 infection, and antenatal care qualitatively were not significant. The significant correlation factor was not eating iodized salt, low education level and residing in the sub-district administrative organization. The results of the correlation analysis using Backward elimination showed that positively correlated with pregnant women whose husbands drink alcohol were hypothyroidism 0.3 times (95%CI=0.10-0.66), husbands smoking 0.4 times (95% CI=0.20-0.94, and pre-pregnancy malnutrition were 2.6 times (95%CI=1.17-5.74).Conclusions: The findings iodine affects to health of pregnant women and fetuses, Therefore, a more rigorous monitoring system for Iodized salt should be designed to encourage a higher rate of pregnant women to take iodine supplementation daily.

Coverage of qualified iodized salt in catering service units in Shanxi Province in 2021 / 中华地方病学杂志

Objective:To investigate the coverage of qualified iodized salt in catering service units where residents ate out in Shanxi Province, so as to provide a basis for taking targeted preventive measures timely and adjusting of intervention strategies scientifically, and to consolidate the achievements of eliminating iodine deficiency disorders (IDD) continuously.Methods:One prefecture level city from each of the five directions of east, west, south, north and middle in Shanxi Province in 2021 was selected. One mountainous county and one plain county were selected in each city. Each of the counties was divided into five sampled regions along five different geographic directions: east, west, south, north and middle. From each region, one town/street was selected randomly and then two canteens of enterprises and institutions (canteens), five medium-sized restaurants and five small restaurants were selected from each town/street. We investigated the basic information of catering service units, collected salt samples and then detected the iodine content of these salt samples. In addition, salt iodine testing data of county residents corresponding to catering service units in the 2021 iodine deficiency disorders monitoring were collected from the Shanxi Institute of Endemic Disease Prevention and Treatment, and compared with the survey results of catering service units.Results:A total of 660 salt samples were detected, the median value of salt iodine was 27.65 mg/kg, the coverage rate of iodized salt was 99.39%(656/660), and the coverage rate of qualified iodized salt was 90.76% (599/660). The median value of salt iodine was 26.70, 28.00 and 27.60 mg/kg in canteens, medium-sized restaurants and small restaurants, respectively, and the coverage rate of qualified iodized salt was 95.54% (107/112), 90.42% (236/261), and 89.20% (256/287), respectively. There was no significant difference in the coverage rate of qualified iodized salt among different types of catering service units (χ 2 = 3.92, P = 0.141). The median value of salt iodine was 28.00 and 27.20 mg/kg in mountainous counties and plain counties, respectively, and the coverage rate of qualified iodized salt was 88.67% (266/300) and 92.50% (333/360), respectively. There was no significant difference in the coverage rate of qualified iodized salt among the counties of different geographical types (χ 2 = 2.87, P = 0.090). The median value of salt iodine in catering service units and households was 27.65 and 23.50 mg/kg, respectively, and the coverage rate of qualified iodized salt was 90.76% and 95.91%, respectively. There was a statistically significant difference in the coverage rate of qualified iodized salt between catering service units and households (χ 2 = 31.19, P < 0.001). Conclusions:The coverage rate of qualified iodized salt in catering service units in Shanxi Province generally meets the national elimination standard (> 90%), but there are still some counties that do not meet the standard. The coverage rate of qualified iodized salt in small and medium-sized restaurants is also not optimistic. It is recommended to strengthen monitoring and supervision of edible salt in catering service units in the future.

Exploring the Status of Iodine Deficiency Disorders Control Program in Nagaland

Globally, 1.9 billion individuals have inadequate iodine nutrition, of whom 285 million are school?aged children. Universal salt iodization is the favored preventive strategy for iodine deficiency disorders (IDD), the single largest cause of preventable mental retardation. Two thousand and twenty estimates show nearly 1 billion people do not consume iodized salt. When at least 90% of households consume adequately iodized salt (?15 ppm), a country is said to have attained USI. Only 23 countries had household coverage of 90% or higher. India has a household coverage of 76.3%. One 67 million people are at risk of IDD, 54 million suffer from goiter, and 2 million from cretinism. Yearly, 9 million pregnant women and 8 million newborns are at risk. Nagaland, with the second highest coverage of iodized salt in India, the study aims to assess the state?specific approach, track various mitigating measures that effectively sustained the gains of the program.

