Associations between thyroid dysfunction and developmental status in children with excessive iodine status

Background and objective: Adequate iodine status and normal thyroid hormone synthesis are important for optimal child development. In this study, we explored whether young children’s developmental status is associated with thyroid dysfunction in an area of chronic excessive iodine exposure. Methods: We included 298 children between 18 and 48 months of age residing in Algerian refugee camps. Early child development was measured using the Ages and Stages Questionnaires, third edition (ASQ-3), consisting of five domains: Communication, Gross Motor, Fine Motor, Problem Solving and Personal-Social. Due to poor discriminatory ability in the Gross Motor domain, the total ASQ-3 scores were calculated both including and excluding this domain. Urinary iodine concentration (UIC), thyroid hormones (TSH, FT3 and FT4), thyroid antibodies and serum thyroglobulin (Tg) were measured. Results: The median UIC was 451.6 μg/L, and approximately 72% of the children had a UIC above 300 μg/L. Furthermore, 14% had thyroid disturbances, of whom 10% had TSH outside the reference range. Children with thyroid disturbances and TSH outside the reference ranges had lower odds of being among the 66% highest total ASQ scores, with adjusted odds ratios (95% CI) of 0.46 (0.23, 0.93) and 0.42 (0.19, 0.94), respectively. Conclusion: We found an association between thyroid dysfunction and poorer developmental status among children with excessive iodine intake. The high iodine intake may have caused the thyroid dysfunction and hence the delayed developmental status; however, other influential factors cannot be excluded. Optimal child development is important for a sustainable future. With iodine excess being an increasing problem globally, this subject should be further explored.publishedVersio

High iodine content in local animal milk and risk of exceeding EFSA upper intake level for iodine among Saharawi women

Excessive iodine intake is a major public health problem in the Saharawi refugee camps in Algeria, where animal milk is an important source of iodine. The purpose of this study was to assess the association between iodine concentrations in locally produced animal milk and in animal drinking water and further to assess the risk of exceeding European Food Safety Authority (EFSA) tolerable upper intake level for iodine (600 μg/d) among Saharawi women. In 2009 and 2010, 202 milk samples from goats and sheep and 52 milk samples from camel were collected. Iodine in milk was determined by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). In addition, iodine in 56 water samples from the general water system and 54 water samples from wells, was determined by modified Sandell-Kolthoff reaction. Animal milk is generally consumed mixed with water. The median (min, max) iodine intake from goat/sheep milk mixed with water in camps with high iodine content in human drinking water was 284 (57, 2889) μg/d and 19% of participants exceeded EFSA upper intake level for iodine. The median (min, max) iodine intake from camel milk mixed with water in all camps was 2100 (210, 11100) and 47% of participants exceeded the EFSA upper intake level. The median (min, max) iodine content in goat/sheep milk from camps with moderate and high iodine content in water was 507 (101, 4791) μg/L and 1612 (487, 9323) μg/L, respectively (p < 0.001). The iodine content in goat/sheep milk was positively associated with iodine content in animal drinking water (regression coefficient, B 5.71, 95% CI 4.03, 7.39). In conclusion, consumption of camel milk and living in camps with high water iodine content increased the risk of exceeding the EFSA upper intake level for iodine. We suggest that purified water for both human and animal consumption should be provided.publishedVersio

Environmental implication of iodine in water, milk and other foods used in Saharawi refugees camps in Tindouf, Algeria

A cross-sectional survey among Saharawi refugees in four camps carried out in 2007 revealed enlarged thyroid volume and high urinary iodine concentration in women and school children. The purpose of this paper is to describe the content of iodine in food and water and explore whether any sources in the environment can explain the situation. Samples of water (n = 143), milk (n = 19) and salt (n = 89) were collected. Different wells supplied the camps with water and the median iodine concentration was 108 mg/L (range 55–545 mg/L) and significantly higher in two of the camps (El Aiune and Ausserd; 300 mg/L (range 55–545 mg/L)), compared to the two other camps (Smara; 87 mg/L (55–127 mg/L) and Dakla; 70 mg/L (55–96 mg/L)). In local goat milk the median iodine concentration was 370 mg/L (70– 13,070 mg/L). The median content of iodine in salt was 6 mg/g (0–51 mg/g). Water and local milk were the most important sources of iodine for women. High levels of iodine in water seem to be one of the main sources of iodine that affects humans as well as animal

Iodine-induced goitre and high prevalence of anaemia among Saharawi refugee women

