Mapping Iodine Sources for Human Nutrition in Portugal Considering Geography, Seasonality, and Processing: Milk and Plant-Based Milk Alternatives
Abstract
1. Introduction
2. Materials and Methods
2.1. Milk and Plant-Based Alternatives Collection
2.2. Iodine Analysis
2.3. Statistical Analysis
3. Results
3.1. Milk
3.2. Plant-Based Milk Alternatives
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Zimmermann, M.B.; Jooste, P.L.; Pandav, C.S. Iodine-deficiency disorders. Lancet 2008, 372, 1251–1262. [Google Scholar] [CrossRef]
- Zimmermann, M.B. The remarkable impact of iodisation programmes on global public health. Proc. Nutr. Soc. 2023, 82, 113–119. [Google Scholar] [CrossRef]
- Glinoer, D. Pregnancy and iodine. Thyroid 2001, 11, 471–481. [Google Scholar] [CrossRef]
- World Health Organization (WHO). Universal Salt Iodization and Sodium Intake Reduction: Compatible, Cost-Effective Strategies of Great Public Health Benefit; World Health Organization: Geneva, Switzerland, 2022. [Google Scholar]
- World Health Organization (WHO); United Nations Children’s Fund (UNICEF); International Council for the Control of Iodine Deficiency Disorders (ICCIDD). Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers, 3rd ed.; World Health Organization: Geneva, Switzerland, 2007. [Google Scholar]
- Hatch-McChesney, A.; Lieberman, H.R. Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue. Nutrients 2022, 14, 3474. [Google Scholar] [CrossRef] [PubMed]
- Nomos Verlagsgesellschaft. The European Banking Union: A Compendium; Nomos Verlagsgesellschaft: Baden-Baden, Germany, 2015. [Google Scholar]
- The European Parliament; The Council of the European Union. Regulation (EU) No 1169/2011 of the European Parliament and of the Council. Off. J. Eur. Union 2011, 304, 18–63. [Google Scholar]
- Ferreira, P.; Pinheiro, C.; Matta Coelho, C.; Guimaraes, J.; Pereira, G.; Xavier Moreira, N.; Cortez, A.; Bracchi, I.; Pestana, D.; Barreiros Mota, I.; et al. The association of milk and dairy consumption with iodine status in pregnant women in Oporto region. Br. J. Nutr. 2021, 126, 1314–1322. [Google Scholar] [CrossRef] [PubMed]
- Bath, S.C.; Rayman, M.P. Dairy foods as a source of dietary iodine. In Milk and Dairy Foods; Givens, D.I., Ed.; Academic Press: Cambridge, MA, USA, 2020; pp. 323–345. [Google Scholar]
- Machado, A.; Goncalves, C.; Moreira, P.; Pinho, O.; Padrao, P.; Silva-Santos, T.; Rodrigues, M.; Norton, P.; Bordalo, A.A. Iodine intake assessment in the staff of a Porto region university (Portugal): The iMC Salt trial. Eur. J. Nutr. 2023, 62, 2245–2256. [Google Scholar] [CrossRef]
- Lopes, C.; Torres, D.; Oliveira, A.; Severo, M.; Alarcão, V.; Guiomar, S.; Mota, J.; Teixeira, P.; Ramos, E.; Rodrigues, S.; et al. Inquérito Alimentar Nacional e de Atividade Física, IAN-AF 2015-2016: Relatório Metodológico; Universidade do Porto: Porto, Portugal, 2017. [Google Scholar]
- Delgado, I.; Coelho, I.; Calhau, M.; Albuquerque, J.; Breda, J. Scientific Update on the Iodine Content of Portuguese Foods; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- Instituto Nacional de Estatística (INE). Balança Alimentar Portuguesa: 2020–2024; Instituto Nacional de Estatística (INE): Lisboa, Portugal, 2025. [Google Scholar]