Iodine nutrition and goiter prevalence among children at ages of 8 to 10 years in Zhejiang Province / 预防医学

Objective@#To investigate the status of iodine nutrition and prevalence of goiter among children at ages of 8 to 10 years in Zhejiang Province in 2021, so as to provide insights into the management of iodine deficiency in children.@*Methods @#A total of 90 counties (districts) were sampled as field survey sites from 11 cities of Zhejiang Province using a multi-stage stratified random sampling method in 2021, and non-residential children at ages of 8 to 10 years in these sites were sampled as study subjects. Subjects' household edible salt samples and random urine samples were collected. The iodine content in salt and urinary iodine level were determined using the direct titration method and arsenic-cerium catalytic spectrophotometry for evaluation of iodine nutrition among children. In addition, the lateral lobe of the thyroid gland was measured using ultrasound, and the prevalence of goiter was estimated. @*Results@#A total of 19 363 children were recruited, including 9 710 male children and 9 653 female children, with a male to female ratio of 1.01︰1, and there were 10 704 urban children (55.28%) and 8 659 rural children (44.72%), 9 149 children living in coastal areas (47.25%) and 10 214 children in inland regions (52.75%). The mean iodine content was (19.79±9.25) mg/kg in salt, and the coverage of qualified iodized salt (15 252) was 78.77%. The coverage of qualified iodized salt was significantly lower in urban children than in rural children (76.70% vs. 81.21%; χ2=68.301, P<0.001), and was lower in children living in coastal regions than in inland regions (68.05% vs. 88.27%; χ2=1 270.769, P<0.001). The median urinary iodine concentration was 195.1 μg/L, and the household iodine content in salt correlated positively with urinary iodine concentration in children (rs=0.383, P<0.001). There were 2 885 children with iodine deficiency (14.90%), 7 137 children with adequate iodine (36.86%), 5 414 children with excessive iodine intake (27.96%), and 3 927 children with iodine overdose (20.28%), and the distribution of iodine nutrition in children varied significantly in regions (χ2=283.277, P<0.001) and gender (χ2=126.349, P<0.001). The prevalence of goiter was 2.45% among 7 195 children receiving ultrasound examinations, and a higher prevalence rate of goiter was detected in urban children than in rural children (2.76% vs. 2.00%; χ2=3.962, P=0.047). @*Conclusions @#The overall urinary iodine nutrition was adequate among children at ages of 8 to 10 years in Zhejiang Province in 2021, and the prevalence of goiter in children fell within the threshold defined in the criteria of elimination of iodine deficiency. However, the supervision of the iodized salt quality remains to be improved and iodine deficiency control remains to be reinforced.

Investigation on salt sales and salt iodine content in Guizhou Province three years after the system reform of salt industry / 中华地方病学杂志

