Improving Pregnant Women’s Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Location
2.3. Study Population
2.4. Data Collection
2.5. Dietary Intake Data
2.6. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Doyle, I.M.; Borrmann, B.; Grosser, A.; Razum, O.; Spallek, J. Determinants of Dietary Patterns and Diet Quality during Pregnancy: A Systematic Review with Narrative Synthesis. Public Health Nutr. 2017, 20, 1009–1028. [Google Scholar] [CrossRef] [PubMed]
- Iodine Global Network (IGN). Annual Report—2021. Available online: https://www.ign.org/reports.htm (accessed on 10 July 2022).
- Fuge, R.; Johnson, C.C. Iodine and Human Health, the Role of Environmental Geochemistry and Diet, a Review. Appl. Geochem. 2015, 63, 282–302. [Google Scholar] [CrossRef]
- Miller, B.D.D.; Welch, R.M. Food System Strategies for Preventing Micronutrient Malnutrition. Food Policy 2013, 42, 115–128. [Google Scholar] [CrossRef]
- Tan, L.; Tian, X.; Wang, W.; Guo, X.; Sang, Z.; Li, X.; Zhang, P.; Sun, Y.; Tang, C.; Xu, Z.; et al. Exploration of the Appropriate Recommended Nutrient Intake of Iodine in Healthy Chinese Women: An Iodine Balance Experiment. Br. J. Nutr. 2019, 121, 519–528. [Google Scholar] [CrossRef] [PubMed]
- Chen, W.; Gao, S.; Guo, W.; Tan, L.; Pan, Z.; Dong, S.; Jin, Y.; Zhang, Y.; Zhang, W.; Shen, J. Intra-Individual and Inter-Individual Variations in Iodine Intake and Excretion in Adult Women: Implications for Sampling. Br. J. Nutr. 2020, 123, 987–993. [Google Scholar] [CrossRef]
- Willett, W. Nutritional Epidemiology, 3rd ed.; Oxford University Press: New York, NY, USA, 2013. [Google Scholar]
- Gibson, R.S.; Charrondiere, U.R.; Bell, W. Measurement Errors in Dietary Assessment Using Self-Reported 24-Hour Recalls in Low-Income Countries and Strategies for Their Prevention. Adv. Nutr. Int. Rev. J. 2017, 8, 980–991. [Google Scholar] [CrossRef]
- National Cancer Institute (NCI). Dietary Assessment Primer. Available online: https://dietassessmentprimer.cancer.gov/ (accessed on 27 September 2020).
- European Food Safety Authority (EFSA). Scientific Opinion on Dietary Reference Values for Iodine. EFSA J. 2014, 12, 3660. [Google Scholar] [CrossRef]
- Tooze, J.A.; Kipnis, V.; Buckman, D.W.; Carroll, R.J.; Freedman, L.S.; Guenther, P.M.; Krebs-Smith, S.M.; Subar, A.F.; Dodd, K.W. A Mixed-Effects Model Approach for Estimating the Distribution of Usual Intake of Nutrients: The NCI Method. Stat. Med. 2010, 29, 2857–2868. [Google Scholar] [CrossRef]
- Tooze, J.A.; Midthune, D.; Dodd, K.W.; Freedman, L.S.; Krebs-Smith, S.M.; Subar, A.F.; Guenther, P.M.; Carroll, R.J.; Kipnis, V. A New Statistical Method for Estimating the Usual Intake of Episodically Consumed Foods with Application to Their Distribution. J. Am. Diet. Assoc. 2006, 106, 1575–1587. [Google Scholar] [CrossRef]
- Luo, H.; Dodd, K.W.; Arnold, C.D.; Engle-Stone, R. Introduction to the SIMPLE Macro, a Tool to Increase the Accessibility of 24-Hour Dietary Recall Analysis and Modeling. J. Nutr. 2021, 151, 1329–1340. [Google Scholar] [CrossRef]
- German Institute of Human Nutrition Potsdam-Rehbrücke. Multiple Source Method (MSM) for Estimating Usual Dietary Intake from Short-Term Measurement Data. 2011. Available online: https://msm.dife.de/static/MSM_UserGuide.pdf (accessed on 27 September 2020).
- Dekkers, A.; de Jong, M.; Verkaik-Kloosterman, J.; Ocké, M. SPADE: Statistical Program to Assess Habitual Dietary. 2021. Available online: https://www.rivm.nl/documenten/manual-spade-version-4100 (accessed on 20 July 2022).
- Kipnis, V.; Midthune, D.; Buckman, D.W.; Dodd, K.W.; Guenther, P.M.; Krebs-Smith, S.M.; Subar, A.F.; Tooze, J.A.; Carroll, R.J.; Freedman, L.S. Modeling Data with Excess Zeros and Measurement Error: Application to Evaluating Relationships between Episodically Consumed Foods and Health Outcomes. Biometrics 2009, 65, 1003–1010. [Google Scholar] [CrossRef] [PubMed]
- Subar, A.F.; Dodd, K.W.; Guenther, P.M.; Kipnis, V.; Midthune, D.; McDowell, M.; Tooze, J.A.; Freedman, L.S.; Krebs-Smith, S.M. The Food Propensity Questionnaire: Concept, Development, and Validation for Use as a Covariate in a Model to Estimate Usual Food Intake. J. Am. Diet. Assoc. 2006, 106, 1556–1563. [Google Scholar] [CrossRef] [PubMed]
- Laureano, G.H.C. Influência Da Suposição Sobre a Frequência Do Consumo, Diário Ou Episódico, e Do Uso de Covariáveis Na Distribuição Do Consumo Alimentar Usual Nos Métodos MSM, NCI e SPADE. Master’s Thesis, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 2018. Available online: https://lume.ufrgs.br/handle/10183/199064 (accessed on 19 June 2020).
