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Non-salt Food Fortification Programs

  • Peter Laurberg
  • Lone Banke RasmussenEmail author
Chapter
  • 586 Downloads

Abstract

Both high and low population iodine intake increase the risk of thyroid disease in a population. This should be taken into account when planning iodine fortification programs. A number of methods are available to adjust iodine content of diet, among them the most important non-salt targets for fortification are bread and dairy products. Monitoring and adjusting population iodine intake is important for public health.

Keywords

Iodine Thyroid disease Hyperthyroidism Hypothyroidism Goiter Food fortification Public health Bread fortification Bread iodization Water iodine Milk iodine Iodine biofortification 

References

  1. 1.
    Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21:1081–25.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Andersen SL, Olsen J, Laurberg P. Foetal programming by maternal thyroid disease. Clin Endocrinol. 2015;83:751–8.CrossRefGoogle Scholar
  3. 3.
    Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab. 2010;24:13–27.CrossRefPubMedGoogle Scholar
  4. 4.
    Laurberg P, Pedersen KM, Hreidarsson A, Sigfusson N, Iversen E, Knudsen PR. Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland. Denmark J Clin Endocrinol Metab. 1998;83:765–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Biondi B, Bartalena L, Cooper DS, Hegedus L, Laurberg P, Kahaly GJ. The 2015 European thyroid association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. Eur Thyroid J. 2015;4:149–63.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Hetzel BS, Dunn JT. The iodine deficiency disorders: their nature and prevention. Annu Rev Nutr. 1989;9:21–38.CrossRefPubMedGoogle Scholar
  7. 7.
    WHO. Guideline: sodium intake for adults and children. Geneva: World Health Organization (WHO); 2012.Google Scholar
  8. 8.
    Rasmussen LB, Ovesen L, Bulow I, Jorgensen T, Knudsen N, Laurberg P, et al. Dietary iodine intake and urinary iodine excretion in a Danish population: effect of geography, supplements and food choice. Br J Nutr. 2002;87:61–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Rasmussen LB, Ovesen L, Bulow I, Jorgensen T, Knudsen N, Laurberg P, et al. Evaluation of a semi-quantitative food frequency questionnaire to estimate iodine intake. Eur J Clin Nutr. 2001;55:287–92.CrossRefPubMedGoogle Scholar
  10. 10.
    Portulano C, Paroder-Belenitsky M, Carrasco N. The Na+/I symporter (NIS): mechanism and medical impact. Endocr Rev. 2014;35:106–49.Google Scholar
  11. 11.
    Flachowsky G, Franke K, Meyer U, Leiterer M, Schone F. Influencing factors on iodine content of cow milk. Eur J Nutr. 2014;53:351–65.CrossRefPubMedGoogle Scholar
  12. 12.
    Phillips DI. Iodine, milk, and the elimination of endemic goitre in Britain: the story of an accidental public health triumph. J Epidemiol Community Health. 1997;51:391–3.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Nystrom HF, Brantsaeter AL, Erlund I, Gunnarsdottir I, Hulthen L, Laurberg P, et al. Iodine status in the Nordic countries – past and present. Food Nutr Res. 2016;60:31969.CrossRefPubMedGoogle Scholar
  14. 14.
    Laurberg P, Andersen S, Knudsen N, Ovesen L, Nohr SB, Bulow PI. Thiocyanate in food and iodine in milk: from domestic animal feeding to improved understanding of cretinism. Thyroid. 2002;12:897–902.CrossRefPubMedGoogle Scholar
  15. 15.
    Weiss WP, Wyatt DJ, Kleinschmit DH, Socha MT. Effect of including canola meal and supplemental iodine in diets of dairy cows on short-term changes in iodine concentrations in milk. J Dairy Sci. 2015;98:4841–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Pedersen AN, Christensen T, Matthiesen J, Knudsen VK, Sørensen MR, Biltoft-jensen A, et al. Dietary habits in Denmark 2011–2013. Copenhagen: DTU fødevareinstitutet; 2015.Google Scholar
  17. 17.
    Rasmussen LB, Ovesen L, Bulow I, Jorgensen T, Knudsen N, Laurberg P, et al. Relations between various measures of iodine intake and thyroid volume, thyroid nodularity, and serum thyroglobulin. Am J Clin Nutr. 2002;76:1069–76.PubMedGoogle Scholar
  18. 18.
    Krejbjerg A, Bjergved L, Bulow Pedersen I, Carle A, Knudsen N, Perrild H, et al. Serum thyroglobulin as a biomarker of iodine deficiency in adult populations. Clin Endocrinol. 2016; 2016;85(3):475–82.Google Scholar
  19. 19.
    Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Carle A, Pedersen IB, et al. Thyroglobulin as a marker of iodine nutrition status in the general population. Eur J Endocrinol. 2009;161:475–81.CrossRefPubMedGoogle Scholar
