Salt Used for the National School Nutrition Program (NSNP) in Rural Schools of Limpopo Province, South Africa, has Adequate Levels of Iodine

Background. Salt iodisation is considered the most effective long-term public health intervention for achieving optimal iodine nutrition. Effective salt iodisation is a prerequisite for the sustainable elimination of iodine deficiency disorders. The aim of this study was to determine iodine concentration of salt used for the National School Nutrition Program (NSNP). Methods. A cross-sectional study was conducted in 359 food handlers from Vhembe and Mopani districts of Limpopo Province, South Africa. The questionnaire was administered to solicit data on demographic information, general questions on salt fortification, and iodine nutrition knowledge. After the interviews, two tablespoons of salt used for the NSNP food preparation was collected from 318 schools in small zip-lock plastic bags. The salt samples were coded and stored at room temperature and protected from light and moisture until the time of analysis. Salt iodine concentrations were determined at the North-West University (NWU) in Potchefstroom by means of the iCheck test method. Results. The median iodine concentration of both Mopani (31.65 ppm) and Vhembe (32.56 ppm) districts signified adequate iodine levels. Of 318 salt samples, 113 (71%) samples in Mopani and 104 (65%) in Vhembe had an iodine concentration of 15–64 ppm. A few (6%) food handlers in Mopani and almost half (45.9%) in Vhembe could correctly identify iodated salt as the main source of iodine. Almost half of the food handlers (%) in Mopani and 36.5% in Vhembe did not know which part of body needs iodine for functioning. Conclusion. More than 20 years after the implementation of the USI program, the result of the study shows that the international goal of 90% coverage is still far from being realised

Household socio-economic determinants of food security in Limpopo Province of South Africa: a cross sectional survey

Abstract Background Despite the strong commitment at both national and international levels to eradicate hunger and achieve household food security, by 2030 food insecurity remains a public health problem. South Africa is amongst the countries with the highest rate of income inequality in the world and extremely high levels of absolute poverty. The Gini coefficient in South Africa is estimated at 0.68 Although South Africa may be food secure at a national level, large numbers of households within the country are food insecure approximately 52% of the rural households in Limpopo Province of South Africa were considered severely food insecure. It has been noted that the majority of households in South African informal settlements and rural areas were moderately or severely food insecure due to lack of access to food which was directly related to income. Rural areas have assets that can be explored to support households. The adult population above 18 years in South Africa make up 78% of the 5.9 million population with about 40% living in rural areas, this study explored household food insecurity in adults in rural environments. The current study aimed to explore the socioeconomic and dietary determinants of household food insecurity among the adult population in the Limpopo Province. Methods A cross-sectional survey design was used, and data were collected using a validated pre-tested questionnaire. The participants were recruited from households in Limpopo province. Multiple linear regression was computed to explore the influence of socioeconomic and dietary practices on food insecurity. Results The study included 699 randomly selected participants of which the majority earned a monthly income ≤ 3000 ZAR, and 31.8% experiencing hunger in the past 30 days at the time of study. The dietary practices of the participants were found to be associated with household food insecurity. The study found that large family size, being female in South Africa, low household income and low rate of regular breakfast intake were significant determinants of household food insecurity (p < 0.05). Conclusion In summary, most of the households were poor and approximately one-third were food insecure. The implementation of sustainable employment policies, and food-based approaches and targeting rural household food production could significantly reduce food insecurity in the rural area

Dried blood spot thyroglobulin as a biomarker of iodine status in pregnant women

Context: Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.ISSN:0021-972XISSN:1945-719

Dried Blood Spot Thyroglobulin as a Biomarker of Iodine Status in Pregnant Women

DBS-Tg is a sensitive biomarker of iodine status in PW, the reference range in iodine sufficient PW is 0.3-43.5 μg/L and a median DBS-Tg <10 μg/L indicates iodine sufficiency in PW