Objective:To understand the salt sales situation and salt iodine content in the market of Guizhou Province 3 years after the system reform of salt industry.Methods:From August to October 2020, in 9 cities (prefectures) of Guizhou Province, 2 counties (cities and districts) were selected from each city (prefecture), 1 urban area and 1 township were selected from each county (city and district), 1 large supermarket and 1 farmers' market were selected in the urban area, and 1 small supermarkets or convenience stores were selected in the township, to check the varieties, place of origin and iodine content label on the package of salt sold, and different brands of salt were collected and sent to the provincial and county salt iodine laboratories. The iodine content was determined and analyzed.Results:A total of 18 large supermarkets, 18 farmers' markets and 18 small supermarkets or convenience stores were investigated, and 70 salt samples of 23 brands, 3 types and origin from 11 provinces were collected. Among them, there were 56 samples with iodine content of 21 - 39 mg/kg on the package. The iodine content range of provincial detection was 19.23 - 37.41 mg/kg (two of them were lower than 21.0 mg/kg), and the median was 25.75 mg/kg. There were 12 samples of two iodine contents (18 - 33 and 21 - 39 mg/kg) marked on the package, and the salt iodine range of provincial detection was 23.52 - 32.90 mg/kg, with a median of 26.55 mg/kg. One sample was marked with 18 - 33 mg/kg, and the iodine content of provincial detection was 25.20 mg/kg; the iodine content of 1 sample of non-iodized salt was not detected. According to the actual test value, iodine contents of 68 samples were within the range of packaging marks, accounting for 97.14% of the total. Taking the provincial test results as a standard, the absolute value of the relative deviation of the provincial and county test results was 0 - 27.45%, the average deviation was 7.65%, and the coincidence rate was 91.43% (66/70). The county test results were acceptable.Conclusions:After the system reform of salt industry, there are many kinds of salt which come from many provinces, and more than 97% of the salt iodine content which is within the standard range of salt concentration in Guizhou Province.

Iodine nutritional status of 8-10 year-old school-age children after the implementation of new salt iodine standard in Suzhou / 公共卫生与预防医学

Objective To explore the iodine nutritional status among school-age children within 5 years of implementation of the new salt iodine standard in Suzhou, and to provide a basis for dynamically adjusting the salt iodization strategy. Methods The observation period (2012-2019) was divided into two sub-periods: the adjustment transition period (2012-2014) and the adjustment completion period (2015-2019). According to the “Jiangsu Iodine Deficiency Disease Surveillance Program”, household salt samples and urine samples of school-age children aged 8 to 10 years were collected to detect the content of salt iodine and urine iodine. The coverage rate of iodized salt, qualified iodized salt consumption rate, and the median urinary iodine were determined. Results Totally 2 893 and 9 132 salt samples were collected in the adjustment transition and adjustment completion periods, with the median salt iodine content being 26.50 and 23.20 mg/kg, respectively. The iodized salt coverage rates were 97.03% (2 807/2 893) and 91.01% (2 633/2 893), and the consumption rates of qualified iodized salt were 97.25% (8 881/9 132) and 93.93% (8 578/9 132), respectively, in the two periods. The differences between the coverage rate of iodized salt and the consumption rate of qualified iodized salt between the two periods were statistically significant (χ2=38.465, P2 trend= 17.528, P<0.01). During the adjustment transition period, the median urinary iodine content of school-age children in Suzhou was 215.61 μg/L , and the proportion of urine iodine value <50 μg/L was 1.5%, while during the adjustment completion period the median urinary iodine and proportion of urine iodine value <50 μg/L were 192.60 μg/L and 2.40%, respectively. The difference in urine iodine between the two periods was statistically significant (Z=-9.918, P<0.01); Conclusions Five years after the implementation of the new salt iodization standard, the iodine nutritional level of school-age children in Suzhou was generally at an appropriate level. However, there was no significant changes in iodine nutritional levels in some areas after the adjustment of the new standard, suggesting that surveillance on iodine nutrition should be continuously consolidated in the future.

Assessment of goitre among primary school children in district Chamba, Himachal Pradesh, India

Background: Goiter is one of the most visible manifestations of iodine deficiency disorders (IDD) that is caused due to overstimulation of thyroid as an adaptation to Iodine deficiency. IDD is among the major public health threats and important micronutrient deficiencies in developing countries.Methods: This cross-sectional study was conducted among 6-12 years school children in district Chamba of Himachal Pradesh from February to June 2019. The sample size of 336 was calculated and a total of 504 children from government schools were enrolled in the study. The assessment of goitre was done clinically by inspection and palpation of thyroid gland.Results: In this study, 504 school aged children of 6-12 yrs from district Chamba with mean age of 9±1.86 years were included. The prevalence of total goitre rate was 16% with mean age of 8.75±1.37 years. The highest prevalence (%) was observed in age of 10 years (28.4%) followed by 8 years and 9 years (25.9 % and 23.5% respectively).Conclusions: This study showed mild goitre prevalence in school aged children of 6-12 years in district Chamba of Himachal Pradesh. There is dire need of periodic survey to assess the magnitude of IDD in future.

