Breast-milk iodine concentration declines over the first 6 mo postpartum in iodine-deficient women. Reference values for spot urinary iodine concentrations in iodine-sufficient newborns using a new pad collection method. Development of thyroid gland volume during the first 3 months of life in breast-fed versus iodine-supplemented and iodine-free formula-fed infants The nutritional iodine supply of Belgian neonates is still insufficient Efficacy of daily and weekly multiple micronutrient food-like tablets for the correction of iodine deficiency in Indonesian males aged 6-12 mo. Dietary supplements for the lactating mother: influence on the trace element content of milk Iodine status and thyroid function of pregnant, lactating women and infants (0-1 yr) residing in areas with an effective Universal Salt Iodization program. Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial. Urinary iodine excretion as a predictor of the iodine content of breast milk. Effects of iodine supplementation during pregnancy on child growth and development at school age. Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth. Effect of iron-, iodine-, and beta-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial. Effect of a Multiple-Micronutrient-Fortified Fruit Powder Beverage on the Nutrition Status, Physical Fitness, and Cognitive Performance of Schoolchildren in the Philippines Improved iodine status is associated with improved mental performance of schoolchildren in Benin. A multimicronutrient-fortified seasoning powder enhances the hemoglobin, zinc, and iodine status of primary school children in North East Thailand: a randomized controlled trial of efficacy. Serum thyroglobulin and urinary iodine concentration are the most appropriate indicators of iodine status and thyroid function under conditions of increasing iodine supply in schoolchildren in Benin. The impact of iodine supplementation and bread fortification on urinary iodine concentrations in a mildly iodine deficient population of pregnant women in South Australia Effect of iodine and selenium upon thyroid function. Iodine Concentration in Breastmilk and Urine among Lactating Women of Bhaktapur, Nepal Iodine supplementation improves cognition in mildly iodine-deficient children. Multiple micronutrient supplementation increases the growth of Mexican infants. Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo. Intermittent oral administration of potassium iodide solution for the correction of iodine deficiency.
BACKGROUND Little is known about the iodine status of lactating mothers and their infants during the first 6 mo postpartum or , if deficient , the amount of supplemental iodine required to improve status . OBJECTIVE The objective was to determine maternal and infant iodine status and the breast-milk iodine concentration ( BMI C ) over the first 6 mo of breastfeeding . DESIGN A r and omized , double-blind , placebo-controlled supplementation trial was conducted in lactating women who received placebo ( n = 56 ) , 75 μg I/d ( n = 27 ) , or 150 μg I/d ( n = 26 ) after their infants ' birth until 24 wk postpartum .  Maternal and infant urine sample s and breast-milk sample s were collected at 1 , 2 , 4 , 8 , 12 , 16 , 20 , and 24 wk . Maternal serum thyrotropin and free thyroxine concentrations were measured at 24 wk . RESULTS Over 24 wk , the median urinary iodine concentration ( UIC ) of unsupplemented women and their infants ranged from 20 to 41 μg/L and 34 to 49 μg/L , respectively , which indicated iodine deficiency ( ie , UIC < 100 μg/L ) . Mean maternal UIC was 2.1 - 2.4 times higher in supplemented than in unsupplemented women ( P < 0.001 ) but did not differ significantly between the 2 supplemented groups . BMI C in the placebo group decreased by 40 % over 24 wk ( P < 0.001 ) and was 1.3 times and 1.7 times higher in women supplemented with 75 μg I/d ( P = 0.030 ) and 150 μg I/d ( P < 0.001 ) , respectively , than in unsupplemented women . Thyrotropin and free thyroxine did not differ significantly between groups . CONCLUSION BMI C decreased in the first 6 mo in these iodine-deficient lactating women ; supplementation with 75 or 150 μg I/d increased the BMI C but was insufficient to ensure adequate iodine status in women or their infants . The study was registered with the Australian New Zeal and Clinical Trials Registry as ACTRN12605000345684 BACKGROUND Iodine deficiency in infancy can impair neurocognitive development , but there are few available indicators of iodine intake during this critical period . In many countries , access to newborns in maternity clinics in the first few days after birth is high . If spot urine sample s could be collected , reference data for urinary iodine concentration ( UIC ) would be useful to evaluate their iodine status . The study objectives were 1 ) to develop and vali date a simple pad system for collection of spot urine sample s for iodine ; 2 ) to establish a reference range for UIC in newborns in the first week after birth for use in monitoring iodine nutrition . METHODS A two-stage cluster sampling was used to obtain a representative national sample of healthy , term Swiss infants , 0 to 5 days old ( n = 634 ) .  