- Souverein, O.W.; Dekkers, A.L.; Geelen, A.; Haubrock, J.; de Vries, J.H.; Ocké, M.C.; Harttig, U.; Boeing, H.; Veer, P. Comparing Four Methods to Estimate Usual Intake Distributions. Eur. J. Clin. Nutr. 2011, 65, S92–S101. [Google Scholar] [CrossRef] [PubMed]
- Laureano, G.H.C.; Torman, V.B.L.; Crispim, S.P.; Dekkers, A.L.M.; Camey, S.A. Comparison of the ISU, NCI, MSM, and SPADE Methods for Estimating Usual Intake: A Simulation Study of Nutrients Consumed Daily. Nutrients 2016, 8, 166. [Google Scholar] [CrossRef]
- Juan, W.Y.; Trumbo, P.R.; Spungen, J.H.; Dwyer, J.T.; Carriquiry, A.L.; Zimmerman, T.P.; Swanson, C.C.B.A.; Murphy, S.P. Comparison of 2 Methods for Estimating the Prevalences of Inadequate and Excessive Iodine Intakes. Am. J. Clin. Nutr. 2016, 104, 888S–897S. [Google Scholar] [CrossRef] [PubMed]
- Bonham, M.P.; Duffy, E.M.; Robson, P.J.; Wallace, J.M.; Myers, G.J.; Davidson, P.W.; Clarkson, T.W.; Shamlaye, C.F.; Strain, J.J.; Livingstone, M.B.E. Contribution of Fish to Intakes of Micronutrients Important for Fetal Development: A Dietary Survey of Pregnant Women in the Republic of Seychelles. Public Health Nutr. 2009, 12, 1312–1320. [Google Scholar] [CrossRef]
- Bouga, M.; Lean, M.E.J.; Combet, E. Contemporary Challenges to Iodine Status and Nutrition: The Role of Foods, Dietary Recommendations, Fortification and Supplementation. Proc. Nutr. Soc. 2018, 77, 302–313. [Google Scholar] [CrossRef]
- do Franceschini, S.C.C.; de Macedo, M.S. Estado Nutricional de Iodo Entre Gestantes, Nutrizes e Lactentes Brasileiros: Um Estudo Multicêntrico. Available online: https://emdibrasil.com.br/ (accessed on 20 April 2019).
- Instituto Brasileiro de Geografia e Estatística (IBGE). Panorama—Brasil. 2022. Available online: https://cidades.ibge.gov.br/brasil/panorama (accessed on 19 July 2022).
- Iodine Global Network (IGN). Global Iodine Nutrition Scorecard and Map. Available online: https://www.ign.org/cm_data/IGN_Global_Scorecard_2021_7_May_2021.pdf (accessed on 27 September 2020).
- Brasil Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Manual Técnico e Operacional Do Pró-Iodo: Programa Nacional Para a Prevenção e Controle Dos Distúrbios Por Deficiência de Iodo 2008, 22. Available online: https://bvsms.saude.gov.br/bvs/publicacoes/manual_tecnico_operacional_proiodo.pdf (accessed on 20 April 2019).
- Ministério da Saúde RDC No 23, De 24 De Abril De 2013. Diário Oficial da União 2013, 1. Available online: https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2013/res0023_23_04_2013.html (accessed on 20 April 2019).
- Battisti, I. Análise de Dados Epidemiológicos Incorporando Planos Amostrais Complexos. Master’s Thesis, Universidade Federal do Rio Grande do Sul, Porto Algre, Brazil, 2008. Available online: https://lume.ufrgs.br/handle/10183/14675 (accessed on 15 June 2018).
- Patridge, E.F.; Bardyn, T.P. Research Electronic Data Capture (REDCap). J. Med. Libr. Assoc. 2018, 106, 142–144. [Google Scholar] [CrossRef]
- Instituo Adolfo Lutz. Normas Analíticas do Instituto Adolfo Lutz: Métodos Químicos e Físicos Para Análise de Alimentos, 3rd ed.; IMESP: São Paulo, Brazil, 1985; p. 288. [Google Scholar]
- American Public Health Association. Standard Methods for the Examination of Water and Wastewater; American Public Health Association: Washington, DC, USA, 2005; Volume 21. [Google Scholar]
- Moshfegh, A.J.; Rhodes, D.G.; Baer, D.J.; Murayi, T.; Clemens, J.C.; Rumpler, W.V.; Paul, D.R.; Sebastian, R.S.; Kuczynski, K.J.; Ingwersen, L.A.; et al. The US Department of Agriculture Automated Multiple-Pass Method Reduces Bias in the Collection of Energy Intakes. Am. J. Clin. Nutr. 2008, 88, 324–332. [Google Scholar] [CrossRef]
- Crispim, S.P.; Fisberg, R.M.; Almeida, C.C.B.; Geneviève, N.; Knase, V.; Pereira, R.A.; Marchioni, D.M.L.; dos Santos, N.A.; Steluti, J.; Slimani, N. Manual Fotográfico de Quantificação Alimentar; Universidade Federal do Paraná: Curitiba, Brazil, 2017; ISBN 9788568566084. [Google Scholar]
- Bel-Serrat, S.; Knaze, V.; Nicolas, G.; Marchioni, D.M.; Steluti, J.; Mendes, A.; Crispim, S.P.; Fisberg, R.M.; Pereira, R.A.; Araujo, M.C.; et al. Adapting the Standardised Computer- and Interview-Based 24 h Dietary Recall Method (GloboDiet) for Dietary Monitoring in Latin America. Public Health Nutr. 2017, 20, 2847–2858. [Google Scholar] [CrossRef]
- de Milagres, R.C.R.M.; de Souza, E.C.G.; do Peluzio, M.C.G.; do Franceschini, S.C.C.; Duarte, M.S.L. Food Iodine Content Table Compiled from International Databases. Rev. Nutr. 2020, 33, 1–12. [Google Scholar] [CrossRef]
- Universidade de São Paulo (USP). Tabela Brasileira de Composição de Alimentos. Available online: http://www.tbca.net.br/ (accessed on 2 October 2020).
