Iodine intake and status in Iceland through a period of 60 years

Iodine deficiency is considered to be one of the most common nutrition disorders in the world and the world's greatest single cause of preventable brain damage. Despite a worldwide application of successful iodine supplementation programs over the last four decades, iodine deficiency remains a major public health problem throughout the world. All European countries except Iceland have experienced this health and socioeconomic threat to a greater or lesser extent. The fact that mild to severe iodine deficiency persists in many European countries may have important public health consequences, including impaired intellectual development of infants and children. Iceland has in the past been known for its high iodine status, based on results from studies of iodine status from 1939, 1988, and 1998 suggested to be due to high fish consumption. Fish together with milk and other dairy products are the main sources of iodine in the Icelandic diet, but iodized salt is not commonly used. In recent years fish and dairy intake has decreased, especially among young people. In this paper, historical data on iodine status and iodine intake in Iceland is reviewed and the need for further studies as well as possible need for public health actions evaluated

Can health claims made on food be scientifically substantiated? Review on satiety and weight management

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObesity is becoming an increasing health problem and results when energy intake exceeds energy expenditure. Food has a crucial role in weight management. The new EU legislation on nutrition and health claims permits the use of weight regulation and satiety related health claims on foods, if they are based on generally accepted scientific evidence. In this review the current knowledge on food properties, that have been proposed to affect satiety and/or energy expenditure and thus might be useful in weight control are considered, as part of the project "Substantiation of weight regulation and satiety related health claims on foods" funded by the Nordic Innovation Centre. At this point the scientific evidence of the short term effects of dietary fibers and proteins in relation to satiety seems to be convincing. However, it might be challenging to make product specific satiety and weight management claims as the dose response is not always known. On the other hand two step health claims might be applied, for example rich in dietary fibre - dietary fibre can increase satiety or rich in protein - protein can increase satiety.Ný evrópsk reglugerð leyfir heilsufullyrðingar á umbúðir matvæla um áhrif innihaldsefna á seddutilfinningu og þátt þeirra við þyngdarstjórnun, að því gefnu að fullyrðingin standist kröfur um vísindalegar sannanir. Rökin fyrir reglugerðinni eru meðal annars að seddutilfinning eftir neyslu matar minnki líkur á að orkuinntaka verði meiri heldur en orkunotkun og gegni þannig hlutverki í þyngdarstjórnun. Á þann hátt er reiknað með því að geta minnkað líkur á offitu sem er vaxandi heilsufarsvandi. Í þessari yfirlitsgrein er gerð grein fyrir stöðu þekkingar á því hvernig ýmsir fæðuþættir tengjast mælikvörðum fyrir seddu og/eða orkujafnvægi. Samantektin byggist á vinnu norrænna sérfræðinga verkefnis (Substantiation of weight regulation and satiety related health claims on foods) sem styrkt var af Norrænu nýsköpunarmiðstöðinni. Nú virðast vísindalegar sannanir á skammtímaáhrifum trefja og próteina á seddu vera mest sannfærandi og gætu þar af leiðandi reynst góður kostur við þyngdarstjórnun. Hins vegar má draga í efa að unnt sé að nota fullyrðingar varðandi seddu og þyngdarstjórnun á umbúðir einstakra matvæla þar sem skammtaáhrif eru ennþá illa skilgreind á þessu sviði. Styðjast mætti við tveggja þrepa fullyrðingar á borð við trefjaríkt - trefjar auka seddu eða próteinríkt - prótein auka seddu