Gestational information , whole blood for thyrotropin , and spot urine sample s on two consecutive days were collected . RESULTS The pad collection system was well-accepted and performed well during recovery and contamination testing . Median UIC in the total sample ( n = 1224 ) was 77 ( 95 % confidence interval ; 76 , 81 ) microg/L ; there was a gradual increase in median UIC within the range of 70 - 100 microg/L from days 1 through 4 . Because urinary creatinine concentrations were high and variable , the UI : creatinine ratio was not useful for st and ardization . CONCLUSIONS The current WHO median UIC cut-off ( > 100 microg/L ) for iodine sufficiency in infancy may be too high for the first week after birth . Reference data from iodine-sufficient newborns and a simple collection system may facilitate use of UIC as an indicator of iodine status in this age group Summary The spontaneous development of thyroid gl and volume ( TGV ) during the first 3 months of life was studied in entirely breast-fed infants ( n = 21 ) and compared to those fed an iodine-supplemented formula ( n = 19 ) , an iodine-free formula ( n = 5 ) , or partially breast-fed in addition to an iodine-free ( n = 4 ) or an iodine-supplemented formula ( n = 16 ) . The TGV of the infants and their mothers was determined sonographically in addition to their urinary iodine concentrations 57 days postpartum and 3 months later . In ten additional lactating mothers the breast milk concentrations of thyroid hormones and iodine were determined . It was shown that at 3 months of age an infant consuming about 1000 ml breast milk per day receives about 2 μg thyroid hormones and 55 μg iodine per day . At the end of their first week of life the infants showed a TGV between 0.28 and 1.5 ml ( median 0.61 ml ) and a urinary iodine concentration between 0.03 and 16.3 μg/dl ( median 3.0 μg/dl ) . At 3 months of age the TGV of the breast-fed infants had decreased by a median of 0.24 ml (= −34 % ; median of percentage changes ) whereas those fed a formula without iodine had increased by a median of 0.26 ml (= + 50 % ; median of percentage changes ) . Those receiving an iodine-supplemented formula  showed a TGV reduction of 0.14 ml (= + 2 % ; median of percentage changes ) . The TGV development of the partially breast-fed infants lay between those being exclusively breast or formula fed . It is concluded that with respect to the development of TGV , breast milk is superior even to the feeding of an iodine-supplemented formula Abstract . Belgium used to be affected by mild iodine deficiency . Improvement in iodine nutrition has been recently documented in schoolchildren in Belgium in spite of the absence of any systematic programme of iodine supplementation . The question arises as to whether this ' silent iodine prophylaxis ' affected also the neonates . A total of 185 r and om urine sample s were collected from 90 full term and 65 preterm neonates in Brussels on day 5 and repeated on day 30 in 30 preterms who were bottle-fed with iodine-enriched formula-milk . The iodine content was also determined in 58 sample s of breast-milk on day 5 . The median urinary iodine on day 5 in full term neonates was 86 µg/l , which is markedly higher than the figure of 48 µg/L reported 15 years previously in neonates in the same area but still much lower than normal for this age group ( 150–200 µg/l ) . The mean iodine content of breast-milk was 78 µg/l , which is unchanged as compared to 15 years ago and is about 66 % of normal . Finally , the median urinary iodine increased from 60 µg/l on day 5 to 150 µg/l on day 30 in preterms bottle-fed with iodine-enriched formula-milk . Conclusion : the status of iodine nutrition has also improved spontaneously in Belgian neonates but has not yet normalised . Lactating and probably pregnant women remain clearly iodine deficient . The iodine-enriched formula-milk for preterms is efficient in correcting their iodine deficiency . National measures are urgently required for correction of iodine deficiency in Belgium BACKGROUND Infants are highly vulnerable to iodine deficiency , and little data exist on the effect of multiple micronutrient supplementation on their iodine status . OBJECTIVE We aim ed to compare the efficacy of daily and weekly multiple micronutrient food-like tablets ( foodLETs ) on increasing iodine status among infants . DESIGN In a double-blind , placebo-controlled trial , 133 Indonesian males aged 6 - 12 mo were r and omly assigned to 1 of 4 groups : a daily multiple-micronutrient foodLET providing the Recommended Nutrient Intake (RNI)(DMM ) , a weekly multiple-micronutrient foodLET providing twice the RNI ( WMM ) , a daily 10-mg Fe foodLET ( DI ) , or placebo .  Urinary iodine ( UI ) concentrations were measured at baseline and at 23 wk . RESULTS At baseline , the average UI concentration ( 1.37 micromol/L ) was within the normal range , and 30.8 % of subjects had iodine deficiency ( UI < 0.79 micromol/L ) . At 23 wk , the DMM group had the highest increment in UI ; however , after adjustment for initial UI , the changes in UI were not significantly different between the 4 groups ( P = 0.39 ) . Initial UI correlated inversely with the changes in UI ( P < 0.001 ) . The DMM group had the greatest reduction and increment in the proportion of iodine-deficient infants and in infants with iodine excess , respectively ; however , no significant difference was found in these proportions ( P = 0.13 and P = 0.42 ) between the 4 groups . CONCLUSION Daily consumption of a multiple-micronutrient foodLET providing the RNI during infancy may be one strategy to improve iodine status Milk production is a complex process where nutritional factors interact with structural hormonal and behavioural influences . In recent years important advances have been made in underst and ing the role of the