- Stadlmayr, B.; Wijesinha-Bettoni, R.; Haytowitz, D.B.; Rittenschober, D.; Cunningham, J.; Sobolewski, R.; Eisenwagen, S.; Baines, J.; Probst, Y.; Fitt, E.; et al. INFOODS Guidelines for Food Matching. 2011. Available online: www.fao.org/infoods/INFOODSGuidelinesforFoodMatchingfinal.pdf (accessed on 2 October 2020).
- Crispim, S.P.; Silva, D.L.F.; de Macedo, M.S.; Almeida, C.C.B.; Elias, V.C.M.; Garmus, L.M.; Duarte, L.M.; Silva, G.B.; Schrubbe, V.; do Franceschini, S.C.C. Aspectos Metodológicos Na Avaliação Do Consumo Alimentar de Gestantes No Estudo Multicêntrico de Deficiência de Iodo (EMDI- BRASIL); Universidade Federal do Paraná: Curitiba, Paraná, Brasil, 2023; to be submitted. [Google Scholar]
- Bath, S.P.C.; Walter, A.; Taylor, A.; Wright, J.; Rayman, M.P. Iodine Deficiency in Pregnant Women Living in the South East of the UK: The Influence of Diet and Nutritional Supplements on Iodine Status. Br. J. Nutr. 2014, 111, 1622–1631. [Google Scholar] [CrossRef] [PubMed]
- Brantsæter, A.L.; Abel, M.H.; Haugen, M.; Meltzer, H.M. Risk of Suboptimal Iodine Intake in Pregnant Norwegian Women. Nutrients 2013, 5, 424–440. [Google Scholar] [CrossRef] [PubMed]
- Saraiva, D.; de Morais, N.A.; Corcino, C.; Berbara, T.; Schtscherbyna, A.; Santos, M.; Botelho, H.; Vaisman, M.; Teixeira, P.d.F.D.S. Iodine Status of Pregnant Women from a Coastal Brazilian State after the Reduction in Recommended Iodine Concentration in Table Salt According to Governmental Requirements. Nutrition 2018, 53, 109–114. [Google Scholar] [CrossRef]
- Henjum, S.; Brantsæter, A.L.; Kurniasari, A.; Dahl, L.; Aadland, E.K.; Gjengedal, E.L.F.; Birkeland, S.; Aakre, I. Suboptimal Iodine Status and Low Iodine Knowledge in Young Norwegian Women. Nutrients 2018, 10, 941. [Google Scholar] [CrossRef]
- Kedir, H.; Berhane, Y.; Worku, A. Subclinical Iodine Deficiency among Pregnant Women in Haramaya District, Eastern Ethiopia: A Community-Based Study. J. Nutr. Metab. 2014, 2014, 878926. [Google Scholar] [CrossRef] [PubMed]
- Macedo, M.d.S. Estado Nutricional de Iodo Materno Durante Gestação e Lactação e Sua Relação Com Deficiência de Iodo Em Recém-Nascidos e Lactentes No Município de Diamantina—MG., Faculdade de Medicina da Universidade Federal de Minas Gerais. 2017. Available online: https://repositorio.ufmg.br/handle/1843/BUOS-B56G47 (accessed on 10 August 2019).
- Mian, C.; Vitaliano, P.; Pozza, D.; Barollo, S.; Pitton, M.; Callegari, G.; di Gianantonio, E.; Casaro, A.; Acamulli, D.N.; Busnardo, B.; et al. Iodine Status in Pregnancy: Role of Dietary Habits and Geographical Origin. Clin. Endocrinol. 2009, 70, 776–780. [Google Scholar] [CrossRef]
- Murcia, M.; Rebagliato, M.; Espada, M.; Vioque, J.; Santa Marina, L.; Alvarez-Pedrerol, M.; Lopez-Espinosa, M.-J.; León, G.; Íñiguez, C.; Basterrechea, M.; et al. Iodine Intake in a Population of Pregnant Women: INMA Mother and Child Cohort Study, Spain. J. Epidemiol. Community Health 2010, 64, 1094–1099. [Google Scholar] [CrossRef]
- Takele, W.W.; Alemayehu, M.; Derso, T.; Tariku, A. Two-Thirds of Pregnant Women Attending Antenatal Care Clinic at the University of Gondar Hospital Are Found with Subclinical Iodine Deficiency, 2017. BMC Res. Notes 2018, 11, 738. [Google Scholar] [CrossRef] [PubMed]
- Torres, M.T.; Frances, L.; Vila, L.; Manresa, J.M.; Falguera, G.; Prieto, G.; Casamitjana, R.; Toran, P. Iodine Nutritional Status of Women in Their First Trimester of Pregnancy in Catalonia. BMC Pregnancy Childbirth 2017, 17, 249. [Google Scholar] [CrossRef] [Green Version]
- Vandevijvere, S.; Amsalkhir, S.; Mourri, A.B.; van Oyen, H.; Moreno-Reyes, R. Iodine Deficiency among Belgian Pregnant Women Not Fully Corrected by Iodine-Containing Multivitamins: A National Cross-Sectional Survey. Br. J. Nutr. 2013, 109, 2276–2284. [Google Scholar] [CrossRef] [PubMed]
- Kasap, B.; Akbaba, E.; Yeniçeri, E.N.; Akın, M.N.; Akbaba, E.; Öner, G.; Turhan, N.; Duru, M.E. Adequate Iodine Levels in Healthy Pregnant Women. A Cross-Sectional Survey of Dietary Intake in Turkey. Saudi Med. J. 2016, 37, 698–702. [Google Scholar] [CrossRef] [PubMed]
- Sousa, A.G.; da Costa, T.H.M. Diet and Supplement Assessment in a Brazilian Urban Population. Rev. Saude Publica 2021, 55, 26. [Google Scholar] [CrossRef]
- Allen, L.H.; Carriquiry, A.L.; Murphy, S.P. Perspective: Proposed Harmonized Nutrient Reference Values for Populations. Adv. Nutr. 2020, 11, 469–483. [Google Scholar] [CrossRef] [PubMed]
- Bozdogan, H. Model Selection and Akaike’s Information Criterion (AIC): The General Theory and Its Analytical Extensions. Psychometrika 1987, 52, 345–370. [Google Scholar] [CrossRef]
- SAS Institute Inc. SAS® OnDemand for Academics; SAS Institute Inc.: Cary, NC, USA, 2014; Available online: https://welcome.oda.sas.com/ (accessed on 16 April 2021).
