Evaluation of impact of dietary pattern on iodine and thyroid status of adolescent girls in Lahore

ABSTRACT

Study was designed to determine, inter alia, the impact of dietary pattern on the iodine status of adolescent girls' population in City District, Lahore. Cross-sectional study. The study was conducted in the Department of Nutrition and Dietetics, Institute of Public Health, Lahore from 21[st] March to 02[nd] June, 2009. It was a community based study conducted in the 66 public and private girls secondary schools situated within urban and rural areas of Capital City District, Lahore. The study population comprised adolescent school girls of age group 11-16 years in 09 administrative towns of Lahore. Multistage sampling technique was used. In first stage, 75 schools in Lahore were selected by simple random sampling. In second stage, 10 girls students of 11-16 years age from each school were selected by using the table of random number. 660 subjects were recruited for the study and urine samples were collected for urinalysis. In third stage, 01 girl student out of 10 from each school was randomly selected and her venous blood taken for TSH estimation. Data was collected through interview on predesigned and pretested questionnaire. Chi-squared, Fisher's exact and ANOVA tests were employed to determine the association between different variables. P-value <0.05 was considered significant except in case of impact of food items and goiter, where P value Results: Of sample population [n=660], 78.6% [519] had goiter of grade-0, whereas 8.8% [58] respondents having goiter of grade 01 A, 01B and 02 were found with lower UI level [iodine deficiency goiter] and 12.25% [81] had goiter of grade 01 A, 01B and 02 with optimal UI level, [physiological goiter]. The figure of 8.8% vis-a'-vis <05% recommended by WHO signified public health problem. Sea foods and dairy products showed a significant relationship with mean UI level, whereas no relationship between mean UI level -and- meat, cabbage, cauliflower, salad leaves, spinach, turnips, fruits and eggs could be ascertained. No relationship between sea foods, cauliflower, salad leaves, turnips, spinach, fruits, yogurt, cereals and eggs -and- goiter could be ascertained. However, meat, milk, butter and cabbage exhibited significant association with goiter. Percentage of UI deficient subjects using non-iodized salt was higher [60%] as compared to those [31%] with optimal UI level using the same. Contrary to that, the percentage of UI sufficient subjects using iodized salt [44%] was higher than those with deficient urinary iodine level [07%]. Statistical analysis P<0.001 confirmed definite impact of iodized salt on urinary iodine level. The goiter rate of 8.8% in the adolescent girls of Lahore with lower urinary iodine level invites the attention of policy makers and enforcing agencies. The findings of the studies were not in consonance with WHO, UNICEF, ICCIDD's criteria for monitoring progress towards the goal of ID elimination as public health problem and call for strict implementation of iodine fortification and supplementation programs in Lahore for the purpose of halting and reversing the upward trends of ID/ IDD