nutritional status of lactating women on the outcome of breastfeeding . Many questions remain unanswered about the exact requirement of trace elements for lactating mothers . The effect of dietary zinc , copper and iodine supplements on the milk concentration of these micronutrients was studied . The supplementation trial employed a specific balanced nutritional supplement prepared for the nursing mothers . The study was carried out on women living in Ferrara and its surrounding area . The population under study was healthy Italian mothers , of good socioeconomic status , and their normal infants . In total , 32 women were enrolled in the study and 22 completed it . The infants ( 9F , 13 M ) were full‐term , healthy singletons and were put to breast within 12 h of birth . All women who finished the study completed a 3 d dietary record . Nutrient analysis revealed the following mean daily dietary trace element intake in the lactating mothers : zinc = 12 mg , copper = 1.4 mg and iodine = 145 μg . The zinc and copper dietary intake was in agreement with the daily intake proposed for nursing Italian mothers , while the daily intake of iodine was below the recommended intake of 200 μg . The breastfeeding mothers were placed in 2 groups , with 7 primiparas and 4 multiparas per group : lactating women eating a traditional Italian diet without vitamin and mineral supplements  , and lactating women enrolled in the nutrification programme  and given a nutritional supplement to their traditional diet . The supplement ( PerMamma Abbott ) provided 20 mg zinc sulfate , 2 mg copper sulfate and 116 μg potassium iodide . These quantities cover about 60‐90 % of the recommended intake for nursing Italian mothers . Sample s of 10 ml of milk were collected at 3 , 30 , 90 d postpartum . Zinc milk concentrations declined significantly over the study period for all lactating subjects , without differences in the rate of decline between the women who started supplementation during lactation and those who did not . Copper did not change during the first month of lactation , then declined at day 90 in supplemented and unsupplemented women , without significant differences between the two groups . An early sharp decline in milk iodine occurred in all lactating subjects , independently of iodine supplementation . After the first month of lactation breast milk iodide levels remained stable in all subjects under study . No significant differences between the two study groups were observed . The lack of correlation between the iodide level in breast milk and maternal dietary intake of iodine is not in agreement with previously published reports . The present results indicate that in healthy , well‐nourished lactating Italian women , whose diet is adequate , the levels of zinc , copper and iodine in milk are not influenced by short‐term supplementary intakes and that the milk levels of the trace elements studied are maintained over different levels of intake . Further research and examination by longitudinal studies are needed to establish the exact relationship between the amount of iodine furnished to the nursing mother and the iodine content of human milk . The role of compensatory homeostatic mechanisms which act during lactation needs further consideration and closer scrutiny OBJECTIVE To assess the iodine nutrition and thyroid function of pregnant women , lactating women and infants residing in areas where the Universal Salt Iodization program is in place . METHODS Pregnant women , lactating women and infants were selected r and omly in the regions where iodized salt coverage rate is more than 90 % since 2000 .  Urine iodine levels of pregnant woman , lactating woman and infants , milk iodine of lactating woman , thyroid-stimulating hormone ( TSH ) and free T4 of women were tested respectively . RESULTS Median Urinary Iodine ( MUI ) of infants , three groups of pregnant women ( first , second and third trimester ) and two groups lactating women ( breastfeeding less than or more than six months ) were 233 , 174 , 180 , 147 , 126 and 145 microg/L , respectively . Median milk iodine of lactating women was 163 microg/L. Percentage of milk iodine < 150 microg/L of early lactating women was 40 % less than that of late lactating women ( p < 0.01).There was a positive correlation between urine iodine of infants and milk iodine of lactating women ( r = 0.526 , p = 0.000 ) . T4 of two women were above or below the reference range . Total 15.4 % women 's TSH were abnormal . Most of these women 's urinary iodine were lower than 150 microg/L. CONCLUSION Iodine status of most of the target population for Universal Salt Iodization program is adequate , but iodine deficiency still existed in some . To assure every new life 's brain not be damaged by iodine deficiency , iodine status of targeted population s should be monitored and supplements provided according to the monitoring outcomes BACKGROUND Iodine deficiency in infants can damage the developing brain and increase mortality . Present recommendations state that oral iodised oil should be given to breastfeeding mothers to correct iodine deficiency in infancy when iodised salt is not available , and that direct supplementation should be given to infants who are not being breastfed or receiving iodine-fortified complimentary foods . However , there is little evidence for these recommendations . We aim ed to assess the safety and efficacy of direct versus indirect supplementation of the infant . METHODS We did this double blind , r and