Iodine and Selenium Intake in a Sample of Women of Childbearing Age in Palmerston North, New Zealand after Mandatory Fortification of Bread with Iodised Salt

Abstract

Iodine deficiency is a worldwide public health problem, which has long been observed in many parts of the world, including New Zealand (NZ). The aim of this study was to assess iodine and selenium intake among women of childbearing age in Palmerston North, New Zealand post mandatory fortification of bread with iodised salt. Fifty women of childbearing age completed a researcher-led questionnaire, including a semi-quantitative food frequency questionnaire. Iodine and selenium were analysed in 24-hour urine samples. The median urinary iodine concentration (UIC) was 65 μg/l with 30% below 50 μg/l; representing mild iodine deficiency according to the World Health Organization. The estimated median daily iodine intake (130 μg/day) was higher than the Estimated Average Requirement (100 μg/day) and higher than seen in women prior to fortification. The median excretion of selenium (32 μg/day) was slightly above level suggested as adequate (30 μg/day) and estimated median intake (57 μg/day) was higher than Estimated Average Requirement (50 μg/day). Selenium and iodine excretion were significantly correlated (Spearman’s rank order; r(50) = 0.547, p < 0.001). The major contributors to iodine intake were milk (36%), bread (25%) and fish/seafood (15%). Participants had a mean intake of 2.5 slices of bread/day, which contributed approximately 14 to 20 μg of iodine. The majority of participants (74%) had iodised salt at home, but less than half (48%) used iodised salt exclusively. In conclusion, despite the mandatory fortification of bread with iodised salt in NZ, UIC of the study population indicates iodine deficiency although their estimated dietary intakes appear adequate. It is essential that government initiatives to improve iodine status are evaluated for their efficacy.

Share and Cite:

N. Shukri, J. Coad, J. Weber, Y. Jin and L. Brough, "Iodine and Selenium Intake in a Sample of Women of Childbearing Age in Palmerston North, New Zealand after Mandatory Fortification of Bread with Iodised Salt," Food and Nutrition Sciences, Vol. 5 No. 4, 2014, pp. 382-389. doi: 10.4236/fns.2014.54046.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] M. Andersson, V. Karumbunathan and M. B. Zimmermann, “Global Iodine Status in 2011 and Trends over the Past Decade,” Journal of Nutrition, Vol. 142, No. 4, 2012, pp. 744-750.
http://dx.doi.org/10.3945/jn.111.149393
[2] M. B. Zimmermann, P. L. Jooste and C. S. Pandav, “Iodine-Deficiency Disorders,” Lancet, Vol. 372, No. 9645, 2008, pp. 1251-1262.
http://dx.doi.org/10.1016/S0140-6736(08)61005-3
[3] C. D. Thomson and S. Skeaff, “Chapter 129—Iodine Status and Deficiency Disorders in New Zealand,” In: R. P. Victor, N. B. Gerard and W. Ronald, Eds., Comprehensive Handbook of Iodine, Academic Press, San Diego, 2009, pp. 1251-1258.
http://dx.doi.org/10.1016/B978-0-12-374135-6.00129-1
[4] H. D. Purves, “The Aetiology and Prophylaxis of Endemic Goitre and Cretinism. The New Zealand Experience,” The New Zealand Medical Journal, Vol. 80, 1974, pp. 477-479.
[5] J. Mann and E. Aitken, “The Re-Emergence of Iodine Deficiency in New Zealand?” The New Zealand Medical Journal, Vol. 116, No. 1170, 2003, pp. 351-355.
[6] C. Thoma, J. Seal, D. Mackerras and A. Hunt, “Chapter 26-Iodine Fortification of Bread: Experiences from Australia and New Zealand,” In: P. Victor, W. Ronald and P. Vinood, Eds., Flour and Breads and their Fortification in Health and Disease Prevention, Academic Press, San Diego, 2011, pp. 281-291.
http://dx.doi.org/10.1016/B978-0-12-380886-8.10026-1
[7] WHO, UNICEF and ICCIDD, “Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination. A Guide for Programme Managers,” World Health Organization, Geneva, 2007.
[8] M. B. Zimmermann, “Iodine Deficiency in Pregnancy and the Effects of Maternal Iodine Supplementation on the Offspring: A Review,” The American Journal of Clinical Nutrition, Vol. 89, No. 2, 2009, pp. 668S-672S.
http://dx.doi.org/10.3945/ajcn.2008.26811C
[9] S. C. Bath, C. D. Steer, J. Golding, P. Emmet and M. P. Rayman, “Effect of Inadequate Iodine Status in UK Pregnant Women on Cognitive Outcomes in Their Children: Results from the Avon Longitudinal Study of Parents and Children (ALSPAC),” Lancet, Vol. 382, No. 9889, 2013, pp. 331-337.
http://dx.doi.org/10.1016/S0140-6736(13)60436-5
[10] K. L. Hynes, C. L. Blizzard, P. Otahal, A. J. Venn, J. A. Seal, R. Taylor, et al., “Mild Iodine Deficiency during Pregnancy Is Associated with Reduced Educational Outcomes in the Offspring: 9-Year Follow-Up of the Gestational Iodine Cohort,” Journal of Clinical Endocrinology & Metabolism, Vol. 98, No. 5, 2013, pp. 1954-1962.
http://dx.doi.org/10.1210/jc.2012-4249
[11] Food Standards Australia NZ. Food Standards Code, “Standard 2.1.1. Cereals and Cereal Products,” 2009.
http://www.comlaw.gov.au/Details/F2009C00811
[12] S. Schiess, P. J. Cressey and B. M. Thomson, “Predictive Modelling of Interventions to Improve Iodine Intake in New Zealand,” Public Health Nutrition, Vol. 15, No. 10, 2012, pp. 1932-1940.
http://dx.doi.org/10.1017/S1368980011003545
[13] Ministry of Health New Zealand, “Supplement (Tablet) to Take When Pregnant or Breastfeeding,” 2010.
www.health.govt.nz/our-work/life-stages/maternity-services/supplement-tablet-take-when-pregnant-or-breastfeeding
[14] C. D. Thomson, “Assessment of Requirements for Selenium and Adequacy of Selenium Status: A Review,” European Journal of Clinical Nutrition, Vol. 58, 2004, pp. 391-402.
http://dx.doi.org/10.1038/sj.ejcn.1601800
[15] C. D. Thomson, “Selenium and Iodine Intakes and Status in New Zealand and Australia,” British Journal of Nutrition, Vol. 91, No. 5, 2004, pp. 661-672.
http://dx.doi.org/10.1079/BJN20041110
[16] V. Triggiani, E. Tafaro, V. A. Giagulli, C. Sabba, F. Resta, B. Licchelli, et al., “Role of Iodine, Selenium and Other Micronutrients in Thyroid Function and Disorders,” Endocrine, Metabolic & Immune Disorders-Drug Targets, Vol. 9, No. 3, 2009, pp. 277-294.
http://dx.doi.org/10.2174/187153009789044392
[17] L. Brough, Y. Jin, N. H. Shukri, Z. R. Wharemate, J. L Weber and J. Coad, “Iodine Intake and Status during Pregnancy and Lactation before and after Government Initiatives to Improve Iodine Status, in Palmerston North, New Zealand: A Pilot Study,” Maternal & Child Nutrition, 2013.