- Niero, G.; Visentin, G.; Censi, S.; Righi, F.; Manuelian, C.L.; Formigoni, A.; Mian, C.; Bérard, J.; Cassandro, M.; Penasa, M.; et al. Invited review: Iodine level in dairy products—A feed-to-fork overview. J. Dairy Sci. 2023, 106, 2213–2229. [Google Scholar] [CrossRef]
- Flachowsky, G.; Franke, K.; Meyer, U.; Leiterer, M.; Schöne, F. Influencing factors on iodine content of cow milk. Eur. J. Nutr. 2014, 53, 351–365. [Google Scholar] [CrossRef]
- Castro, S.I.; Berthiaume, R.; Robichaud, A.; Lacasse, P. Effects of iodine intake and teat-dipping practices on milk iodine concentrations in dairy cows. J. Dairy Sci. 2012, 95, 213–220. [Google Scholar] [CrossRef]
- Willett, W.; Rockström, J.; Loken, B.; Springmann, M.; Lang, T.; Vermeulen, S.; Garnett, T.; Tilman, D.; DeClerck, F.; Wood, A.; et al. Food in the Anthropocene: The EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 2019, 393, 447–492. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization; Regional Office for Europe. Prevention and Control of Iodine Deficiency in the WHO European Region: Adapting to Changes in Diet and Lifestyle; World Health Organization Regional Office for Europe: Copenhagen, Denmark, 2024. [Google Scholar]
- Bath, S.C. Plant-based diets for sustainability and health—But are we ignoring vital micronutrients? Proc. Nutr. Soc. 2025, 84, 216–224. [Google Scholar] [CrossRef] [PubMed]
- Antunes, I.C.; Bexiga, R.; Pinto, C.; Martins, L.L.; Mourato, M.; Pereira, G.; Vieira, E.; Delerue-Matos, C.; Quaresma, M. Mineral profile of cow milk and plant-based milk alternatives. J. Dairy Sci. 2025, 108, 3324–3333. [Google Scholar] [CrossRef] [PubMed]
- Shelor, C.P.; Dasgupta, P.K. Review of analytical methods for the quantification of iodine in complex matrices. Anal. Chim. Acta 2011, 702, 16–36. [Google Scholar] [CrossRef]
- Hedayati, M.; Ordookhani, A.; Daneshpour, M.S.; Azizi, F. Rapid acid digestion and simple microplate method for milk iodine determination. J. Clin. Lab. Anal. 2007, 21, 286–292. [Google Scholar] [CrossRef]
- Sandell, E.B.; Kolthoff, I.M. Micro determination of iodine by a catalytic method. Microchim. Acta 1937, 1, 9–25. [Google Scholar] [CrossRef]
- Machado, A.; Lima, L.; Mesquita, R.B.R.; Bordalo, A.A. Improvement of the Sandell-Kolthoff reaction method (ammonium persulfate digestion) for the determination of iodine in urine samples. Clin. Chem. Lab. Med. (CCLM) 2017, 55, e206–e208. [Google Scholar] [CrossRef]
- EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA). Scientific Opinion on Dietary Reference Values for iodine. EFSA J. 2014, 12, 3660. [Google Scholar] [CrossRef]
- World Health Organization (WHO), Nutrition Unit. Recommended Iodine Levels in Salt and Guidelines for Monitoring Their Adequacy and Effectiveness; World Health Organization: Geneva, Switzerland, 1996. [Google Scholar]
- Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc; The National Academies Press: Washington, DC, USA, 2001; p. 800. [Google Scholar]
- Regulation (EU) 2018/848 of the European Parliament and of the Council of 30 May 2018 on organic production and labelling of organic products and repealing Council Regulation (EC) No 834/2007. Off. J. Eur. Union 2018, 150, 1–92.