omised , placebo-controlled trial in Morocco . Healthy breastfeeding mothers and their term newborn babies ( aged ≤8 weeks ) were block r and omised by clinic day to receive either : one dose of 400 mg iodine to the mother and placebo to the infant ( indirect infant supplementation ) , or one dose of about 100 mg iodine to the infant and placebo to the mother ( direct infant supplementation ) . R and omisation was masked to participants and investigators . Co primary outcomes were : maternal and infant urinary iodine concentrations , breastmilk iodine concentration , maternal and infant thyroid-stimulating hormone ( TSH ) concentrations , maternal and infant thyroxine ( T4 ) concentrations , and infant growth . These outcomes were measured at baseline , and when infants were aged about 3 months , 6 months , and 9 months , and the two groups were compared using mixed effects models . This study is registered with Clinical Trials.gov , number NCT01126125 . FINDINGS We recruited 241 mother-infant pairs between Feb 25 , and Aug 10 , 2010 , and completed data collection by Aug 6 , 2011 . At baseline , median urinary iodine concentration was 35 μg/L ( IQR 29 - 40 ) in mothers and 73 μg/L ( 29 - 237 ) in infants , suggesting iodine deficiency . During the study , maternal urinary iodine concentration ( p=0.011 ) , breastmilk iodine concentration ( p<0.0001 ) , and infant urinary iodine concentration ( p=0.042 ) were higher in the indirect infant supplementation group than in the direct supplementation group . Maternal TSH ( p=0.276 ) and T4 ( p=0.074 ) concentrations did not differ between the groups over the course of the study , nor did infant TSH ( p=0.597 ) and T4 ( p=0.184 ) concentrations , but the number of infants with thyroid hypofunction was lower ( p=0.023 ) in the indirect supplementation group than the direct supplementation group . The infant groups did not differ in anthropomorphic measures , except that length-for-age Z score was slightly greater in the direct infant supplementation group ( p=0.032 ) . At 3 months and 6 months of age , median infant urinary iodine concentration in the indirect infant supplementation group was sufficient ( > 100 μg/L ) , whereas infant urinary iodine concentration was sufficient only at 6 months in the direct supplementation group . There were no serious adverse events in either group . INTERPRETATION In regions of moderate-to-severe iodine deficiency without effective salt iodisation , lactating women who receive one dose of 400 mg iodine as oral iodised oil soon after delivery can provide adequate iodine to their infants through breastmilk for at least 6 months , enabling the infants to achieve euthyroidism . Direct supplementation is less effective in improving infant iodine status . FUNDING ETH Zurich , Switzerl and ; the Medicor Foundation , Vaduz , Lichtenstein Endemic goitre has re-emerged in Thail and . This is particularly dangerous for children since iodine deficiency disorders ( IDDs ) might negatively influence their intellectual and mental development . In order to assess the situation , the iodine content of breast milk was determined and a method is proposed on how to monitor IDDs in lactating mothers later on . Seventy-five lactating women aged from 15 to 45 years , from 12 villages of 3 districts , namely Chumpae . Srichompu and Pupaman within the mountainous areas of Khon Kaen province , Northeast of Thail and were investigated . The breast milk from 46.7 per cent of mothers was found to be below recommended st and ards . In addition , 52.0 per cent of the women investigated had low urinary iodine excretion . The risk of women with low iodine excretion was 15 fold higher in comparison to women with sufficient iodine excretion to provide breast milk for their babies with insufficient iodine content . It is concluded that urinary iodine excretion can be used to monitor the IDDs in lactating mothers Growth and development of 207 children ( 49 % males ; mean age 5.4 years [ SD 0.2 ] , range 4 to 7.3 years whose mothers received iodine during pregnancy , and children who received iodine first in their 2nd year , were examined in 1996 ; 192 children ( 49 % males ; mean age 6.5 years [ SD 0.2 ] , range 5.8 to 6.9 years ) whose mothers received iodine while pregnant were seen in 1998 . Children were from the southern part of China 's Xinjiang Province which has the lowest levels of iodine in water and soil ever recorded .  Head circumference but not height was improved for those who received iodine during pregnancy ( compared with those receiving iodine at age 2 ) and for those supplemented before the end of the 2nd trimester ( relative to those supplemented during the 3rd trimester ) . Iodine before the 3rd trimester predicted higher psychomotor test scores for children relative to those provided iodine later in pregnancy or at 2 years . Results from the test for cognitive development result ed in trend only differences between those children supplemented during pregnancy versus later . The results address the question of when maternal iodine supplements should begin in public health programs world wide . Findings may be relevant to the treatment of maternal and newborn thyroid deficiency in industrialized countries , particularly for those infants delivered before the end of the second trimester CONTEXT Iodine deficiency in utero impairs fetal growth , but the relationship between iodine deficiency and postnatal growth is less clear . OBJECTIVE The objective of the study was to determine