A study to assess the prevalence of iodine deficiency disorders in Betul district, Madhya Pradesh, India

Background: Iodine deficiency disorders (IDD) constitute the single largest cause of preventable neurological damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. The study was conducted to assess the prevalence of goiter in school children aged 6-12 years, to estimate the urinary iodine excretion and to assess the level of iodine concentration in salt samples obtained from households of selected school children.Methods: Population proportionate to size sampling. Sample size was 90 primary school-going children of age 6-12 years in each selected village, total 2700 from 30 villages/wards in Betul district, Madhya Pradesh, India.Results: The prevalence of goiter among the 6-12 years children was found to be 32.06%. Females had higher prevalence compared to males. Of the 540 salt samples, 370 (68.4%) had iodine concentration ?15 ppm at household level.Conclusions: IDD is a mild public health problem in Betul district.

Giant Euthyroid Goitre: Clinical Profile as Seen in Otorhinolaryngology Department of a Tertiary Health Institution, in Northwestern Nigeria

Background: Goiter refers to a diffuse enlargement of thyroid gland. It has a high prevalence in adult population in endemic areas where iodized salt is not part of the regular diet.Aim: We report the clinical profile of giant goiters seen in a tertiary hospital in Northwestern Nigeria.Methods: A prospective study of all surgically operated cases of goiter carried out in a tertiary health hospital in Northwestern Nigeria, over a period of 6 years between January 2011 and December 2016. Bio data, duration of goiter, symptoms, geographical location, thyroid function tests, radiological reports and treatment were recorded and analyzed.Results: Ninety-Seven patients were operated for goitre during the study period. Out of these 19 (19.6%) were giant goitres weighing between 900g-3200g. There were 13 (68.4%) females and 6 (31.6%) males with M: F ratio of 1:2.2. Age range was between 39 –71 years with a mean age of 53.2 years. Prevalence was high in the 41-60 year age group. Duration of goiter in 13 (68.4%) of patients was between 11-20years. Retrosternal extension was observed in 7 (36.8%) patients. Tracheal deviation was the most common risk factor for respiratory complication in all the patients followed by tracheomalacia in 8(42.1%). Postoperative temporary Tracheostomy was carried out in 4(21.1%) of patients. Recurrent laryngeal nerve injury occurred in 2(10.5%). No mortality was recorded.Conclusion: Respiratory complications are commonly associated withgiant goiters, a pathology that is entirely preventive if diagnosed and managed at an early stage

A cross sectional study on proper use of iodized salt in communities of rural areas and its relevant factors in Prakasam district, Andhra Pradesh, India

Background: The coverage of adequately iodized salt in old Andhra Pradesh was 63.6%, which is below the national average. Despite of high coverage rural households were less likely to consume adequately iodized salt. Objectives were (1) to find out the use of iodized salt and practices among community and knowledge regarding iodine deficiency diseases (2) to test salt at the household level to assess level of iodine.Methods: Community based cross-sectional study conducted from July to December 2016 in RHTC, Maddipadu, Prakasam district. Proportionate households from four villages of this area were interviewed for the purpose of study. Factors related to use of iodized salt in the communities like type of salt using in houses, storage practices, practices during cooking, knowledge regarding iodine deficiency disorders were assessed. The salt was tested for iodine using iodine rapid test MBI kits. The data was collected using pre-tested questionnaire and analyzed by using SPSS 22.0 version.Results: Most of households (68.5%) were between 25-50 years age, 68% wives were illiterate and 48.5% wives involved in labor work. Majority (83.6%) of the families were using iodized packed salt, 75% had adequately iodized salt with ≥15 ppm and 25% with inadequate iodized salt <15ppm. Association between illiterate wives and poor knowledge regarding iodized salt found to be significant (p<0.005).Conclusions: Specific education regarding proper storage, handling, duration and the importance of iodized salt needs to be implemented to increase community awareness and to focus on behavior change communication to bring positive attitude toward utilization of iodized salt.