- Bath, S.C.; Hill, S.; Infante, H.G.; Elghul, S.; Nezianya, C.J.; Rayman, M.P. Iodine concentration of milk-alternative drinks available in the UK in comparison with cows’ milk. Br. J. Nutr. 2017, 118, 525–532. [Google Scholar] [CrossRef]
- Linhares, D.P.S.; Garcia, P.V.; Almada, A.; Ferreira, T.; Queiroz, G.; Cruz, J.V.; Rodrigues, A.D.S. Iodine environmental availability and human intake in oceanic islands: Azores as a case-study. Sci. Total Environ. 2015, 538, 531–538. [Google Scholar] [CrossRef]
- van de Kamp, M.E.; Saridakis, I.; Verkaik-Kloosterman, J. Iodine content of semi-skimmed milk available in the Netherlands depending on farming (organic versus conventional) and heat treatment (pasteurized versus UHT) and implications for the consumer. J. Trace Elem. Med. Biol. 2019, 56, 178–183. [Google Scholar] [CrossRef] [PubMed]
- Arrizabalaga, J.J.; Jalon, M.; Espada, M.; Canas, M.; Latorre, P.M. Iodine contents in conventional ultra-high temperature (UHT) processed cow milk: Changes over the year and regional differences. Implications for epidemiological studies on iodine nutritional status. Endocrinol. Diabetes Nutr. 2020, 67, 383–393. [Google Scholar] [CrossRef] [PubMed]
- Guerra, A.; Costa, A.; De Marchi, M.; Righi, F.; Simoni, M.; Manuelian, C.L. The effects of dietary iodine content, milking system, and farming practices on milk iodine concentration and quality traits. J. Dairy Sci. 2024, 107, 2143–2155. [Google Scholar] [CrossRef] [PubMed]
- French, E.A.; Mukai, M.; Zurakowski, M.; Rauch, B.; Gioia, G.; Hillebrandt, J.R.; Henderson, M.; Schukken, Y.H.; Hemling, T.C. Iodide Residues in Milk Vary between Iodine-Based Teat Disinfectants. J. Food Sci. 2016, 81, T1864–T1870. [Google Scholar] [CrossRef]
- National Academies of Sciences, Engineering, and Medicine. Nutrient Requirements of Dairy Cattle: Eighth Revised Edition; The National Academies Press: Washington, DC, USA, 2021; p. 502. [Google Scholar]
- EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP). Scientific Opinion on the safety and efficacy of iodine compounds (E2) as feed additives for all species: Calcium iodate anhydrous and potassium iodide, based on a dossier submitted by HELM AG. EFSA J. 2013, 11, 3101. [Google Scholar] [CrossRef]
- Schöne, F.; Leiterer, M.; Lebzien, P.; Bemmann, D.; Spolders, M.; Flachowsky, G. Iodine concentration of milk in a dose–response study with dairy cows and implications for consumer iodine intake. J. Trace Elem. Med. Biol. 2009, 23, 84–92. [Google Scholar] [CrossRef]
- Ventura, M.; Melo, M.; Carrilho, F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int. J. Endocrinol. 2017, 2017, 1297658. [Google Scholar] [CrossRef]
- Bath, S.C.; Verkaik-Kloosterman, J.; Sabatier, M.; Ter Borg, S.; Eilander, A.; Hora, K.; Aksoy, B.; Hristozova, N.; van Lieshout, L.; Tanju Besler, H.; et al. A systematic review of iodine intake in children, adults, and pregnant women in Europe-comparison against dietary recommendations and evaluation of dietary iodine sources. Nutr. Rev. 2022, 80, 2154–2177. [Google Scholar] [CrossRef]
- Nicol, K.; Thomas, E.L.; Nugent, A.P.; Woodside, J.V.; Hart, K.H.; Bath, S.C. Iodine fortification of plant-based dairy and fish alternatives: The effect of substitution on iodine intake based on a market survey in the UK. Br. J. Nutr. 2023, 129, 832–842. [Google Scholar] [CrossRef]
- Dahl, L.; Opsahl, J.A.; Meltzer, H.M.; Julshamn, K. Iodine concentration in Norwegian milk and dairy products. Br. J. Nutr. 2003, 90, 679–685. [Google Scholar] [CrossRef]
- Nicol, K.; Nugent, A.P.; Woodside, J.V.; Hart, K.H.; Bath, S.C. The impact of replacing milk with plant-based alternatives on iodine intake: A dietary modelling study. Eur. J. Nutr. 2024, 63, 599–611. [Google Scholar] [CrossRef]
- Ana Pimenta, M.; Daniela, C.; Catarina, C.; Carla, L.; Ana Maria, G.; Duarte, T. Análise da oferta de alimentos fortificados em micronutrientes em Portugal. Acta Port. Nutr. 2022, 29, 10–19. Available online: https://actaportuguesadenutricao.pt/edicoes/https-actaportuguesadenutricao-pt-wp-content-uploads-2022-09-03_ao-pdf/ (accessed on 14 November 2025).
- Commission Regulation (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children’s development and health Text with EEA relevance. Off. J. Eur. Union 2012, 136, 1–40.