  20. 20.
    Krejbjerg A, Bjergved L, Pedersen IB, Carle A, Knudsen N, Perrild H, et al. Serum thyroglobulin before and after iodization of salt: an 11-year DanThyr follow-up study. Eur J Endocrinol. 2015;173:573–81.CrossRefPubMedGoogle Scholar
  21. 21.
    Katagiri R, Asakura K, Sasaki S, Hirota N, Notsu A, Miura A, et al. Estimation of habitual iodine intake in Japanese adults using 16 d diet records over four seasons with a newly developed food composition database for iodine. Br J Nutr. 2015;114:624–34.CrossRefPubMedGoogle Scholar
  22. 22.
    Kim JY, Moon SJ, Kim KR, Sohn CY, Oh JJ. Dietary iodine intake and urinary iodine excretion in normal Korean adults. Yonsei Med J. 1998;39:355–62.CrossRefPubMedGoogle Scholar
  23. 23.
    WHO, UNICEF, ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. 3rd ed. Geneva: World Health Organization; 2007.Google Scholar
  24. 24.
    Usydus Z, Szlinder-Richert J, Polak-Juszczak L, Komar K, Adamczyk M, Malesa-Ciecwierz M, et al. Fish products available in Polish market – assessment of the nutritive value and human exposure to dioxins and other contaminants. Chemosphere. 2009;74:1420–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Pedersen KM, Laurberg P, Nohr S, Jorgensen A, Andersen S. Iodine in drinking water varies by more than 100-fold in Denmark. Importance for iodine content of infant formulas. Eur J Endocrinol. 1999;140:400–3.CrossRefPubMedGoogle Scholar
  26. 26.
    Rasmussen LB, Larsen EH, Ovesen L. Iodine content in drinking water and other beverages in Denmark. Eur J Clin Nutr. 2000;54:57–60.CrossRefPubMedGoogle Scholar
  27. 27.
    Laurberg P, Jorgensen T, Perrild H, Ovesen L, Knudsen N, Pedersen IB, et al. The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives. Eur J Endocrinol. 2006;155:219–28.CrossRefPubMedGoogle Scholar
  28. 28.
    Carle A, Laurberg P, Pedersen IB, Knudsen N, Perrild H, Ovesen L, et al. Epidemiology of subtypes of hypothyroidism in Denmark. Eur J Endocrinol. 2006;154:21–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Andersen S, Pedersen KM, Iversen F, Terpling S, Gustenhoff P, Petersen SB, et al. Naturally occurring iodine in humic substances in drinking water in Denmark is bioavailable and determines population iodine intake. Br J Nutr. 2008;99:319–25.PubMedGoogle Scholar
  30. 30.
    Szabolcs I, Podoba J, Feldkamp J, Dohan O, Farkas I, Sajgo M, et al. Comparative screening for thyroid disorders in old age in areas of iodine deficiency, long-term iodine prophylaxis and abundant iodine intake. Clin Endocrinol. 1997;47:87–92.CrossRefGoogle Scholar
  31. 31.
    Shen H, Liu S, Sun D, Zhang S, Su X, Shen Y, Han H. Geographical distribution of drinking-water with high iodine level and association between high iodine level in drinking-water and goitre: a Chinese national investigation. Br J Nutr. 2011;106:243–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Elnagar B, Eltom M, Karlsson FA, Bourdoux PP, Gebre-Medhin M. Control of iodine deficiency using iodination of water in a goitre endemic area. Int J Food Sci Nutr. 1997;48:119–27.CrossRefPubMedGoogle Scholar
  33. 33.
    Squatrito S, Vigneri R, Runello F, Ermans AM, Polley RD, Ingbar SH. Prevention and treatment of endemic iodine-deficiency goiter by iodination of a municipal water supply. J Clin Endocrinol Metab. 1986;63:368–75.CrossRefPubMedGoogle Scholar
  34. 34.
    Wiersinga WM, Podoba J, Srbecky M, van Vessem M, van Beeren HC, Platvoet-Ter Schiphorst MC. A survey of iodine intake and thyroid volume in Dutch schoolchildren: reference values in an iodine-sufficient area and the effect of puberty. Eur J Endocrinol. 2001;144:595–603.CrossRefPubMedGoogle Scholar
  35. 35.
    DePaoli KM, Seal JA, Burgess JR, Taylor R. Improved iodine status in Tasmanian schoolchildren after fortification of bread: a recipe for national success. Med J Aust. 2013;198:492–4.CrossRefPubMedGoogle Scholar
  36. 36.
    Jones E, McLean R, Davies B, Hawkins R, Meiklejohn E, Ma ZF, et al. Adequate iodine status in New Zealand school children post-fortification of bread with iodised salt. Nutrients. 2016;8. doi: 10.3390/nu8050298.
  37. 37.
    Rasmussen LB, Carle A, Jorgensen T, Knudsen N, Laurberg P, Pedersen IB, et al. Iodine intake before and after mandatory iodization in Denmark: results from the Danish investigation of iodine intake and thyroid diseases (DanThyr) study. Br J Nutr. 2008;100:166–73.CrossRefPubMedGoogle Scholar
  38. 38.
