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Assessment of iodine nutrition in populations: past, present, and future.

Abstract
Iodine status has been historically assessed by palpation of the thyroid and reported as goiter rates. Goiter is a functional biomarker that can be applied to both individuals and populations, but it is subjective. Iodine status is now assessed using an objective biomarker of exposure, i.e., urinary iodine concentrations (UICs) in spot samples and comparison of the median UIC to UIC cut-offs to categorize population status. This has improved standardization, but inappropriate use of the crude proportion of UICs below the cut-off level of 100 µg/L to estimate the number of iodine-deficient children has led to an overestimation of the prevalence of iodine deficiency. In this review, a new approach is proposed in which UIC data are extrapolated to iodine intakes, adjusted for intraindividual variation, and then interpreted using the estimated average requirement cut-point model. This may allow national programs to define the prevalence of iodine deficiency in the population and to quantify the necessary increase in iodine intakes to ensure sufficiency. In addition, thyroglobulin can be measured on dried blood spots to provide an additional sensitive functional biomarker of iodine status.
AuthorsMichael B Zimmermann, Maria Andersson
JournalNutrition reviews (Nutr Rev) Vol. 70 Issue 10 Pg. 553-70 (Oct 2012) ISSN: 1753-4887 [Electronic] United States
PMID23035804 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Copyright© 2012 International Life Sciences Institute.
Chemical References
  • Biomarkers
  • Sodium Chloride, Dietary
  • iodized salt
  • Thyrotropin
  • Iodine
  • Thyroxine
Topics
  • Biomarkers (urine)
  • Goiter (epidemiology)
  • Humans
  • Iodine (administration & dosage, deficiency, urine)
  • Nutrition Assessment
  • Nutritional Status
  • Prevalence
  • Sodium Chloride, Dietary (administration & dosage)
  • Thyroid Gland (pathology)
  • Thyrotropin (blood)
  • Thyroxine (blood)

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