whether iodine repletion improves somatic growth in iodine-deficient children and investigate the role of IGF-I and IGF binding protein (IGFBP)-3 in this effect . DESIGN , PARTICIPANTS , AND INTERVENTIONS Three prospect i ve , double-blind intervention studies were done : 1 ) in a 10-month study , severely iodine-deficient , 7- to 10-yr-old Moroccan children ( n = 71 ) were provided iodized salt and compared with children not using iodized salt ; 2 ) in a 6-month study , moderately iodine-deficient , 10- to 12-yr-old Albanian children ( n = 310 ) were given 400 mg iodine as oral iodized oil or placebo ; 3 ) in a 6-month study , mildly iodine-deficient 5- to 14-yr-old South African children ( n = 188 ) were given two doses of 200 mg iodine as oral iodized oil or placebo . At baseline and follow-up , height , weight , urinary iodine ( UI ) , total T4 ( TT4 ) , TSH , and IGF-I were measured ; in Albania and South Africa , IGFBP-3 was also measured . RESULTS In all three studies , iodine treatment increased median UI to more than 100 microg/liter , whereas median UI in the controls remained unchanged . In South Africa , iodine repletion modestly increased IGF-I but did not have a significant effect on IGFBP-3 , TT4 , or growth . In Albania and Morocco , iodine repletion significantly increased TT4 , IGF-I , IGFBP-3 , weight-for-age z scores , and height-for-age z scores . CONCLUSION This is the first controlled study to clearly demonstrate that iodine repletion in school-age children increases IGF-I and IGFBP-3 concentrations and improves somatic growth BACKGROUND Deficiencies of iron , iodine , and vitamin A are prevalent worldwide and can affect the mental development and learning ability of schoolchildren . OBJECTIVE The aim of this study was to determine the effect of micronutrient-fortified biscuits on the micronutrient status of primary school children . DESIGN Micronutrient status was assessed in 115 children aged 6 - 11 y before and after consumption of biscuits ( fortified with iron , iodine , and beta-carotene ) for 43 wk over a 12-mo period and was compared with that in a control group ( n = 113 ) who consumed nonfortified biscuits .  Cognitive function , growth , and morbidity were assessed as secondary outcomes . RESULTS There was a significant between-group treatment effect on serum retinol , serum ferritin , serum iron , transferrin saturation , and urinary iodine ( P < 0.0001 ) and in hemoglobin and hematocrit ( P < 0.05 ) . The prevalence of low serum retinol concentrations ( < 0.70 micromol/L ) decreased from 39.1 % to 12.2 % , of low serum ferritin concentrations ( < 20 microg/L ) from 27.8 % to 13.9 % , of anemia ( hemoglobin < 120 g/L ) from 29.6 % to 15.6 % , and of low urinary iodine concentrations ( < 100 microg/L ) from 97.5 % to 5.4 % . There was a significant between-group treatment effect ( P < 0.05 ) in cognitive function with the digit span forward task ( short-term memory ) . Fewer school days were missed in the intervention than in the control group because of respiratory- ( P = 0.097 ) and diarrhea-related ( P = 0.013 ) illnesses . The intervention had no effect on anthropometric status [ corrected ] . CONCLUSIONS Fortified biscuits result ed in a significant improvement in the micronutrient status of primary school children from a poor rural community and also appeared to have a favorable effect on morbidity and cognitive function [ corrected ] This study aim ed to determine the effect of a multiple-micronutrient-fortified beverage on the micronutrient status , physical fitness , and cognitive performance of schoolchildren . The study was a r and omized , double-blind , placebo-controlled trial of schoolchildren assigned to receive either the fortified or nonfortified beverage with or without anthelmintic therapy .  Data on hemoglobin level , urinary iodine excretion ( UIE ) level , physical fitness , and cognitive performance were collected at baseline and at 16 weeks post-intervention . The fortified beverage significantly improved iron status among the subjects that had hemoglobin levels < 11 g/dl at baseline . The proportion of children who remained moderately to severely anemic was significantly lower among those given the fortified beverage . In the groups that received the fortified product , the median UIE level increased , whereas among those who received the placebo beverage , the median UIE level was reduced significantly . Iron- and /or iodine-deficient subjects who received the fortified beverage showed significant improvements in fitness ( post-exercise reduction of heart rate ) and cognitive performance ( nonverbal mental ability score ) . The study showed that consumption of a multiple-micronutrient-fortified beverage for 16 weeks had significant effects on iron status , iodine status , physical fitness , and cognitive performance among iron- and /or iodine-deficient Filipino schoolchildren .  