- de Castro, R.d.S.A.; Giatti, L.; Barreto, S.M. Fatores Associados à Adição de Sal à Refeição Pronta. Cien Saude Colet 2014, 19, 1503–1512. [Google Scholar] [CrossRef] [PubMed]
- Rana, R.; Raghuvanshi, R.S. Effect of Different Cooking Methods on Iodine Losses. J. Food Sci. Technol. 2013, 50, 1212–1216. [Google Scholar] [CrossRef]
- World Health Organization (WHO). Global Status Report on Noncommunicable Diseases; WHO: Geneva, Switzerland, 2014. Available online: https://reliefweb.int/report/world/global-status-report-noncommunicable-diseases-2014-attaining-nine-global?gclid=Cj0KCQiA4OybBhCzARIsAIcfn9muaM6M6lrJi-L6uOsQ4abkHO-eJRZFdZkPdrxTiqfl1Aj16rRyv_0aAm9zEALw_wcB (accessed on 15 March 2021).
- World Health Organization (WHO). Salt Reduction and Iodine Fortification Strategies in Public Health 2013. Available online: https://www.who.int/publications-detail-redirect/978924150669 (accessed on 15 March 2021).
- Sarno, F.; Claro, R.M.; Levy, R.B.; Bandoni, D.H.; Monteiro, C.C.B.A. Estimated sodium intake for the Brazilian population, 2008–2009. Rev. Saude Publica 2013, 47, 571–578. [Google Scholar] [CrossRef]
- Mill, J.G.; Malta, D.C.; Machado, Í.E.; Pate, A.; Pereira, C.C.B.A.; Jaime, P.C.; Szwarcwald, C.L.; Rosenfeld, L.G. Estimation of salt intake in the Brazilian population: Results from the 2013 National Health Survey. Rev. Bras. Epidemiol. 2019, 22 (Suppl. 02), E190009. Available online: https://www.scielo.br/j/rbepid/a/Z4bKXzyLGF7shzb3Kwk8qsy/?lang=pt (accessed on 27 June 2021). [CrossRef]
- Mill, J.G.; Rodrigues, S.L.; Baldo, M.P.; Malta, D.C.; Szwarcwald, C.L. Validation study of the Tanaka and Kawasaki equations to estimate the daily sodium excretion by a spot urine sample. Rev. Bras. Epidemiol. 2015, 18, 224–237. [Google Scholar] [CrossRef] [Green Version]
- Knowles, J.; van der Haar, F.; Shehata, M.; Gerasimov, G.; Bimo, B.; Cavenagh, B.; Maramag, C.C.; Otico, E.; Izwardy, D.; Spohrer, R.; et al. Iodine Intake through Processed Food: Case Studies from Egypt, Indonesia, the Philippines, the Russian Federation and Ukraine, 2010–2015. Nutrients 2017, 9, 797. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization (WHO). Assessment of the Iodine Deficiency Disorders and Monitoring Their Elimination; WHO: Geneva, Switzerland, 2007; pp. 1–107. Available online: https://apps.who.int/iris/handle/10665/43781 (accessed on 15 March 2021).
- Rohner, F.; Zimmermann, M.; Jooste, P.; Pandav, C.; Caldwell, K.; Raghavan, R.; Raiten, D.J. Biomarkers of Nutrition for Development—Iodine Review. J. Nutr. 2014, 144, 1322S–1342S. [Google Scholar] [CrossRef] [PubMed]
- Shi, X.; Han, C.; Li, C.; Mao, J.; Wang, W.; Xie, X.; Li, C.; Xu, B.; Meng, T.; Du, J.; et al. Optimal and Safe Upper Limits of Iodine Intake for Early Pregnancy in Iodine-Sufficient Regions: A Cross-Sectional Study of 7190 Pregnant Women in China. J. Clin. Endocrinol. Metab. 2015, 100, 1630–1638. [Google Scholar] [CrossRef]
- Brasil Ministério da Saúde. Secretaria de Atenção Básica. Departamento de Atenção Básica. Coordenação-Geral de Alimentação e Nutrição. XIV Reunião Ordinária Da Comissão Interinstitucional Para Prevenção e Controle Dos Distúrbios Por Deficiência de Iodo. 2016. Available online: http://189.28.128.100/dab/docs/portaldab/documentos/14_reuniao_iodo.pdf (accessed on 20 June 2022).
