Campanozzi, Angelo

De Filippo, Gianpaolo

Macchia, Paolo Emidio

Strazzullo, Pasquale

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Campanozzi A.

MacChia P. E.

De Filippo G.

Strazzullo P.

Archivio Istituzionale della Ricerca- Università degli Studi di Foggia

Reply to A Olivieri et al

Archivio della ricerca - Università degli studi di Napoli Federico II

Letters to the EditorReply to A Olivieri et al.Dear Editor:With regard to the comment on our article by Olivieri et al. (1), wewish to point out that the recruitment of our national sample of Italianschoolchildren and adolescents (aged 6–18 y) for the assessment ofdietary iodine intake using 24-h urine collections took place in 2012and thus our conclusions refer to that time (2). We appreciate thatOlivieri et al. (1) report results of an independent survey conductedbetween 2007 and 2012 in another population of schoolchildrenresiding in 9 Italian regions, showing that in fact most of thoseregions appeared to be iodine deficient based on a different criterion[i.e., median spot urinary iodine concentration (UIC) < 100 μg/L](3).Of course, inferring information about a population’s “iodinestatus” by the measurement of UIC in spot urine samples andapproaching the knowledge of “true” habitual dietary iodine intakeof a population through the collection of 24-h urine samples are 2different things and we believe that both may be useful and necessaryin different settings and to different purposes. Indeed, as mentionedin our article, just based on iodine intakes ensuring a UIC (≥100μg/L) associated with the lowest prevalence of goiter in school-aged children, the European Food Safety Authority (EFSA) set age-specific Adequate Intakes (AIs) of iodine ranging between 70 μg/24h for schoolchildren and 150 μg/24 h at the end of adolescence (4).Using the EFSA AIs as a reference, we found out that 47.2% of ouryoung Italian population sample had a lower than adequate iodineintake and the situation was particularly critical for children belowthe age of 8 y.We are happy to learn that a further survey initiated in 2015by Olivieri et al. (1) and still in progress seems to suggest amarked improvement with regard to the iodine status of the youngItalian population: although we look forward to the publicationof their results once the study is completed, we think that a newassessment of actual iodine intake in a representative sample of theyoung population in Italy using the gold-standard assessment of24-h urinary iodine excretion would be more than appropriate tofind out whether the percentage of nutritional inadequacy detectedin our survey of 2012 has been reduced thanks to the publiccampaigns undertaken in the interim. One reason for concern in ouropinion is that these campaigns addressed almost exclusively a morewidespread discretionary use of iodized salt at home and in collectivecatering, whereas much less emphasis was put on the need to increasethe use of iodized salt in artisanal and industrial food products andon the promotion of milk and fish consumption among children andadolescents as important additional sources of dietary iodine.None of the authors reported a conflict of interest.Angelo CampanozziPaolo Emidio MacchiaGianpaolo De FilippoPasquale StrazzulloFrom Pediatrics, Department of Medical and Surgical Sciences,University of Foggia Medical School, Foggia, Italy (AC, e-mail:angelo.campanozzi@unifg.it); Department of Clinical Medicineand Surgery, Federico II University of Naples Medical School,Naples, Italy (PEM, GDF, and PS); and AssistancePublique—Hôpitaux de Paris, Hôpital Bicêtre, Service deMédecine des Adolescents, Le Kremlin-Bicêtre, France (GDF).References1. Olivieri A, Andò S, Bagnasco M, Meringolo D, Mian C, Moleti M,Puxeddu E, Regalbuto C, Taccaliti A, Tanda ML, et al. The iodinenutritional status in the Italian population: data from the Italian NationalObservatory for Monitoring Iodine Prophylaxis (OSNAMI) (period2015–2019). Am J Clin Nutr 2019, https://doi.org/10.1093/ajcn/nqz206.2. Campanozzi A, Rutigliano I, Macchia PE, De Filippo G, Barbato A,Iacone R, Russo O, D’Angelo G, Frigeri M, Pensabene L, et al. Iodinedeficiency among Italian children and adolescents assessed through 24-hour urinary iodine excretion. Am J Clin Nutr 2019;109:1080–7.3. Olivieri A, Di Cosmo C, De Angelis S, Da Cas R, Stacchini P, PastorelliA, Vitti P; Regional Observatories for Goiter Prevention. The wayforward in Italy for iodine. Minerva Med 2017;108(2):159–68.4. European Food Safety Authority Panel. Scientific opinion on dietaryreference values for iodine. EFSA J 2014;12(5):3660.doi: https://doi.org/10.1093/ajcn/nqz207.Am J Clin Nutr 2019;110:1267. Printed in USA. Copyright © American Society for Nutrition 2019. All rights reserved. 1267Downloaded from https://academic.oup.com/ajcn/article-abstract/110/5/1267/5609708 by Universita di Napoli user on 06 November 2019

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Archivio Istituzionale della Ricerca- Università degli Studi di Foggia

Archivio della ricerca - Università degli studi di Napoli Federico II