Anthelmintic therapy improved iron status of anemic children and iodine status of the iron-adequate children at baseline but it had no effect on physical fitness and cognitive performance . The results from the clinical study showed that a multiple-micronutrient-fortified beverage could play an important role in preventing and controlling micronutrient deficiencies BACKGROUND An adequate iodine supply in utero and shortly after birth is known to be crucial to an individual 's physical and mental development . The question of whether iodine supplementation later in life can exert a favorable influence on the mental performance of iodine-deficient population s was addressed in various studies , but with contradictory results . OBJECTIVE The aim of this study was to examine the effect of an improvement in iodine status on mental and psychomotor performance of schoolchildren ( 7 - 11 y ) who were moderately to severely iodine deficient . DESIGN The study , which was originally planned as a double-blind , r and omized , placebo-controlled intervention , was carried out in an iodine-deficient population of schoolchildren ( n = 196 ) in northern Benin . As the population began to have access to iodized salt during the 1-y intervention period , the study population was split post hoc-on the basis of urinary iodine concentrations-into a group with improved iodine status and a group with unchanged iodine status . Changes in mental and psychomotor performance over the intervention period were compared . RESULTS Children with increased urinary iodine concentrations had a significantly greater increase in performance on the combination of mental tests than did the group with no change in urinary iodine concentrations . CONCLUSIONS An improvement in iodine status , rather than iodine status itself , determined mental performance in this population , which was initially iodine deficient . These findings suggest a " catch-up " effect in terms of mental performance Anemia and co-existing deficiencies of zinc , iron , iodine , and vitamin A occur among children in many developing countries including NE Thail and , probably contributing to impairments in growth , immune competence , and cognition . Sustainable strategies are urgently required to combat these deficiencies . We assessed the efficacy of a micronutrient-fortified seasoning powder served with a school lunch on reducing anemia and improving the micronutrient status of rural NE Thai children . Children ( n = 569 ) aged 5.5 - 13.4y from 10 schools were r and omly assigned to receive a seasoning powder either unfortified or fortified with zinc ( 5 mg ) , iron ( 5 mg ) , vitamin A ( 270 microg ) , and iodine ( 50 microg ) ( per serving ) and incorporated into a school lunch prepared central ly and delivered 5 d/wk for 31 wk . Teachers monitored school lunch consumption . Baseline and final micronutrient status , hemoglobinopathies , and infection or inflammation were assessed from blood and urine sample s. For the primary outcome , anemia ( based on hemoglobin ) , no intervention effect was apparent ( odds ratio : 1.02 95 % CI : 0.69 , 1.51 ) after adjustment for design strata . The odds of zinc ( based on serum zinc ) and urinary iodine deficiency in the fortified group were 0.63 ( 0.42 , 0.94 ) and 0.52 ( 0.38 , 0.71 ) times those in the unfortified group , respectively . Fortification had no effect on serum retinol ( 0.61 : 0.25,1.51 ) , ferritin ( 1.12 : 0.43 , 2.96 ) , or mean red cell volume ( 1.16 : 0.82 , 1.64 ) . Therefore , a micronutrient-fortified seasoning powder is a promising vehicle for improving zinc , iodine , and hemoglobin status , and its potential for incorporation into lunch programs in day care centers and schools in NE Thail and warrants investigation Iodine deficiency control programs have greatly reduced iodine deficiency disorders worldwide . For monitoring changes in iodine status , different indicators may be used . The aim of this study was to evaluate the suitability of indicators of iodine status and thyroid function , thyroglobulin ( Tg ) , thyroid-stimulating hormone ( TSH ) and free thyroxine ( FT4 ) in serum , thyroid volume and urinary iodine concentration , in iodine-deficient schoolchildren under conditions of increasing iodine supply . The study was established as a double-blind , placebo-controlled oral administration of a single dose of iodized oil to schoolchildren ( 7 - 10 y old ) , living in an iodine-deficient area of Benin , with an observation period of 10 mo . However , 3 - 4 mo after supplementation , iodized salt became available in the area . The study population therefore comprised an iodized oil-supplemented group  and a nonsupplemented group  , both of which had variable , uncontrolled intakes of iodized salt during the last 6 mo of the study . Initial mean serum concentrations of TSH and FT4 were within the normal range , whereas serum Tg concentration , urinary iodine concentration and thyroid volume were indicative of moderate-to-severe iodine deficiency . At the end of the study , all indicators had improved significantly , except thyroid volume , which had decreased only in the supplemented group . The supplemented group also still had significantly lower serum Tg and higher urinary iodine concentrations than the nonsupplemented group . Serum Tg and urinary iodine concentrations are the indicators most influenced by a changing iodine supply . Current normal reference ranges of serum concentrations of TSH and FT4 are too wide for detecting iodine deficiency in this age group Mild iodine deficiency during pregnancy can have significant effects on fetal development and future cognitive function . The purpose of this study was to characterise the iodine status of South Australian women during pregnancy and relate it to the use of iodine-containing multivitamins . The impact of fortification of bread with iodized salt was also assessed . Women ( n = 196 ) were recruited prospect ively at the beginning of pregnancy and urine collected at 12 , 18 , 30 , 36 weeks gestation and 6 months postpartum . The use of a multivitamin supplement was recorded