- Goldberg, G.R.; Black, A.E.; Jebb, S.A.; Cole, T.J.; Murgatroyd, P.R.; Coward, W.A.; Prentice, A.M. Critical Evaluation of Energy Intake Data Using Fundamental Principles of Energy Physiology: 1. Derivation of Cut-off Limits to Identify under-Recording. Eur. J. Clin. Nutr. 1991, 45, 569–581. [Google Scholar] [PubMed]
- Instituto Brasileiro de Geografia e Estatística (IBGE) Pesquisa Nacional de Saúde: Ciclos Da Vida; Rio de Janeiro. 2019. Available online: https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101846 (accessed on 1 July 2022).
- Silva, D.L.F.S.; Azevedo, F.M.; Candido, A.C.; Priore, S.E.; Crispim, S.P.; Franceschini, S.d.C.C. Ingestão Habitual de Iodo Em Gestantes: Uma Revisão Sistemática e Metanálise; Universidade Federal de Viçosa: Viçosa, Minas Gerais, Brasil, 2023; to be submitted. [Google Scholar]
- Borges, R.B.; Mancuso, A.C.B.; Camey, S.A.; Leotti, V.B.; Hirakata, V.N.; Azambuja, G.S.; de Castro, S.M.J. Power and Sample Size for Health Researchers:a tool for calculating sample size and statistical power designed for health researchers. Clin. Biomed. Res. 2021, 40, 247–253. [Google Scholar] [CrossRef]
Models | |
---|---|
Baseline | Iodine Intake from Food Adjusted for Intraindividual Variability |
1 | Iodine intake from food and iodine-containing supplements adjusted for intraindividual variability |
2 | Model 1 + recalled day of the week + season + 24-h recall sequence |
3 | Model 2 + municipality location + age + color/race + schooling + gestational age |
4 | Model 3 + type of salt used |
5 | Model 3 + use of pure salt |
6 | Model 3 + habit of adding salt after preparing/cooking |
7 | Model 3 + use of homemade seasoning |
8 | Model 3 + use of industrialized seasoning |
9 | Model 3 + type of salt used + use of pure salt |
10 | Model 3 + type of salt used + habit of adding salt after preparing/cooking |
11 | Model 3 + type of salt used + use of homemade seasoning |
12 | Model 3 + type of salt used + use of industrialized seasoning |
13 | Model 3 + type of salt used + use of pure salt + habit of adding salt after preparing/cooking |
14 | Model 3 + type of salt used + use of pure salt + use of homemade seasoning |
15 | Model 3 + type of salt used + use of pure salt + use of industrialized seasoning |
16 | Model 3 + type of salt used + use of pure salt + habit of adding salt to meals after preparing/cooking + use of homemade seasoning |
17 | Model 3 + type of salt used+ use of pure salt + habit of adding salt to meals after preparing/cooking + use of industrialized seasoning |
18 | Model 3 + type of salt used + use of pure salt + use of homemade seasoning + use of industrialized seasoning |
19 | Model 3 + type of salt used + habit of adding salt to meals after preparing/cooking + use of homemade seasoning |
20 | Model 3 + type of salt used + habit of adding salt to meals after preparing/cooking + use of industrialized seasoning |
21 | Model 3 + type of salt used + habit of adding salt to meals after preparing/cooking + use of homemade seasoning + use of industrialized seasoning |
22 | Model 3 + type of salt used + use of homemade seasoning + use of industrialized seasoning |
23 | Model 3 + use of pure salt + habit of adding salt to meals after preparing/cooking |
24 | Model 3 + use of pure salt + habit of adding salt to meals after preparing/cooking + use of homemade seasoning |
25 | Model 3 + use of pure salt + habit of adding salt to meals after preparing/cooking + use of industrialized seasoning |
26 | Model 3 + use of pure salt + habit of adding salt to meals after preparing/cooking + use of homemade seasoning + use of industrialized seasoning |