Assessment of the Magnitude of Goiter in the Age Group of 6-12 Years in district Bandipura of Kashmir Division

Introduction: Iodine deficiency disorders (IDD) has beenrecognized as a public health problem in India Enlargementof thyroid gland is the common manifestation of the IDDand goiter prevalence survey is used as diagnostic tool foridentifying areas of IDD. Failure to undertake early detectionand intervention measure results in secondary disablingconditions. Aim: In the present study we have estimated theprevalence of goiter in the age group of 6-12 years in districtBandipura of Jammu and Kashmir state, India and haveassessed type of salt consumed by the population.Material and Methods: This was a Cross-sectional studyconducted in Bandipura district of J and K state and the studywas conducted between July 2018 to October 2018. Samplingmethod was Gender stratified cluster sampling technique andthe sample size was based on a goiter prevalence of 30% and95% confidence interval. 30 clusters were selected and eachcluster included 90 children. Data was entered in Microsoftexcel and then analyzed using appropriate statistical software.Data was interpreted using percentages, means and SD.Results: The prevalence of grade 1 and grade 2 goitre inmales was 35.6% and 15.1% respectively whereas it was30.8% and 15.1% in females and the prevalence was morein males to the extent of 52.08% and in girls it was 49.23%.Goitre was found to be highest (51.7%) in subjects 12 yearsof age and lowest (40.6%) in subjects aged 7 years of age.There was a significantly higher goitre prevalence in childrenwho consumed crystalline/non-iodised salt than in childrenconsuming iodised salt. The TGR was 61.4% and 46.9% inchildren consuming non-iodised and iodised salt respectivelyConclusion: We conclude our study with the finding thatpopulation of Bandipura district in the north Kashmir isseverely iodine deficient. We recommended a major thrustin the implementation of NIDDCP in the said district withregular and continuous monitoring of iodine status.

Iodine from seaweed is used in salt industry in China / 中华地方病学杂志

With the increase of people's health concept,more and more natural healthy food appear in people's sight.The addition of seaweed iodine in salt not only meets the needs of human body function,but also satisfies the modem people's pursuit of quality life.There are many methods for determination and extraction of iodine from seaweed and preparation of seaweed iodized salt.The authors reviewed the measurement of seaweed iodine and the preparation of seaweed iodized salt.This will help to understand and appreciate the seaweed iodine extraction and the preparation of seaweed iodized salts.

National Iodine Deficiency Disorders Control Programme: Current status & future strategy

Iodine deficiency disorders (IDDs) constitute a significant public health problem globally. In India, the entire population is prone to IDDs due to deficiency of iodine in the soil of the sub-continent and thus both animal and plant source food grown on the iodine-deficient soil. IDDs encompass the spectrum of disability and disease and include goitre, cretinism, hypothyroidism, abortion, stillbirth, brain damage, learning disabilities, mental retardation, psychomotor defects, hearing and speech impairment. Iodine deficiency is known to be the single largest cause of preventable brain damage. IDDs with their causal association with brain development, cognition, and learning disabilities impair the human resource development and progress of the country. The children born in iodine-deficient regions on an average have 13.5 intelligence quotient (IQ) points lesser than children born in iodine-sufficient regions. IDD control programme in India is a public health success story, with 92 per cent of the population consuming iodized salt. The partnership between government agencies, academic institutions, salt industry, development agencies and civil society has been key to achieve this success story. The sustainable elimination of iodine deficiency in India is within reach, what is required is accelerated and coordinated effort by all key stakeholder at national and State level.