at each visit . Spot urinary iodine concentrations ( UIC ) were assessed . Median UICs were within the mildly deficient range in women not taking supplements ( < 90 μg/L ) . Among the women taking iodine-containing multivitamins  UICs were within WHO recommendations ( 150–249 μg/L ) for sufficiency and showed an increasing trend through gestation . The fortification of bread with iodized salt  increased the median UIC from 68 μg/L to 84 μg/L ( p = .011 ) which was still in the deficient range . Pregnant women in this region of Australia were unlikely to reach recommended iodine levels without an iodine supplement , even after the m and atory iodine supplementation of bread was instituted in October 2009 Iodine is an essential element with unique role in organism : it is indispensable component of thyroid hormones . After binding with specific nuclear receptor , T3/T4 induce transcription of genetic code via mRNA and regulate proteo synthesis in most tissues . Thyroid hormones regulate rate of metabolic processes and consequently development of organism . Czech Republic was in past typical region with moderate to severe iodine deficiency . Therefore epidemiological survey was started in r and omly selected sample s of peoples . Thereafter a complex program of improving iodine supply was realized . Prompt effects of this changes were recorded , namely increase of ioduria and decrease of thyroid volume . Essential trace element selenium has a fundamental importance to the cell and body metabolism regulation by thyroid hormones . Activities of selenoenzymes deiodinases lead to the activation of prohormone T4 to active hormone T3 and the inactivation of T3 and of T4 , as well . There is unfortunately moderate to mild Se deficit in the CR . Average serum Se concentrations for the population s from 6 to 65 years are in the regions of the CR between 42 and 62 micrograms/l and urine Se values are between 8 and 15 micrograms/l . We have found statistically significant correlations among indexes of selenium status and indexes of thyroid hormone metabolism and function . Especially dangerous are concomitant deficiencies of both key elements for thyroid hormone metabolism -- I and Se -- from the point of thyroid hormone regulative functions Adequate iodine concentration in breastmilk ( BMI C ) is essential for optimal neonatal thyroid hormone synthesis and neurological development in breastfed infants . For many decades , iodine deficiency has been a public health problem in Nepal . However , recently , excessive iodine intakes among Nepali infants have been reported . This study aim ed to measure BMI C and urinary iodine concentration ( UIC ) among lactating women in a peri-urban area of Nepal .  Iodine concentration was measured in spot urine ( n = 485 ) and breastmilk sample s ( n = 291 ) of 500 r and omly selected lactating women . The median ( p25 , p75 ) BMI C and median UIC were 250 ( 130 , 370 ) µg/L and 230 ( 135–377 ) µg/L , respectively . Around 82 % had BMI C > 100 µg/L , 61 % had BMI C > 200 µg/L and 81 % had UIC > 100 µg/L , 37 % had > 300 µg/L and 20 % had > 500 µg/L. In multiple linear regression models , time since birth ( β 3.0 , 95 % CI ( 0.2 , 5.0 ) ) and UIC ( β 1.0 , 95 % CI ( 0.1 , 2.0 ) ) were associated with BMI C , explaining 26 % of the variance . A large proportion of the women had adequate BMI C and UIC ; however , a subset had high iodine concentrations . These findings emphasize the importance of carefully monitoring iodine intake to minimize the risk of iodine excess and subsequently preventing transient iodine-induced hypothyroidism in breastfed infants BACKGROUND The effects of severe iodine deficiency during critical periods of brain development are well documented . There is little known about the consequences of milder forms of iodine deficiency on neurodevelopment . OBJECTIVE The objective was to determine whether supplementing mildly iodine-deficient children with iodine improves cognition . DESIGN A r and omized , placebo-controlled , double-blind trial was conducted in 184 children aged 10 - 13 y in Dunedin , New Zeal and . Children were r and omly assigned to receive a daily tablet containing either 150 microg I or placebo for 28 wk .  Biochemical , anthropometric , and dietary data were collected from each child at baseline and after 28 wk . Cognitive performance was assessed through 4 subtests from the Wechsler Intelligence Scale for Children . RESULTS At baseline , children were mildly iodine deficient [ median urinary iodine concentration ( UIC ) : 63 microg/L ; thyroglobulin concentration : 16.4 microg/L ] . After 28 wk , iodine status improved in the supplemented group ( UIC : 145 microg/L ; thyroglobulin : 8.5 microg/L ) , whereas the placebo group remained iodine deficient ( UIC : 81 microg/L ; thyroglobulin : 11.6 microg/L ) . Iodine supplementation significantly improved scores for 2 of the 4 cognitive subtests [ picture concepts ( P = 0.023 ) and matrix reasoning ( P = 0.040 ) ] but not for letter-number sequencing ( P = 0.480 ) or symbol search ( P = 0.608 ) . The overall cognitive score of the iodine-supplemented group was 0.19 SDs higher than that of the placebo group ( P = 0.011 ) . CONCLUSIONS Iodine supplementation improved perceptual reasoning in mildly iodine-deficient children and suggests that mild iodine deficiency could prevent children from attaining their full intellectual potential . The trial was registered with the Australia New Zeal and Clinical Trials Register as ACTRN12608000222347 