27 | Model 3 + use of pure salt + use of homemade seasoning |
28 | Model 3 + use of pure salt + use of industrialized seasoning |
29 | Model 3 + use of pure salt + use of homemade seasoning + use of industrialized seasoning |
30 | Model 3 + habit of adding salt to meals after preparing/cooking + use of homemade seasoning |
31 | Model 3 + habit of adding salt to meals after preparing/cooking + use of industrialized seasoning |
32 | Model 3 + habit of adding salt to meals after preparing/cooking + use of homemade seasoning + use of industrialized seasoning |
33 | Model 3 + use of homemade seasoning + use of industrialized seasoning |
34 | Model 3 + type of salt used + use of pure salt + habit of adding salt to meals after preparing/cooking + use of homemade seasoning + use of industrialized seasoning |
Characteristics | Mean | 95% CI | |
---|---|---|---|
Age (in years) (n = 2247) | 26.7 | 26.5–27.0 | |
Usual salt intake (in grams) (n = 2247) | 2.3 | 2.2–2.3 | |
n | % | 95% CI | |
Season (n = 2247) | |||
Summer | 568 | 25.3 | 23.5–27.1 |
Autumn | 629 | 28.0 | 26.1–29.9 |
Winter | 503 | 22.4 | 20.7–24.2 |
Spring | 547 | 24.3 | 22.6–26.2 |
Municipality location (n = 2247) | |||
Coastal | 819 | 36.4 | 34.5–38.5 |
Countryside | 1428 | 63.6 | 61.5–65.5 |
Gestational age (in trimester) (n = 2234) | |||
1 | 473 | 21.2 | 19.5–22.9 |
2 | 887 | 39.7 | 37.3–41.8 |
3 | 874 | 39.1 | 37.1–41.2 |
Color/race (n = 2101) | |||
Black, parda (mixed) and indigenous | 1533 | 73 | 71.0–74.9 |
White and yellow | 568 | 27.0 | 25.1–29.0 |
Schooling (n = 2091) | |||
No education and elementary school | 455 | 21.7 | 20.0–23.6 |
High school | 1300 | 62.2 | 60.1–64.3 |
Graduate or postgraduate | 336 | 16.1 | 14.5–17.7 |
Use of iodine-containing supplements (n = 2247) | |||
Yes | 189 | 8.4 | 7.3–9.6 |
No | 2058 | 91.6 | 90.4–92.7 |
Type of salt used (n = 2105) | |||
None | 12 | 0.5 | 0.3–1.0 |
Refined iodized | 1957 | 93.0 | 91.8–94.0 |
Others | 136 | 6.5 | 5.4–7.6 |
Use of pure salt (n = 2106) | |||
Yes | 1658 | 78.7 | 76.9–80.5 |
No | 448 | 21.3 | 19.5–23.1 |
Habit of adding salt to meals after preparing/cooking (n = 1632) | |||
Yes | 262 | 16.1 | 14.3–17.9 |
No | 1370 | 83.9 | 82.1–85.7 |
Use of homemade seasoning(n = 2098) | |||
Yes | 735 | 35.0 | 33.0–37.1 |
No | 1363 | 65.0 | 62.9–67.0 |
Use of industrialized seasoning (n = 2103) | |||
Yes | 1252 | 59.5 | 57.4–61.6 |
No | 851 | 40.5 | 38.4–42.6 |
Models | Mean | 95% CI Mean | Supplement Mean | 95% CI Supplement Mean | P5 | P25 | P50 | P75 | P95 | Ins. (%) | 95% CI Ins. | Exc. (%) | 95% CI Exc. |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Baseline | 163.1 | 162.9–163.2 | 0.0 | 105.0 | 135.8 | 160.2 | 187.2 | 230.7 | 49.8 | 49.6–50.0 | 0.0 | ||
1 | 182.8 | 182.0–183.6 | 19.8 | 19.0–20.5 | 106.3 | 138.3 | 164.7 | 197.5 | 307.9 | 45.5 | 45.3–45.7 | 0.1 | 0.1–0.1 |
2 | 183.8 | 183.0–184.6 | 19.8 | 19.0–20.5 | 105.5 | 138.4 | 165.6 | 199.6 | 309.1 | 44.7 | 44.5–44.9 | 0.1 | 0.1–0.1 |
3 | 171.7 | 170.9–172.5 | 19.8 | 19.0–20.5 | 1.2 | 131.3 | 160.7 | 195.2 | 304.7 | 49.4 | 49.2–49.6 | 0.1 | 0.1–0.1 |
4 | 171.6 | 170.7–172.4 | 19.8 | 19.0–20.5 | 1.2 | 131.2 | 160.6 | 195.3 | 304.8 | 49.5 | 49.2–49.7 | 0.1 | 0.1–0.1 |
5 | 171.6 | 170.8–172.4 | 19.8 | 19.0–20.5 | 1.2 | 131.3 | 160.7 | 195.2 | 304.7 | 49.4 | 49.2–49.6 | 0.1 | 0.1–0.1 |
6 | 137.5 | 136.6–138.3 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.8 | 185.6 | 284.2 | 60.6 | 60.4–60.8 | 0.1 | 0.1–0.1 |
7 | 171.1 | 170.3–171.9 | 19.8 | 19.0–20.5 | 1.2 | 131.1 | 160.6 | 195.1 | 304.9 | 49.5 | 49.3–49.7 | 0.1 | 0.1–0.1 |
8 | 171.4 | 170.6–172.2 | 19.8 | 19.0–20.5 | 1.2 | 130.9 | 160.6 | 195.4 | 304.6 | 49.5 | 49.3–49.7 | 0.1 | 0.1–0.1 |