Development and Validation of a Photographic Method to Use for Dietary Assessment in School Settings.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.To develop and validate a photographic method aimed at making assessment of dietary intake in school canteens non-obstrusive, practical and feasible.The study was conducted in two elementary schools representing two different school canteen systems; main dish being served by canteen staff (Iceland), and complete self-serving (Sweden). Food items in serving and leftovers were weighed and photographed. Trained researchers estimated weights of food items by viewing the photographs and comparing them with pictures of half and full reference portions with known weights. Plates of servings and leftovers from 48 children during five school days (n = 448 plates) and a total of 5967 food items were estimated. The researchers' estimates were then compared with the true weight of the foods and the energy content calculated.Weighed and estimated amounts correlated across meals both in grams and as total energy (0.853-0.977, p<0.001). The agreement between estimated energy content in school meals was close to the true measurement from weighed records; on average 4-19 kcal below true values. Organisation of meal service impacted the efficacy of the method as seen in the difference between countries; with Iceland (served by canteen staff) having higher rate of acceptable estimates than Sweden (self-serving), being 95% vs 73% for total amount (g) in serving. Iceland more often had serving size between or above the half and full reference plates compared with Sweden.The photographic method provides acceptable estimates of food and energy intake in school canteens. However, greater accuracy can be expected when foods are served by canteen staff compared with self-serving

Iodine status of breastfed infants and their mothers' breast milk iodine concentration.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadIodine is an essential nutrient for growth and development during infancy. Data on iodine status of exclusively (EBF) and partially breastfed (PBF) infants as well as breast milk iodine concentration (BMIC) are scarce. We aimed to assess (a) infant iodine nutrition at the age of 5.5 months by measuring urinary iodine concentration (UIC) in EBF (n = 32) and PBF (n = 28) infants and (b) mothers' breast milk iodine concentration (n = 57). Sixty mother-infant pairs from three primary health care centres in Reykjavik and vicinities provided urine and breast milk samples for iodine analysis and information on mothers' habitual diet. The mother-infant pairs were participants of the IceAge2 study, which focuses on factors contributing to infant growth and development, including body composition and breast-milk energy content. The median (25th-75th percentiles) UIC was 152 (79-239) μg/L, with no significant difference between EBF and PBF infants. The estimated median iodine intake ranged from 52 to 86 μg/day, based on urinary data (assuming an average urine volume of 300-500 ml/day and UIC from the present study). The median (25th-75th percentiles) BMIC was 84 (48-114) μg/L. It is difficult to conclude whether iodine status is adequate in the present study, as no ranges for median UIC reflecting optimal iodine nutrition exist for infants. However, the results add important information to the relatively sparse literature on UIC, BMIC, and iodine intake of breastfed infants

Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadExcessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11-14, using a 40-item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0-5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support.UoI Research Fund Technology Development Fund/The Icelandic Centre for Research (RANNIS

The combined effect of pre-pregnancy body mass index and gestational weight gain on the risk of pre-labour and intrapartum caesarean section—The ICE-MCH study

Funding Information: A project grant from the Research Fund of the University of Iceland (https://english.hi.is/research/the_university_of_iceland_research_ fund_0, author IT). A personal grant from Finnish Cultural Foundation (https://skr.fi/en, author AE). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: Copyright: © 2023 Eloranta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: © 2023 Eloranta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Women who are obese before pregnancy have a higher risk of caesarean section than normal weight women. We investigated the combined effect of pre-pregnancy weight and gestational weight gain on pre-labour and intrapartum caesarean section risk. We collected data on 22,763 singleton, term, live deliveries in 2003–2014 from the Icelandic Maternal and Child Health Study (ICE-MCH), based on Icelandic registries. These were the Icelandic Medical Birth Registry and the Saga Maternal and Child Health Database. Pre-pregnancy body mass index was categorised into underweight, normal weight, overweight and obese. Gestational weight gain was classified according to the Institute of Medicine's recommendation into below, within and above the recommended range. Logistic regression models, adjusted for maternal and gestational characteristics, were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the risk of caesarean section. Obese women had a higher risk of pre-labour (AOR 1.56, 95% CI 1.34–1.81) and intrapartum caesarean section (AOR 1.92, 95% CI 1.70–2.17) than normal weight women in all categories of gestational weight gain. Gestational weight gain above the recommended range, compared to within the range, increased the risk of intrapartum caesarean section among normal weight (AOR 1.46, 95% CI 1.23–1.73) and overweight women (AOR 1.291, 95% CI 1.04–1.60). Gestational weight gain below the recommended range, compared to within the range, increased the risk of pre-labour caesarean section (AOR 1.64, 95% CI 1.20–2.25), but only among overweight women. Women who are obese before pregnancy have a high risk of caesarean section regardless of gestational weight gain. However, women who are normal weight or overweight before pregnancy and gain weight above the recommended range during pregnancy may also have an increased risk of caesarean section.Peer reviewe

