School of Nutritional Science; Institute of Biochemistry, Food Science and Nutrition; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 76100, Rehovot, Israel.
Obstetrics and Gynecology Department, "Barzilai" University Medical Center Ashkelon, Ashkelon, Israel.
Isr J Health Policy Res. 2020 Mar 30;9(1):9. doi: 10.1186/s13584-020-00367-4.
Iodine is an essential nutrient for human health throughout the life cycle, especially during early stages of intrauterine life and infancy, to ensure adequate neurocognitive development. The growing global reliance on desalinated iodine-diluted water raises the specter of increased iodine deficiency in several regions. The case of Israel may be instructive for exploring the link between iodine status and habitual iodine intake in the setting of extensive national reliance on desalinated water. The aim of this study was to explore the relationship between iodine intake, including iodized salt and iodine-containing supplements intake, and iodine status among pregnant women residing in a sub-district of Israel that is highly reliant on desalinated iodine-diluted water.
A total of 134 consecutive pregnant women were recruited on a voluntary basis from the obstetrics department of the Barzilai University Medical Center during 2018. Blood was drawn from participants to determine levels of serum thyrotropin (TSH), thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and thyroglobulin (Tg). An iodine food frequency questionnaire (sIFFQ) was used to assess iodine intake from food, IS and ICS. A questionnaire was used to collect data on demographic and health characteristics.
A total of 105 pregnant women without known or reported thyroid disease were included in the study. Elevated Tg values (≥ 13 μg/L), were found among 67% of participants, indicating insufficient iodine status. The estimated iodine intake (median, mean ± SD 189, 187 ± 106 μg/d by sIFFQ) was lower than the levels recommended by the World Health Organization and the Institute of Medicine (250 vs. 220 μg/day respectively). The prevalence of iodized salt intake and iodine containing supplement intake were 4 and 52% (respectively). Values of Tg > 13 μg/L were inversely associated with compliance with World Health Organization and Institute of Medicine recommendations.
While the Israeli Ministry of Health has recommended the intake of iodized salt and iodine containing supplements, this is apparently insufficient for achieving optimal iodine status among Israeli pregnant women. The evidence of highly prevalent probable iodine deficiency in a sample of pregnant women suggests an urgent need for a national policy of iodized salt regulation, as well as guidelines to promote iodine containing supplements and adherence to them by caregivers. In addition, studies similar to this one should be undertaken in additional countries reliant on desalinated iodine-diluted water to further assess the impact of desalinization on maternal iodine status.
碘是人类整个生命周期健康所必需的营养物质，尤其是在子宫内生命早期和婴儿期，以确保足够的神经认知发育。在全球范围内对淡化碘稀释水的依赖日益增加，这使得一些地区的碘缺乏问题更加严重。以色列的情况可能有助于探索在广泛依赖淡化水的情况下，碘状况与习惯性碘摄入量之间的联系。本研究的目的是探讨居住在高度依赖淡化碘稀释水的以色列一个分区的孕妇的碘摄入量（包括碘盐和含碘补充剂）与碘状况之间的关系。
2018 年，我们在巴齐利大学医学中心的妇产科部门自愿招募了 134 名连续孕妇。从参与者中抽取血液以确定血清促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）和甲状腺球蛋白（Tg）的水平。使用碘食物频率问卷（sIFFQ）评估食物、IS 和 ICS 中的碘摄入量。使用问卷收集人口统计学和健康特征数据。
共有 105 名无已知或报告甲状腺疾病的孕妇纳入研究。67%的参与者 Tg 值升高（≥13μg/L），表明碘状况不足。sIFFQ 估计的碘摄入量（中位数，平均值±标准差 189、187±106μg/d）低于世界卫生组织和医学研究所推荐的水平（分别为 250 和 220μg/天）。碘盐摄入量和含碘补充剂摄入量的比例分别为 4%和 52%。Tg 值>13μg/L 与符合世界卫生组织和医学研究所建议呈负相关。
尽管以色列卫生部已建议摄入碘盐和含碘补充剂，但这显然不足以使以色列孕妇达到最佳碘状态。在孕妇样本中发现高度流行的疑似碘缺乏症的证据表明，迫切需要制定国家碘盐监管政策，以及制定准则以促进含碘补充剂的使用并促进照顾者遵守这些准则。此外，应该在其他依赖淡化碘稀释水的国家开展类似的研究，以进一步评估淡化对孕产妇碘状况的影响。