Objective: The main objective was to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women. Design: A cross-sectional survey was performed during January–February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in spot urine samples and in household drinking water. Anthropometry and Hb concentration were measured and background variables were collected using pre-coded questionnaires. Setting: The survey was undertaken in four long-term refugee camps in the Algerian desert. Subjects: Non-pregnant women (n 394), 15–45 years old, randomly selected. Results: Median (25th percentile–75th percentile (P25–P75)) UIC was 466 (294–725)mg/l. Seventy-four per cent had UIC above 300mg/l and 46% above 500mg/l. Median (P25–P75) Tvol was 9?4 (7?4–12?0) ml and the goitre prevalence was 22 %. UIC was positively associated with iodine in drinking water and negatively associated with breast-feeding, and these two variables explained 28% of the variation in UIC. The mean (SD) Hb level was 11.8 (2.4) g/dl. In total 46% were anaemic with 14 %, 25% and 7%, classified with respectively mild, moderate and severe anaemia. Conclusions: The Saharawi women had high UIC, high levels of iodine in drinking water and increased Tvol and probably suffered from iodine-induced goitre. The high prevalence of anaemia is considered to be a severe public health concern. To what extent the excessive iodine intake and the anaemia have affected thyroid function is unknown and should be addressed in future studies. Keywords Excess urinary iodine Iodine-rich drinking water Saharawi refuge women Iron deficiency Women’s micronutrient status is of particular importance since it affects not only their own health, but also the health of their children(1). Deficiencies of iodine and Fe remain major public health problems, affecting .30% of the global population(2,3). Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases(4). Fe deficiency is the most common and widespread micronutrient deficiency worldwide(3) and may have multiple adverse effects on thyroid metabolism(5). Refugees from Western Sahara have been settled in the Algerian desert since 1975 and they are totally dependent on food aid in the harsh, resource-poor desert environment. The refugee population is experiencing a number of challenges related to their food, nutrition and health situation(6). Endemic goitre has been reported among Saharawi schoolchildren and this is probably caused by iodine excess(7–10), but further studies are required to understand the aetiology. The main objective of the present paper is to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women of childbearing age. The secondary objective is to assess their prevalence of anaemia

The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide

Background: A plant-based diet protects against chronic oxidative stress-related diseases. Dietary plants contain variable chemical families and amounts of antioxidants. It has been hypothesized that plant antioxidants may contribute to the beneficial health effects of dietary plants. Our objective was to develop a comprehensive food database consisting of the total antioxidant content of typical foods as well as other dietary items such as traditional medicine plants, herbs and spices and dietary supplements. This database is intended for use in a wide range of nutritional research, from in vitro and cell and animal studies, to clinical trials and nutritional epidemiological studies. Methods: We procured samples from countries worldwide and assayed the samples for their total antioxidant content using a modified version of the FRAP assay. Results and sample information (such as country of origin, product and/or brand name) were registered for each individual food sample and constitute the Antioxidant Food Table. Results: The results demonstrate that there are several thousand-fold differences in antioxidant content of foods. Spices, herbs and supplements include the most antioxidant rich products in our study, some exceptionally high. Berries, fruits, nuts, chocolate, vegetables and products thereof constitute common foods and beverages with high antioxidant values. Conclusions: This database is to our best knowledge the most comprehensive Antioxidant Food Database published and it shows that plant-based foods introduce significantly more antioxidants into human diet than non-plant foods. Because of the large variations observed between otherwise comparable food samples the study emphasizes the importance of using a comprehensive database combined with a detailed system for food registration in clinical and epidemiological studies. The present antioxidant database is therefore an essential research tool to further elucidate the potential health effects of phytochemical antioxidants in diet

Prevalence of goitre and evaluation of food intake among Saharawi refugees in camps in Tindouf, Algeria

In January/February 2007 a cross-sectional survey was conducted in the Saharawi refugee camps. The main objective of this survey was to identify the causes of goitre through assessing the iodine status, identifying sources of iodine and assessing the dietary intake. Totally 421 children (6-14 years) and 405 women (5 – 45 years) were randomly selected from 96 households. The prevalence of goitre was estimated by palpation, ultrasound was used to determine thyroid volume (Tvol) and a casual urine sample was collected from each participant to analyse urinary iodine. In addition anthropometric measurements (weight and height) were preformed and a pre-coded questionnaire for background information and food intake was collected. A HemoCue B-Haemoglobin analyser was used to measure the level of haemoglobi

High iodine content in local animal milk and risk of exceeding EFSA upper intake level for iodine among Saharawi women

Excessive iodine intake is a major public health problem in the Saharawi refugee camps in Algeria, where animal milk is an important source of iodine. The purpose of this study was to assess the association between iodine concentrations in locally produced animal milk and in animal drinking water and further to assess the risk of exceeding European Food Safety Authority (EFSA) tolerable upper intake level for iodine (600 μg/d) among Saharawi women. In 2009 and 2010, 202 milk samples from goats and sheep and 52 milk samples from camel were collected. Iodine in milk was determined by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). In addition, iodine in 56 water samples from the general water system and 54 water samples from wells, was determined by modified Sandell-Kolthoff reaction. Animal milk is generally consumed mixed with water. The median (min, max) iodine intake from goat/sheep milk mixed with water in camps with high iodine content in human drinking water was 284 (57, 2889) μg/d and 19% of participants exceeded EFSA upper intake level for iodine. The median (min, max) iodine intake from camel milk mixed with water in all camps was 2100 (210, 11100) and 47% of participants exceeded the EFSA upper intake level. The median (min, max) iodine content in goat/sheep milk from camps with moderate and high iodine content in water was 507 (101, 4791) μg/L and 1612 (487, 9323) μg/L, respectively (p < 0.001). The iodine content in goat/sheep milk was positively associated with iodine content in animal drinking water (regression coefficient, B 5.71, 95% CI 4.03, 7.39). In conclusion, consumption of camel milk and living in camps with high water iodine content increased the risk of exceeding the EFSA upper intake level for iodine. We suggest that purified water for both human and animal consumption should be provided