BACKGROUND The role of single micronutrient deficiencies in the etiology of growth retardation has recently gained attention . However , because multiple micronutrient deficiencies are common in children in developing countries , it is possible that more than one micronutrient may limit growth and , hence , the correction of a single deficiency may not be enough to improve growth substantially . OBJECTIVE The objective was to evaluate the effect of multiple micronutrient supplementation on the growth of children aged 8 - 14 mo whose diets were poor in several micronutrients . DESIGN Children were r and omly assigned to 1 of 2 groups . One group received a multiple micronutrient supplement containing the recommended dietary allowance ( RDA ) or 1.5 times the RDA of vitamins A , D , E , K , C , B-1 , B-6 , B-12 , riboflavin , niacin , biotin , folic acid , and pantothenic acid , and iron , zinc , iodine , copper , manganese , and selenium . The other group received a placebo . Supplements were administered 6 d/wk for an average of 12.2 mo . Body length was measured at baseline and monthly thereafter until the end of supplementation . RESULTS Supplemented infants initially aged < 12 mo had significantly greater length gains than did the placebo group , with a difference of 8.2 mm ( length-for-age z score : 0.3 ) at the end of supplementation . In contrast , differences in length gains between the supplemented and placebo groups initially aged > or = 12 mo were not significant . CONCLUSIONS Micronutrient deficiencies limited the growth of the Mexican infants studied . Improving micronutrient intakes should be a component of interventions to promote growth in infants living in setting s where micronutrient intakes are inadequate OBJECTIVE Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects , but such data are not available in the Democratic Republic of Congo . We aim ed to assess iodine and Fe status in pregnant women from Lubumbashi . DESIGN Cross-sectional study . We measured urinary iodine concentration ( UIC ) in r and om urine sample s using a modified S and ell – Kolthoff digestion method ; the WHO reference medians were used to classify iodine intake as deficient , adequate , more than adequate or excessive . Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when , 12 ng/ml . SETTING Maternity units from rural , semi-urban and urban areas of Lubumbashi , Democratic Republic of Congo . SUBJECTS Two hundred and twenty-five r and omly selected pregnant women attending prenatal consultation , seventy-five postpartum women and seventy-five non-pregnant women as controls . RESULTS Overall median UIC in pregnant women was 138 ( interquartile range : 105–172 ) mg/l , indicating iodine deficiency , whereas postpartum and nonpregnant women had adequate iodine intake : median UIC5144mg/l and 204mg/l , respectively . Median UIC values were lower in late pregnancy than in early pregnancy : in the first , second and third trimester respectively 255mg/l , 70mg/l and 88mg/l in the rural area ; 306mg/l , 166mg/l and 68mg/l in the semi-urban area ; and 203mg/l , 174mg/l and 99mg/l in the urban area . Fe was insufficient in 39 % of pregnant women compared with 21 % of non-pregnant and postpartum women . In the third trimester , deficiencies in both iodine and Fe were high : 40 % , 12 % and 18 % in the rural , semi-urban and urban areas , respectively . CONCLUSIONS Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi . Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced Iodized salt and iodized oil are the main methods used to prevent iodine deficiency , but sometimes alternative approaches are needed . We tested the efficacy of various regimens for the intermittent administration of potassium iodide in Hwedza , Zimbabwe , an area of known severe iodine deficiency . We divided 304 schoolchildren aged 7 - 13 y into five equal groups that received iodine as a 10 % solution of potassium iodide as follows : 8.7 mg every 2 wk ( group A ) , 29.7 mg every month ( group B ) , 148.2 mg every 3 mo ( group C ) , 382 mg every 6 mo ( group D ) , or 993 mg once ( group E ) . The follow-up period was 13 mo . No adverse effects were encountered with any of these doses . After 6 mo , the median blood spot thyroglobulin concentration had decreased in all groups and had normalized in groups A and B to values found in iodine-sufficient population s. The number of children with elevated thyroid-stimulating hormone concentrations decreased in groups A-C , but the changes were not significant . Urine iodine concentration generally remained low in all groups but increased in group A. After 13 mo , mean thyroid volume measured by ultrasound had decreased in groups A and B to values comparable with those in iodine-sufficient areas , and was unchanged in the other groups . We conclude that oral potassium iodide is effective for the prophylaxis of iodine deficiency if given as a dose of 30 mg I monthly or 8 mg biweekly
The results are thus compatible with the international recommendation that lactating women and infants younger than two years of age who reside in iodine-sufficient countries do not require iodine supplementation
BACKGROUND Iodine , an essential micronutrient , plays a critical role in normal growth and development , especially during the first two years of life .
This systematic review and meta- analysis is among the first to evaluate breast-milk iodine concentrations and infant iodine status in countries characterized by iodine sufficiency or deficiency .