Poor knowledge and practices related to iodine nutrition during pregnancy and lactation in Australian women: pre- and post-iodine fortification.

A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007-2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification) and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%-62%). A low intake of fish and seafood resulted in this food group contributing only 3%-8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring.

Urinary sodium excretion, dietary sources of sodium intake and knowledge and practices around salt use in a group of healthy Australian women.

OBJECTIVE: Strategies that aim to facilitate reduction of the salt content of foods in Australia are hampered by sparse and outdated data on habitual salt intakes. This study assessed habitual sodium intake through urinary excretion analyses, and identified food sources of dietary sodium, as well as knowledge and practices related to salt use in healthy women. METHODS: Cross-sectional, convenient sample of 76 women aged 20 to 55 years, Wollongong, NSW. Data included a 24 hour urine sample, three-day food diary and a self-administered questionnaire. RESULTS: Mean Na excretion equated to a NaCl (salt) intake of 6.41 (SD=2.61) g/day; 43% had values <6 g/day. Food groups contributing to dietary sodium were: bread and cereals (27%); dressings/sauces (20%); meat/egg-based dishes (18%); snacks/desserts/extras (11%); and milk and dairy products (11%). Approximately half the sample reported using salt in cooking or at the table. Dietary practices reflected a high awareness of salt-related health issues and a good knowledge of food sources of sodium. CONCLUSION: These findings from a sample of healthy women in the Illawarra indicate that dietary sodium intakes are lower in this group than previously reported in Australia. However, personal food choices and high levels of awareness of the salt reduction messages are not enough to achieve more stringent dietary targets of <4 g salt per day. IMPLICATIONS: Urinary Na excretion data are required from a larger nationally representative sample to confirm habitual salt intakes. The bread and cereals food group are an obvious target for sodium reduction strategies in manufactured foods.

Poor iodine status and knowledge related to iodine on the eve of mandatory iodine fortification in Australia.

BACKGROUND: Mandatory fortification of bread with iodised salt is proposed to address the re-emergence of iodine deficiency in Australia and New Zealand. The impacts of fortification require baseline data of iodine status among vulnerable sectors of the population. OBJECTIVE: To assess the iodine status of healthy women and to investigate consumer understanding and attitudes related to the proposed mandatory iodine fortification programme. DESIGN: Cross-sectional sample of 78 non-pregnant women aged 20-55 y was conveniently sampled in Wollongong, NSW. A single 24-hr urine sample was collected for urinary iodine concentration (UIC). A self-administered questionnaire assessed consumer understanding, perceptions and attitudes related to iodine fortification. OUTCOMES: Median UIC = 56 microg/L (IQR = 41-68), indicating mild iodine deficiency. Knowledge about iodine was poor with less than half associating low iodine status with adverse pregnancy outcomes. Health education and supplementation, particularly at the medical practitioner interface, was considered the best strategy for improving low iodine levels. CONCLUSIONS: The iodine status of women in one region of New South Wales was low. These data add support to the need for a national approach to address iodine intake which includes an accompanying consumer education campaign.