    Laurberg P, Andersen S, Bjarnadottir RI, Carle A, Hreidarsson A, Knudsen N, et al. Evaluating iodine deficiency in pregnant women and young infants -complex physiology with a risk of misinterpretation. Public Health Nutr. 2007;10:1547–52; discussion 1553.Google Scholar
  39. 39.
    Cerqueira C, Knudsen N, Ovesen L, Perrild H, Rasmussen LB, Laurberg P, et al. Association of iodine fortification with incident use of antithyroid medication – a Danish nationwide study. J Clin Endocrinol Metab. 2009;94:2400–5.CrossRefPubMedGoogle Scholar
  40. 40.
    Shapira N. Modified egg as a nutritional supplement during peak brain development: a new target for fortification. Nutr Health. 2009;20:107–18.CrossRefPubMedGoogle Scholar
  41. 41.
    Bauch K, Anke M, Gurtler H, Hesse V, Knappe G, Korber R, et al. Interdisciplinary aspects of iodine prophylaxis in German Democratic Republic. Endocrinol Exp. 1989;23:77–84.PubMedGoogle Scholar
  42. 42.
    Dai JL, Zhu YG, Zhang M, Huang YZ. Selecting iodine-enriched vegetables and the residual effect of iodate application to soil. Biol Trace Elem Res. 2004;101:265–76.CrossRefPubMedGoogle Scholar
  43. 43.
    Voogt W, Jackson WA. Perchlorate, nitrate, and iodine uptake and distribution in lettuce (lactuca sativa L.) and potential impact on background levels in humans. J Agric Food Chem. 2010;58:12192–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Tonacchera M, Dimida A, De Servi M, Frigeri M, Ferrarini E, De Marco G, et al. Iodine fortification of vegetables improves human iodine nutrition: in vivo evidence for a new model of iodine prophylaxis. J Clin Endocrinol Metab. 2013;98:E694–7.CrossRefPubMedGoogle Scholar
  45. 45.
    Kiferle C, Gonzali S, Holwerda HT, Ibaceta RR, Perata P. Tomato fruits: a good target for iodine biofortification. Front Plant Sci. 2013;4:205.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Cerretani L, Comandini P, Fumanelli D, Scazzina F, Chiavaro E. Evaluation of iodine content and stability in recipes prepared with biofortified potatoes. Int J Food Sci Nutr. 2014;65:797–802.CrossRefPubMedGoogle Scholar
  47. 47.
    Piatkowska E, Kopec A, Biezanowska-Kopec R, Pysz M, Kapusta-Duch J, Koronowicz AA, et al. The impact of carrot enriched in iodine through soil fertilization on iodine concentration and selected biochemical parameters in wistar rats. PLoS One. 2016;11:e0152680.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Smolen S, Sady W, Ledwozyw-Smolen I, Strzetelski P, Liszka-Skoczylas M, Rozek S. Quality of fresh and stored carrots depending on iodine and nitrogen fertilization. Food Chem. 2014;159:316–22.CrossRefPubMedGoogle Scholar
  49. 49.
    Lawson PG, Daum D, Czauderna R, Meuser H, Hartling JW. Soil versus foliar iodine fertilization as a biofortification strategy for field-grown vegetables. Front Plant Sci. 2015;6:450.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Ren Q, Fan J, Zhang Z, Zheng X, Delong GR. An environmental approach to correcting iodine deficiency: supplementing iodine in soil by iodination of irrigation water in remote areas. J Trace Elem Med Biol. 2008;22:1–8.CrossRefPubMedGoogle Scholar
  51. 51.
    Mehra R, Srinivasan K. Iodine fortification: some industrial initiatives and concerns. In: Predy VR, Burrow GN, Watson RR, editors. Comprehensive handbook of iodine: nutritional, biochemical, pathological and therapeutic aspects. Burlington: Academic, Elsevier; 2009. p. 731–9.CrossRefGoogle Scholar
  52. 52.
    WHO Secretariat, Andersson M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the technical consultation. Public Health Nutr. 2007;10:1606–11.CrossRefGoogle Scholar
  53. 53.
    Andersen SL, Laurberg P. Iodine supplementation in pregnancy and the dilemma of ambiguous recommendations. Eur Thyroid J. 2016;5:35–43.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Laurberg P. Section 1: principles of international endocrine practice: prevention in endocrinology. In: Wass JAH, Shalet S, editors. Oxford textbook of endocrinology and diabetes. 1st ed. Oxford: Oxford University Press; 2002. p. 3–8.Google Scholar
  55. 55.
    Papas A, Ingalls JR, Campbell LD. Studies on the effects of rapeseed meal on thyroid status of cattle, glucosinolate and iodine content of milk and other parameters. J Nutr. 1979;109:1129–39.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of EndocrinologyAalborg University HospitalAalborgDenmark
  2. 2.Department of Clinical MedicineAalborg UniversityAalborgDenmark
  3. 3.Department of EndocrinologyBispebjerg University HospitalCopenhagenDenmark

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