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Survey of iodized salt coverage in areas with different water iodine concentrations and the iodine status of local women

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Abstract

Purpose

There were only two definitions of iodine-deficient (water iodine concentration < 10 μg/L) and iodine-excess areas (water iodine concentration > 100 μg/L) in China before 2020. Areas with water iodine concentration between 10 and 100 μg/L implement the same policy as iodine-deficient areas to provide iodized salt. The definition of iodine-adequate areas was formulated in 2020 for the first time. The paper aims to investigate the coverage rate of iodized salt (CR) in different areas defined according to the latest national standards, evaluate the iodine status of local women, and provide a basis for the revision and improvement of relevant policies.

Methods

A total of 1948 women aged 18–60 were recruited from the iodine extra-high areas (IEHA), iodine-excess areas (IEA), iodine-adequate areas (IAA), inland iodine-deficient areas (IIDA), and coastal iodine-deficient areas (CIDA). Information on daily diet was collected with the Food Frequency Questionnaire. Drinking water, salt, food, and urine samples were collected and tested in our laboratory. Based on the recommended daily iodine intake, we assessed whether the subjects' daily iodine intake levels were adequate.

Results

The CR and the median urinary iodine concentrations (UICs) were 4.02% and 98.03 μg/L in CIDA, 89.74% and 144.93 μg/L in IIDA, 26.55% and 178.60 μg/L in IAA, 8.78% and 446.5 μg/L in IEA, 3.95% and 605.4 μg/L in IEHA, respectively. The differences among these five areas were statistically significant (P < 0.0001). The daily dietary iodine intakes were mainly from drinking water in IAA (63.92%), IEA (92.29%), and IEHA (92.93%), and were mainly from iodized salt in IIDA (59.22%) and food in CIDA (86.6%).

Conclusion

Women in IAA and IIDA were in an adequate iodine state. Women in IEA and IEHA were in an iodine-excess state, and it is necessary to carry out water improvements projects. Women in CIDA were in a slight iodine-deficient state, and health education on scientific iodine fortification should be strengthened to increase iodine intake.

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Acknowledgements

We thank the Center for Disease Control and Prevention of Henan Province, Hebei Province, Shandong Province, and Zhejiang Province for their support and help in field investigations. We appreciate the participations of local women.

Funding

This work was supported by the National Health commission of the People’s Republic of China as part of the project "Iodine nutrition status assessment and thyroid disease survey".

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Authors and Affiliations

  1. National Health Commission Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No 155 Changbai Road, Changping District, Beijing, 100050, China

    Ying Zhang, Jianqiang Wang, Wei Ma, Xiuwei Li, Haiyan Wang & Jing Xu

Authors
  1. Ying Zhang
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  2. Jianqiang Wang
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  3. Wei Ma
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Contributions

JX and YZ were responsible for the study design. YZ performed the field investigation, the data analysis, and writing of the manuscript. WM took part in the field investigation and the data collection. JW, XL, and HW took part in the field investigation and laboratory detection of iodine. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Jing Xu.

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Conflict of interest

All authors declare that there are no conflicts of interest.

Ethical approval

The study has been approved by the Ethics Committee of National Institute of the Nutrition and Health of the Chinese Center for Disease Control and Prevention (2018-013). It has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All respondents agreed to participate in the study and signed informed consent.

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Zhang, Y., Wang, J., Ma, W. et al. Survey of iodized salt coverage in areas with different water iodine concentrations and the iodine status of local women. Eur J Nutr 62, 2919–2928 (2023). https://doi.org/10.1007/s00394-023-03198-6

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  • DOI: https://doi.org/10.1007/s00394-023-03198-6

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