9 | 171.5 | 170.7–172.3 | 19.8 | 19.0–20.5 | 1.2 | 131.2 | 160.6 | 195.3 | 304.7 | 49.5 | 49.3–49.7 | 0.1 | 0.1–0.1 |
10 | 137.5 | 136.6–138.3 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.9 | 185.6 | 284.1 | 60.5 | 60.3–60.7 | 0.1 | 0.1–0.1 |
11 | 171.0 | 170.1–171.8 | 19.8 | 19.0–20.5 | 1.2 | 130.9 | 160.5 | 195.1 | 304.9 | 49.6 | 49.4–49.8 | 0.1 | 0.1–0.1 |
12 | 171.3 | 170.5–172.1 | 19.8 | 19.0–20.5 | 1.2 | 130.8 | 160.6 | 195.5 | 304.7 | 49.5 | 49.3–49.7 | 0.1 | 0.1–0.1 |
13 | 137.5 | 136.7–138.3 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.9 | 185.7 | 284.2 | 60.5 | 60.3–60.7 | 0.1 | 0.1–0.1 |
14 | 170.9 | 170.1–171.7 | 19.8 | 19.0–20.5 | 1.2 | 130.8 | 160.5 | 195.1 | 304.9 | 49.6 | 49.4–49.8 | 0.1 | 0.1–0.1 |
15 | 171.2 | 170.4–172.0 | 19.8 | 19.0–20.5 | 1.2 | 130.8 | 160.5 | 195.3 | 304.6 | 49.6 | 49.4–49.8 | 0.1 | 0.1–0.1 |
16 | 136.8 | 135.9–137.6 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.3 | 185.1 | 284.1 | 60.8 | 60.6–61.0 | 0.1 | 0.1–0.1 |
17 | 137.3 | 136.5–138.1 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.6 | 185.6 | 284.1 | 60.6 | 60.4–60.8 | 0.1 | 0.1–0.1 |
18 | 170.6 | 169.8–171.4 | 19.8 | 19.0–20.5 | 1.2 | 130.4 | 160.3 | 195.2 | 304.8 | 49.7 | 49.5–49.9 | 0.1 | 0.1–0.1 |
19 | 136.8 | 136.0–137.7 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.2 | 185.5 | 284.2 | 60.8 | 60.6–61.0 | 0.1 | 0.1–0.1 |
20 | 137.3 | 136.5–138.2 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.7 | 185.6 | 284.0 | 60.6 | 60.4–60.8 | 0.1 | 0.1–0.1 |
21 | 136.6 | 135.8–137.4 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.0 | 185.2 | 283.8 | 60.9 | 60.7–61.1 | 0.1 | 0.1–0.1 |
22 | 170.7 | 169.9–171.5 | 19.8 | 19.0–20.5 | 1.2 | 130.5 | 160.4 | 195.2 | 304.9 | 49.7 | 49.4–49.9 | 0.1 | 0.1–0.1 |
23 | 137.5 | 136.7–138.4 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.9 | 185.6 | 284.3 | 60.5 | 60.3–60.7 | 0.1 | 0.1–0.1 |
24 | 136.8 | 136.0–137.7 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.3 | 185.2 | 284.1 | 60.8 | 60.6–61.0 | 0.1 | 0.1–0.1 |
25 | 137.4 | 136.5–138.2 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.6 | 185.6 | 284.0 | 60.6 | 60.4–60.8 | 0.1 | 0.1–0.1 |
26 | 136.7 | 135.8–137.5 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.1 | 185.2 | 283.9 | 60.9 | 60.7–61.1 | 0.1 | 0.1–0.1 |
27 | 171.0 | 170.2–171.8 | 19.8 | 19.0–20.5 | 1.2 | 130.9 | 160.5 | 195.2 | 304.8 | 49.6 | 49.4–49.8 | 0.1 | 0.1–0.1 |
28 | 171.3 | 170.5–172.1 | 19.8 | 19.0–20.5 | 1.2 | 131.0 | 160.6 | 195.3 | 304.7 | 49.5 | 49.3–49.7 | 0.1 | 0.1–0.1 |
29 | 170.7 | 169.9–171.5 | 19.8 | 19.0–20.5 | 1.2 | 130.6 | 160.4 | 195.1 | 304.8 | 49.7 | 49.5–49.9 | 0.1 | 0.1–0.1 |
30 | 136.8 | 136.0–137.7 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.3 | 185.2 | 284.1 | 60.8 | 60.6–61.0 | 0.1 | 0.1–0.1 |
31 | 137.4 | 136.5–138.2 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.7 | 185.6 | 284.0 | 60.6 | 60.4–60.8 | 0.1 | 0.1–0.1 |
32 | 136.7 | 135.9–137.5 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.1 | 185.2 | 283.8 | 60.9 | 60.7–61.1 | 0.1 | 0.1–0.1 |
33 | 170.8 | 170.0–171.6 | 19.8 | 19.0–20.5 | 1.2 | 130.7 | 160.5 | 195.1 | 304.9 | 49.6 | 49.4–49.8 | 0.1 | 0.1–0.1 |
34 | 136.6 | 135.8–137.4 | 19.8 | 19.0–20.5 | 1.2 | 1.2 | 145.1 | 185.2 | 283.8 | 60.9 | 60.7–61.1 | 0.1 | 0.1–0.1 |
Models | S2b | 95% CI Sb | S2w | 95% CI S2w | S2 | S2w/S2b | Lambda | AIC | Skewness | CV |
---|---|---|---|---|---|---|---|---|---|---|
Baseline | 3.6 | 1.2–6.0 | 10.6 | 4.9–16.4 | 14.2 | 3.0 | 0.4 | 30,317.3 | 2.2 | 6.3 |
1 | 3.6 | 1.2–6.0 | 10.6 | 4.9–16.3 | 14.2 | 3.0 | 0.4 | 30,319.2 | 2.8 | 34.9 |
2 | 3.5 | 2.4–4.7 | 9.8 | 8.4–11.2 | 13.3 | 2.8 | 0.4 | 30,319.8 | 2.8 | 35.2 |