Insufficient iodine status in pregnant women as a consequence of dietary changes

Background: Historically, Iceland has been an iodine-sufficient nation due to notably high fish and milk consumption. Recent data suggest that the intake of these important dietary sources of iodine has decreased considerably. Objective: To evaluate the iodine status of pregnant women in Iceland and to determine dietary factors associated with risk for deficiency. Methods: Subjects were women (n = 983; 73% of the eligible sample) attending their first ultrasound appointment in gestational weeks 11–14 in the period October 2017–March 2018. Spot urine samples were collected for assessment of urinary iodine concentration (UIC) and creatinine. The ratio of iodine to creatinine (I/Cr) was calculated. Median UIC was compared with the optimal range of 150–249 µg/L defined by the World Health Organization (WHO). Diet was assessed using a semiquantitative food frequency questionnaire (FFQ), which provided information on main dietary sources of iodine in the population studied (dairy and fish). Results: The median UIC (95% confidence interval (CI)) and I/Cr of the study population was 89 µg/L (42, 141) and 100 (94, 108) µg/g, respectively. UIC increased with higher frequency of dairy intake, ranging from median UIC of 55 (35, 79) µg/L for women consuming dairy products 2 times per day (P for trend <0.001). A small group of women reporting complete avoidance of fish (n = 18) had UIC of 50 (21, 123) µg/L and significantly lower I/Cr compared with those who did not report avoidance of fish (58 (34, 134) µg/g vs. 100 (94, 108) µg/g, P = 0.041). Women taking supplements containing iodine (n = 34, 3.5%) had significantly higher UIC compared with those who did not take supplements (141 (77, 263) µg/L vs. 87 (82, 94), P = 0.037). Conclusion: For the first time, insufficient iodine status is being observed in an Icelandic population. There is an urgent need for a public health action aiming at improving iodine status of women of childbearing age in Iceland.Recruitment and sample collection was funded by the University of Iceland Research Fund and Science Fund of Landspitali National University Hospital. Shipment of samples and part of the iodine analysis were funded by the EUthyroid Project, supported by the European Union’s Horizon 2020 Research and Innovation Program under grant agreement No 634453. The authors would like to thank nurses and midwives at the Prenatal Diagnostic Unit at Landspitali National University Hospital for their hospitality and positive attitudes, which greatly contributed to the recruitment of participants for this study.Peer Reviewe

Iodine intake in human nutrition: a systematic literature review.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.The present literature review is a part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. The main objective of the review is to assess the influence of different intakes of iodine at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation) in order to estimate the requirement for adequate growth, development, and maintenance of health. The literature search resulted in 1,504 abstracts. Out of those, 168 papers were identified as potentially relevant. Full paper selection resulted in 40 papers that were quality assessed (A, B, or C). The grade of evidence was classified as convincing, probable, suggestive, and no conclusion. We found suggestive evidence for improved maternal iodine status and thyroid function by iodine supplementation during pregnancy. Suggestive evidence was found for the relationship between improved thyroid function (used as an indicator of iodine status) during pregnancy and cognitive function in the offspring up to 18 months of age. Moderately to severely iodine-deficient children will probably benefit from iodine supplementation or improved iodine status in order to improve their cognitive function, while only one study showed improved cognitive function following iodine supplementation in children from a mildly iodine-deficient area (no conclusion). No conclusions can be drawn related to other outcomes included in our review. There are no new data supporting changes in dietary reference values for children or adults. The rationale for increasing the dietary reference values for pregnant and lactating women in the NNR5 needs to be discussed in a broader perspective, taking iodine status of pregnant women in the Nordic countries into account