Constituent ratio and subtype changes of thyroid cancer in Guiyang during the 8 years before and after adjustment of iodized salt content / 中华内分泌代谢杂志

Objective To investigate the composition and pathological subtypes of thyroid cancer in patients with thyroid nodule surgery in Guiyang in recent 8 years, and to analyze their influencing factors. Methods A retrospective pathological analysis of 4 262 thyroid surgery cases in Affiliated Hospital of Guizhou Medical University during the 2009-2016 to investigate the proportion of thyroid cancer and pathological subtype. The iodine content of salt was reduced at the end of 2012 in Guiyang. 2009-2012 as the pre down-regulation group(n＝1 572), 2013-2016 as the after down-regulation group ( n＝2 690), then comparative analysis before and after the adjustment of the iodine content of salt composition of thyroid cancer and changes of pathological subtype was performed. Results From 2009 to 2016, the proportion of thyroid cancer were 17.08%, 17.52%,15.65%, 18.58%, 19.80%, 29.35%, 35.34%, and 48.33%, increased year by year (P＜0.05). Thyroid microcarcinoma were 2.14%, 4.74%, 3.40%, 3.65%, 3.80%, 7.03%, 9.10%, and 25.95%(P＜0.05). The constituent ratio of thyroid cancer after adjustment of salt iodine content was higher than before. Papillary thyroid carcinoma is the main pathological subtype before and after adjustment of salt iodine content. The proportion of female patients was higher than that of males. The age of patients with thyroid cancer after adjustmen was higher than before ( P＜0. 05). Conclusions In the past 8 years, the constituent ratio of thyroid cancer and thyroid microcarcinoma in Guiyang increased year by year. The reason may be related to the increase of radiation in the environment, the improvement of medical level and the higher detection rate of thyroid microcarcinoma. The relationship between iodine nutrition and thyroid cancer needs to be further studied.[Key words] Thyroid cancer; Thyroid microcarcinoma; Thyroid papillary carcinoma; Pathological type;Iodized salt; Iodine nutrition

Analysis of national surveillance results on iodized salt in non-high iodine areas in 2015 / 中华地方病学杂志

Objective To study the current prevention and control status of iodine deficiency disorders (IDD) and learn the current situation of iodized salt consumption at household level in non-high iodine areas in 2015,this surveillance was conducted.Methods In 2015,according to National Surveillance Program on Iodine Deficiency Disorders,the surveillance was conducted at county level in 31 provinces,municipalities,autonomous regions (provinces) and Xinjiang Production and Construction corps (Xinjiang Corps).In each county city,district,banner (county),5 townships were randomly selected according to their sub-area positions of east,west,south,north and center;4 villages were randomly sampled in each chosen township;15 households were randomly selected in each chosen village.Edible salt sample was collected from each household.The iodine level in salt was determined by direct titration;the salt samples from Sichuan and other enhanced salt samples were detected by arbitration.Results There were totally 2 840 counties that reported the surveillance data.In total,849 193 salt samples were examined,including 845 906 salts determined by direct titration and 3 287 samples determined only by semi-quantitative detection.Weighted by population,the national coverage rate of iodized salt was 98.37％.At provincial level,the coverage rate of iodized salt was higher than 95％ except Tianjin,Shanghai and Shandong.At county level,2 669 counties had a coverage rate of iodized salt higher than or equal to 95％,171 counties were lower than 95％,and 31 counties were less than 80％.The national consumption rate of qualified iodized salt was 94.57％ (except 11 counties in Tibet).At provincial level,the consumption rate of qualified iodized salt was higher than 90％ except Shanghai (66.84％),Tianjin (79.14％),Tibet (82.09％) and Qinghai (89.22％).At county level,totally 2 633 counties had a rate of qualified iodized salt higher than 90％,and 196 counties were lower than 90％.The mean of iodine content in iodized salt was (25.37 ± 4.57) mg/kg.At provincial level,the means of iodine content in iodized salt were in the range of 23.51-28.95 mg/kg and the variable coefficient (CV) was in the range of 12.17％-27.37％,the CV was higher than 15％ in 24 provinces and Xinjiang Corps.Conclusions The coverage rate of iodized salt and the qualified iodized salt at national level are in a good condition.However,the problem of non-iodized salt is still serious in some provinces.

