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Iodine Status of Vulnerable Populations in Henan Province of China 2013–2014 After the Implementation of the New Iodized Salt Standard

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Abstract

The standard of salt iodine content in China has been adjusted several times since implementation of the universal salt iodization (USI) in 1995. The new standard of iodized salt content was adjusted from 35 ± 15 to 30 ± 9 mg/kg in Henan province in 2012. We aimed to determine whether the vulnerable populations were iodine sufficient after the adjustment of salt iodine content and to provide a guideline for the adjustment of USI policy in China. Two cross-sectional surveys of iodine status in vulnerable populations, including reproductive-age, pregnant and lactating women, infants <2 years, and children aged 8–10 years, were conducted in Henan province in 2013 and 2014. In 2013, the median urinary iodine concentration (mUIC) of reproductive-age women was 200.1 μg/L and that of school children aged 8–10 years was 221.0 μg/L. These mUICs were considered as “more than adequate.” The mUICs of reproductive-age women and school children in 2014 showed a significant decline compared to the mUICs in 2013 (P = 0.012 and P = 0.001, respectively). The mUICs of the pregnant women were 204.2 μg/L in 2013 and 202.5 μg/L in 2014, which both met the requirement level recommended by WHO. In 2013, the mUIC of lactating women was 169.1 μg/L and that of infants <2 years was 203.2 μg/L, which were significantly lower than that of 2014 (P < 0.001 and P < 0.001, respectively). The lactating women and infants in 2013 and 2014 were both regarded as “iodine adequate.” Iodine status of the vulnerable populations is still adequate as a whole in Henan province after decreasing the salt iodine content. However, the mUIC of school children aged 8–10 years is slightly above the adequate level. To reduce the risk of iodine excess in the general population and prevent the possibility of iodine deficiency of the vulnerable population, it is necessary to explore the appropriate level of iodized salt content.

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References

  1. Hetzel BS (1983) Iodine deficiency disorders (IDD) and their eradication. Lancet 2:1126–1129

    Article  CAS  PubMed  Google Scholar 

  2. Editorial L (1983) From endemic goiter to iodine deficiency disorders. Lancet 2:1121–1122

    Google Scholar 

  3. Campbell N, Dary O, Cappuccio FP, Neufeld LM, Harding KB, Zimmermann MB (2012) Collaboration to optimize dietary intakes of salt and iodine: a critical but overlooked public health issue. Bull World Health Organ 1:73–74. doi:10.2471/BLT.11.092080

    Article  Google Scholar 

  4. World Health Organization (2007) Assessment of iodine deficiency disorders and monitoring their elimination, 2nd edn. WHO, Geneva

    Google Scholar 

  5. Anderson M, Karumbunathan V, Zimmermann MB (2012) Global iodine status in 2011 and trends over the past decade. J Nutr 4:744–750. doi:10.3945/jn.111.149393

    Article  Google Scholar 

  6. Laurberg P, Bülow Pedersen I, Knudsen N, Ovesen L, Andersen S (2001) Environmental iodine intake affects the type of nonmalignant thyroid disease. Thyroid 5:457–469

    Article  Google Scholar 

  7. Zimmermann MB (2008) Iodine requirements and the risks and benefits of correcting iodine deficiency in populations. J Trace Elem Med Biol 22:81–92

    Article  CAS  PubMed  Google Scholar 

  8. WHO/UNICEF/ICCIDD (1996) Recommended iodine levels in salt and guidelines for monitoring their adequacy and effectiveness WHO/NUT96.13. WHO, Geneva

    Google Scholar 

  9. Shen H (2013) The problems and challenges for China after achieving the national elimination IDD standard. Chin J Prev Med 47:5–7(in Chinese)

    Google Scholar 

  10. Li S, Zheng Q, Xu J, Gorstein J, Wang H, Dong H (2011) Iodine excess or not: analysis on the necessity of reducing the iodine content in edible salt based on the national monitoring results. Asia Pac J Clin Nutr 20:501–506

    PubMed  Google Scholar 

  11. Zheng H, Li X, Yang J (2013) Investigation on iodine deficiency disoroders status in Henan province. Chin J Endemiol 5:35–37(in Chinese)

    Google Scholar 

  12. Yang J, Zheng H, Li X, Zhu L, Hao Z, Chen G, Wang Y (2014) Assessment of iodine status and associated factors in vulnerable populations in Henan Province, China, in 2012. Asia Pac J Clin Nutr 23:626–633

    PubMed  Google Scholar 

  13. China’s Ministry of health (2011) GB26878-2011 national food safety standards: iodine content in edible salt. Standards Press of China, Beijing(in Chinese)

    Google Scholar 

  14. UNICEF (2011) The state of the world’s children 2011: adolescence: an age of opportunity. United Nations Children’s fund, New York

    Google Scholar 

  15. Yang J, Zheng H, Chen G (2013) Iodine nutritional status of the vulnerable population in Henan province in 2011. Chin J Prev Med 1:14–17(in Chinese)

    Google Scholar 

  16. Zou Y, Lou X, Ding G, Z M, W Z, G M (2014) Iodine nutritional status after the implementation of the new iodized salt concentration standard in Zhejiang Province, China. BMC Public Health 14:836

    Article  PubMed  PubMed Central  Google Scholar 

  17. Yu J, Liu P, Liu Y, Liu SJ, Sun DJ (2014) Should both iodised and non-iodised salt be made available in Chinese cities? A cross-sectional survey. BMJ Open 4:e005397. doi:10.1136/bmjopen-2014-005397