http://dx.doi.org/10.1111/mcn.12055
[18] M. Nelson, M. Atkinson and J. Meyer, “Food Portion Size: A User’s Guide to the Photographic Atlas,” Ministry of Agriculture Fisheries and Food, London, 1997.
[19] P. A. Fecher, I. Goldmann and A. Nagengast, “Determination of Iodine in Food Samples by Inductively Coupled Plasma Mass Spectrometry after Alkaline Extraction,” Journal of Analytical Atomic Spectrometry, Vol. 13, No. 9, 1998, pp. 977-982. http://dx.doi.org/10.1039/a801671b
[20] R. S. Gibson, “Assessment of Iodine and Selenium Status,” In: R. S. Gibson, Ed., Principles of Nutritional Assessment, 2nd Edition, Oxford University Press, New York, 2005, pp. 750-766.
[21] WHO, ICCIDD and UNICEF, “Progress towards the Elimination of Iodine Deficiency Disorders,” World Health Organization, Geneva, 1999.
[22] M. Rose, R. Gordon and S. Skeaff, “Using Bread as a Vehicle to Improve the Iodine Status of New Zealand Children,” The New Zealand Medical Journal, Vol. 122, No. 1290, 2009, pp. 14-23.
[23] The New Zealand Institute for Crop & Food Research, “FOODfiles,” Crop & Food Research, Christchurch, 2006.
[24] WHO and FAO, “Vitamin and Mineral Requirements in Human Nutrition: Selenium,” World Health Organization, Geneva, 2004.
[25] M. B. Zimmermann and M. Andersson, “Assessment of Iodine Nutrition in Populations: Past, Present, and Future,” Nutrition Reviews, Vol. 70, No. 10, 2012, pp. 553-570.
http://dx.doi.org/10.1111/j.1753-4887.2012.00528.x
[26] University of Otago, MOH, “A Focus on Nutrition, Key Findings of the 2008/09 New Zealand Adult Nutrition Survey,” Ministry of Health NZ, Wellington, 2011.
http://www.health.govt.nz/publication/focus-nutrition-key-findings-2008-09-nz-adult-nutrition-survey
[27] L. B. Rasmussen, L. Ovesen, I. Bulow, T. Jorgensen, N. Knudsen, P. Laurberg, et al., “Evaluation of a SemiQuantitative Food Frequency Questionnaire to Estimate Iodine Intake,” European Journal of Clinical Nutrition, Vol. 55, No. 4, 2001, pp. 287-292.
http://dx.doi.org/10.1038/sj.ejcn.1601156
[28] S. A. Skeaff and E. Lonsdale-Cooper, “Mandatory Fortification of Bread with Iodised Salt Modestly Improves Iodine Status in Schoolchildren,” British Journal of Nutrition, Vol. 109, No. 6, 2013, pp. 1109-1113.
http://dx.doi.org/10.1017/S0007114512003236
[29] S. R. Mallard and L. A. Houghton, “Public Health Policy to Redress Iodine Insufficiency in Pregnant Women May Widen Sociodemographic Disparities,” Public Health Nutrition, 2013, pp. 1-9.
http://dx.doi.org/10.1017/S1368980013001626
[30] R. Vannoort and B. Thomson, “2009 New Zealand Total Diet Survey: Agricultural Compound Residues, Selected Contaminant and Nutrient Elements,” Ministry of Agriculture and Forestry NZ, Wellington, 2011.
[31] C. D. Thomson, A. J Colls, J. V. Conaglen, M. Macormack, M. Stiles and J. Mann, “Iodine Status of New Zealand Residents as Assessed by Urinary Iodide Excretion and Thyroid Hormones,” British Journal of Nutrition, Vol. 78, No. 6, 1997, pp. 901-912.
http://dx.doi.org/10.1079/BJN19970208
[32] MOH, “Eating for Healthy Adult New Zealanders/Te Kai Totika mo te Hunga Pakeke o Aotearoa. Breads and Cereal,” Ministry of Health NZ, Wellington, 2010.
[33] K. L. Hynes, C. L. Blizzard, P. Otahal, A. J. Venn, J. A. Seal, R. Taylor, et al., “Chapter 128—History of Iodine Deficiency in Schoolchildren in Tasmania, Australia,” In: R. P. Victor, N. B. Gerard and W. Ronald, Eds., Comprehensive Handbook of Iodine, Academic Press, San Diego, 2009, pp. 1233-1249.
http://dx.doi.org/10.1016/B978-0-12-374135-6.00128-X
[34] C. D. Thomson, S. K. McLachlan, A. M. Grant, E. Paterson and A. J. Lillico, “The Effect of Selenium on Thyroid Status in a Population with Marginal Selenium and Iodine Status,” British Journal of Nutrition, Vol. 94, No. 6, 2005, pp. 962-968. http://dx.doi.org/10.1079/BJN20051564
[35] L. B. Rasmussen, L. Schomburg, J. Kohrle, I. B. Pedersen, B. Hollenbach, A. Hog, et al., “Selenium Status, Thyroid Volume, and Multiple Nodule Formation in an Area with Mild Iodine Deficiency,” European Journal of Endocrinology, Vol. 164, 2011, pp. 585-590.
http://dx.doi.org/10.1530/EJE-10-1026
[36] K. Ashton, L. Hooper, L. J. Harvey, R. Hurst, A. Casgrain and S. J. Fairweather-Tait, “Methods of Assessment of Selenium Status in Humans: A Systematic Review,” The American Journal of Clinical Nutrition, Vol. 89, No. 6, 2009, pp. 2025S-2039S.
http://dx.doi.org/10.3945/ajcn.2009.27230F

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.