Iodized salt consumption and iodine deficiency status in China: a cross-sectional study / 《全球健康杂志（英文）》

Objective:To monitor iodized salt consumption and evaluate iodine deficiency status in 2014 in China.Materials and Methods:In 2014,a nationwide cross-sectional survey was conducted in 31 provinces (in this study,provinces,autonomous regions and municipalities in Mainland China were named as provinces).Probability proportional to size sampling method was adopted to recruit children ages 8-10 and pregnant women.47,467 children's and 18,994 pregnant women's urine samples were collected and 47,706 children's thyroid volumes were examined.Iodine content in salt was determined with 46,900 edible salt samples from children's households;urinary iodine concentration (UIC) was tested from children and pregnant women's urine samples;thyroid volume of children was assessed by ultrasound.Results:The national coverage rate of iodized salt and consumption rate of qualified iodized salt were 96.3％ and 91.5％,respectively.Median iodine content in iodized salt was 25.2 mg/kg.In 22 of 31 provinces,the provincial coverage rates of iodized salt were over 95％.And consumption rates of qualified iodized salt were more than 90％ in 21 provinces.In this study,the national median urinary iodine concentration (MUIC) of children in China was 197.9 μg/L.At the provincial level,MUIC of children in 19 provinces was 100-199 μg/L,which in 12 provinces was 200-299 μg/L.The national MUIC of pregnant women in 2014 was 154.6 μg/L,slightly higher than the lower limit of the WHO criteria for adequate (150-249 μg/L).At the provincial level,MUIC of pregnant women in 18 provinces was 100-149 μg/L,which in 13 provinces was 150-249 μg/L.The national prevalence of goiter among children in 2014 was 2.6％,of which only Shandong province (5.6％) exceeded the national standard (5％).Conclusions:In China,iodine deficiency disorders (IDD) has been eliminated since 2005.And in 2014,the IDD-free status still remained.

Comprehensive assessment on iodine nutrition and dietary iodine intake among Shanghai residents / 上海预防医学

Objective To assess the changes in iodine status and dietary iodine intake among Shanghai residents since common salt was iodized 20 years ago.Methods As-CE Catalysis spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,wet nurse and adults of Shanghai between 1995 and 2015.B ultrasonic was used to determinate the thyroid volume of school-age children.And then the goiter rate was calculated.Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively.The survey was conducted by using 3 days 24-hour dietary questionnaire and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt.Results The median urine iodine concentration (UIC) of school age children was 72.3 μg/L in 1995,rose to 214-231 μg/L from 1997-1999,and then became stable between 100 μg/L and 200 μg/L since 2002.The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai.The median urine iodine of pregnant women was between 126.5 μg/L and 139.8 μg/L.The median UIC of other populations were all between 100 μg/L and 200 μg/L: with adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine was 138.4,123.1-131.1,150.1 and 125.6 μg/L.The qualified iodized salt at household consumption rate was 90% from 2001 to 2009,the percentage declined year by year from 2010.In the cases of all taking iodine salt,the median iodine intake volume for male aged 7-10,11-13,14-18 and over 18 was 200.3,235.5,252.7 and 215.4 μg/L;women aged 7-10,11-13,14-18 and over 18 was 193.0,213.8,208.3 and 186.1 μg/L.The contribution rate of iodine salt in the diet were 51.6%-54.1% and 49.1%-53% in men and women.Kelp,seaweed and fish and shrimp on the contribution of iodine are 7.6%-16.6% and 4.5%-7.4%.Conclusion In the past about 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level.However,the iodine nutrition of pregnant women was insufficient.As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodized in Shanghai to ensure residents'' needs for iodine and control the risk of iodine deficiency.

Relationship between Iodine Content in Household Iodized Salt and Thyroid Volume Distribution in Children / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To 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.</p><p><b>METHODS</b>Probability 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.</p><p><b>RESULTS</b>The 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.</p><p><b>CONCLUSION</b>With reduced salt iodization levels, the median urinary iodine concentration and median ThV of children decreased significantly, and the symmetry of the ThV distribution improved.</p>