3 | 3.5 | 2.3–4.7 | 9.8 | 8.2–11.3 | 13.3 | 2.8 | 0.4 | 28,204.6 | 1.7 | 33.4 |
4 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 28,178.6 | 1.7 | 33.3 |
5 | 3.5 | 2.3–4.7 | 9.7 | 8.3–11.2 | 13.2 | 2.8 | 0.4 | 28,196.3 | 1.7 | 33.4 |
6 | 3.9 | 2.6–5.3 | 9.2 | 7.6–10.8 | 13.2 | 2.3 | 0.4 | 21,897.9 | −1.2 | 27.5 |
7 | 3.5 | 2.3–4.7 | 9.8 | 8.3–11.2 | 13.2 | 2.8 | 0.4 | 28,081.6 | 1.6 | 33.3 |
8 | 3.6 | 2.3–4.8 | 9.7 | 8.3–11.2 | 13.3 | 2.7 | 0.4 | 28,147.4 | 1.7 | 33.3 |
9 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 28,170.3 | 1.7 | 33.3 |
10 | 3.9 | 2.6–5.2 | 9.2 | 7.6–10.7 | 13.1 | 2.4 | 0.4 | 21,893.2 | −1.3 | 27.5 |
11 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 28,055.5 | 1.6 | 33.3 |
12 | 3.6 | 2.4–4.8 | 9.7 | 8.3–11.1 | 13.3 | 2.7 | 0.4 | 28,121.3 | 1.7 | 33.3 |
13 | 3.9 | 2.6–5.2 | 9.1 | 7.5–10.7 | 12.9 | 2.4 | 0.4 | 21,895.2 | −1.3 | 27.5 |
14 | 3.5 | 2.3–4.7 | 9.7 | 8.3–11.1 | 13.2 | 2.8 | 0.4 | 28,047.0 | 1.6 | 33.3 |
15 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 28,113.0 | 1.6 | 33.3 |
16 | 3.8 | 2.5–5.1 | 9.1 | 7.5–10.7 | 13.0 | 2.4 | 0.4 | 21,786.2 | −1.3 | 27.4 |
17 | 3.9 | 2.6–5.2 | 9.1 | 7.5–10.7 | 13.0 | 2.3 | 0.4 | 21,882.2 | −1.2 | 27.5 |
18 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 27,990.0 | 1.6 | 33.2 |
19 | 4.0 | 2.6–5.3 | 9.1 | 7.5–10.8 | 13.1 | 2.3 | 0.4 | 21,784.2 | −1.3 | 27.4 |
20 | 3.9 | 2.6–5.2 | 9.2 | 7.6–10.7 | 13.1 | 2.3 | 0.4 | 21,880.2 | −1.3 | 27.5 |
21 | 3.9 | 2.6–5.2 | 9.2 | 7.6–10.7 | 13.1 | 2.3 | 0.4 | 21,771.5 | −1.3 | 27.4 |
22 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 27,998.7 | 1.6 | 33.3 |
23 | 3.9 | 2.6–5.2 | 9.1 | 7.5–10.7 | 13.0 | 2.3 | 0.4 | 21,899.9 | −1.3 | 27.5 |
24 | 3.9 | 2.6–5.2 | 9.2 | 7.6–10.8 | 13.1 | 2.4 | 0.4 | 21,790.9 | −1.3 | 27.4 |
25 | 3.9 | 2.6–5.2 | 9.1 | 7.5–10.7 | 13.1 | 2.3 | 0.4 | 21,886.8 | −1.2 | 27.5 |
26 | 3.9 | 2.6–5.2 | 9.1 | 7.6–10.7 | 13.1 | 2.3 | 0.4 | 21,778.1 | −1.3 | 27.4 |
27 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.2 | 13.2 | 2.8 | 0.4 | 28,073.1 | 1.6 | 33.3 |
28 | 3.5 | 2.3–4.7 | 9.7 | 8.3–11.2 | 13.3 | 2.8 | 0.4 | 28,139.0 | 1.7 | 33.3 |
29 | 3.5 | 2.3–4.7 | 9.7 | 8.2–11.3 | 13.2 | 2.8 | 0.4 | 28,016.1 | 1.6 | 33.3 |
30 | 3.9 | 2.6–5.2 | 9.2 | 7.7–10.8 | 13.2 | 2.3 | 0.4 | 21,788.9 | −1.3 | 27.4 |
31 | 4.0 | 2.7–5.3 | 9.2 | 7.7–10.8 | 13.2 | 2.3 | 0.4 | 21,884.8 | −1.2 | 27.5 |
32 | 4.0 | 2.6–5.3 | 9.2 | 7.6–10.9 | 13.2 | 2.3 | 0.4 | 21,776.1 | −1.3 | 27.4 |
33 | 3.5 | 2.3–4.7 | 9.8 | 8.2–11.3 | 13.3 | 2.8 | 0.4 | 28,024.8 | 1.6 | 33.3 |
34 | 3.9 | 2.6–5.2 | 9.1 | 7.5–10.7 | 13.0 | 2.3 | 0.4 | 21,773.5 | −1.3 | 27.4 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Silva, D.L.F.; Crispim, S.P.; Almeida, C.C.B.; Schrubbe, V.; Azevedo, F.M.; de Faria, F.R.; Pizato, N.; Pereira, R.J.; Macedo, M.d.S.; Franceschini, S.d.C.C. Improving Pregnant Women’s Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates. Nutrients 2023, 15, 846. https://doi.org/10.3390/nu15040846
Silva DLF, Crispim SP, Almeida CCB, Schrubbe V, Azevedo FM, de Faria FR, Pizato N, Pereira RJ, Macedo MdS, Franceschini SdCC. Improving Pregnant Women’s Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates. Nutrients. 2023; 15(4):846. https://doi.org/10.3390/nu15040846
Chicago/Turabian StyleSilva, Débora L. F., Sandra P. Crispim, Claudia C. B. Almeida, Vanessa Schrubbe, Francilene M. Azevedo, Franciane R. de Faria, Nathalia Pizato, Renata J. Pereira, Mariana de S. Macedo, and Sylvia do C. C. Franceschini. 2023. "Improving Pregnant Women’s Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates" Nutrients 15, no. 4: 846. https://doi.org/10.3390/nu15040846