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Stilwell G, Reynolds PJ, Parameswaran V, Blizzard L, Greenaway TM, Burgess JR (2008) The influence of gestational stage on urinary iodine excretion in pregnancy. J Clin Endocrinol Metab 5:1737–1742

    Article  Google Scholar 

  19. Brander L, Als C, Buess H, Haldimann F, Harder M, Hanggi W, Herrmann U, Lauber K, Niederer U (2003) Urinary iodine concentration during pregnancy in an area of unstable dietary iodine intake in Switzerland. J Endocrinol Investig 5:389–396

    Article  Google Scholar 

  20. Elnagar B, Eltom A, Wide L, Gebre-Medhin M, Karlsson FA (1998) Iodine status, thyroid function and pregnancy: study of Swedish and Sudanese women. Eur J Clin Nutr 52:351–355

    Article  CAS  PubMed  Google Scholar 

  21. Fuse Y, Ohashi T, Yamaguchi S, Yamaguchi M, Shishiba Y, Irie M (2011) Iodine status of pregnant and postpartum Japanese women: effect of iodine intake on maternal and neonatal thyroid function in an iodine-sufficient area. J Clin Endocrinol Metab 12:3846–3854. doi:10.1210/jc.2011-2180

    Article  Google Scholar 

  22. Rostami R, Beiranvand A, Khakhali H, Salary S, Aghasi M, Nourooz-Zadeh J (2012) Evaluation of accessibility of iodinated salt and nutritional iodine status during pregnancy. Iran J Public Health 8:56–60

    Google Scholar 

  23. Alvarez-Pedrerol M, Guxens M, Mendez M, Canet Y, Martorell R, Espada M, Plana E, Rebagliato M, Sunyer J (2009) Iodine levels and thyroid hormones in healthy pregnant women and birth weight of their offspring. Eur J Endocrinol 160:423–429

    Article  CAS  PubMed  Google Scholar 

  24. Kung AW, Lao TT, Chau MT, Tam SC, Low LCK (2000) Goitrogenesis during pregnancy and neonatal hypothyroxinaemia in a borderline iodine sufficient area. Clin Endocrinol 53:725–731

    Article  CAS  Google Scholar 

  25. Leung AM, Pearce EN, Braverman LE (2011) Iodine nutrition in pregnancy and lactation. Endocrinol Metab Clin N Am 40:765–777. doi:10.1016/j.ecl.2011.08.001

    Article  CAS  Google Scholar 

  26. Stilwell G, Reynolds PJ, Parameswaran V, Blizzard L, Greenaway TM, Burgess JR (2008) The influence of gestational stage on urinary iodine excretion in pregnancy. J Clin Endocrinol Metab 93:1737–1742

    Article  CAS  PubMed  Google Scholar 

  27. Andersson M, Aeberli I, Wüst N, Piacenza AM, Bucher T, Henschen I (2010) The Swiss iodized salt program provides adequate iodine for school children and pregnant women, but weaning infants not receiving iodine-containing complementary foods as well as their mothers are iodine deficient. J Clin Endocrinol Metab 95:5217–5224

    Article  CAS  PubMed  Google Scholar 

  28. U.S. Food and Drug Administration (1980) The Federal Food, Drug, and Cosmetic Act (FFDCA), 21U.S.C. §350a, Section 412. (i). Requirements for infant formula. Code of Federal Regulations

  29. Commission of the European Communities (2006) Commission Directive 2006/125/EC of December 5 2006 on processed cereal-based foods and baby foods for infants and young children. Official Journal of the European Union L 339:16–35

    Google Scholar 

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Acknowledgments

The authors thank the participating women and infants. We are grateful to the support of all the cooperating municipal- and county-level Centers for Disease Control and Prevention, including Zhengzhou, Kaifeng, Luoyang, Pingdingshan, Jiyuan, Anyang, Hebi, Xinxiang, Jiaozuo, Puyang, Xuchang, Luohe, Shangqiu, Zhoukou, Zhumadian, Nanyang, Xinyang, and Sanmenxia. We also thank all participating colleagues from the above organizations for their hard work. And we are very grateful to Dr. Chun-yu Liu (National Heart, Lung, and Blood Institute’s Framingham Heart Study) for the assistance in revising the final manuscript.

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Authors and Affiliations

  1. Department for Endemic Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, China

    Jin Yang, Lin Zhu, Xiaofeng Li, Heming Zheng, Zhe Wang, Yang Liu & Zongyu Hao

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  1. Jin Yang
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  2. Lin Zhu
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  3. Xiaofeng Li
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  4. Heming Zheng
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  5. Zhe Wang
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  6. Yang Liu
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  7. Zongyu Hao
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Correspondence to Jin Yang.

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Financial Support

This work was supported by grants from the Public Health transfer trust and the key scientific and technological project of Henan province (142102310390).

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The authors declare that they have no conflict of interest.

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Yang, J., Zhu, L., Li, X. et al. Iodine Status of Vulnerable Populations in Henan Province of China 2013–2014 After the Implementation of the New Iodized Salt Standard. Biol Trace Elem Res 173, 7–13 (2016). https://doi.org/10.1007/s12011-016-0619-1

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  • DOI: https://doi.org/10.1007/s12011-016-0619-1

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