| Type of Milk | Summer Iodine Content | Winter Iodine Content | ||
|---|---|---|---|---|
| n | Median (IQR) (μg/100 mL) | n | Median (IQR) (μg/100 mL) | |
| Cow’s milk | 132 | 20.2 (6.3) | 137 | 19.9 (9.9) |
| Ultra-pasteurized | 126 | 19.8 (6.4) | 132 | 19.9 (9.5) |
| Pasteurized | 6 | 25.0 (5.1) | 5 | 29.0 (8.5) |
| Sheep’s milk | 1 | 72.3 | 1 | 105.7 |
| Goat’s milk | 2 | 26.2 (9.9) | 2 | 28.5 (6.3) |
| Infant milk | 7 | 25.2 (14.1.) | 6 | 17.6 (12.8) |
| Adjusted Iodine Content Median (P25, P75) (μg/100 mL) | β (95% CI) | t | |
|---|---|---|---|
| Thermic processing | |||
| Ultra-pasteurized * | 16.4 (13.2, 17.9) | - | - |
| Pasteurized | 20.3 (15.9, 22.2) | 3.9 (−0.4, 8.1) | 1.8 |
| Lactose presence | |||
| Yes * | 16.4 (13.2, 17.9) | - | - |
| No | 18.4 (17.4, 19.2) | −2.0 (−4.4, 0.4) | −1.7 |
| Fat level | |||
| Whole | 17.0 (15.5, 17.7) | 0.6 (−2.4, 3.6) | 0.4 |
| Semi-skimmed * | 16.4 (13.2, 17.9) | - | - |
| Skimmed | 16.9 (13.9, 20.6) | 0.4 (−1.5, 2.4) | 0.5 |
| Season | |||
| Winter * | 16.4 (13.2, 17.9) | - | - |
| Summer | 16.3 (14.1, 18.5) | −0.1 (−1.8, 1.7) | −0.1 |
| Organic and/or from pasture | |||
| Yes * | 14.6 (9.6, 18.9) | - | - |
| No | 16.4 (13.2, 17.9) | 1.8 (−1.0, 4.7) | 1.8 |
| Region | |||
| North * | 22.1 (19.8, 22.8) | - | - |
| Centre | 28.9 (18.9, 39.9) | 6.8 (3.8, 9.9) | 4.4 |
| Lisbon and Tejo Valley | 19.4 (15.0, 20.8) | −2.6 (−5.0, 0.6) | −1.6 |
| Alentejo | 27.5 (11.4, 20.9) | −4.6 (−7.5, −1.6) | −3.0 |
| Azores | 16.4 (13.2, 17.9) | −5.0 (−8.7, −2.7) | −3.7 |
| All Products | Organic and/or from Pasture | Not Organic or From Pasture | ||||
|---|---|---|---|---|---|---|
| n | Iodine Content Median (IQR) (μg/100 mL) | n | Iodine Content Median (IQR) (μg/100 mL) | n | Iodine Content Median (IQR) (μg/100 mL) | |
| All regions | 137 | 19.9 (9.9) | ||||
| Portugal | 104 | 20.9 (9.7) | 16 | 16.5 (10.2) | 88 | 21.6 (9.5) |
| Norte (North) | 22 | 22.5 (7.4) | 1 | 40.3 | 21 | 22.3 (6.5) |
| Centro (Center) | 22 | 30.8 (13.5) | 0 | NA | 22 | 30.8 (13.5) |
| Lisboa e Vale do Tejo (Lisbon and Tejo Valley) | 15 | 20.3 (7.8) | 0 | NA | 15 | 20.3 (7.8) |
| Alentejo | 20 | 16.5 (8.2) | 3 | 21.9 (13.0) | 17 | 15.9 (6.0) |
| Azores | 25 | 17.7 (4.7) | 12 | 15.7 (8.1) | 13 | 19.7 (6.7) |
| Spain | 31 | 15.7 (7.8) | ||||
| France | 1 | 25.7 | ||||
| Germany | 1 | 11.4 | ||||
| Milk (g/Day) * | Iodine Milk Content (μg/100 g) | Adequate Intake (μg) ** | Estimated Contribution to Iodine Intake (μg) and % of Contribution to Adequate Intake | |
|---|---|---|---|---|
| IAN-AF *, 2015–2016 [12] | 19.9 | |||
| Older adults (65–84 years) | 156 | 150 | 31.0 (21%) | |
| Adults (18–64 years) | 149 | 150 | 29.7 (20%) | |
| Adolescents (10–17 years) | 250 | 120–130 | 49.75 (40%) | |
| Children (<10 years) | 267 | 90 | 53.1 (58%) |
| Non-Enriched | Enriched with Iodine | |||
|---|---|---|---|---|
| Plant-Based Milk Alternatives | Number of Products | Iodine Content μg/100 mL (Median, IQR) | n (%) | Iodine Content μg/100 mL (Median, IQR) |
| All (128) | 124 | 3.3 (5.3) | 4 (5%) | 24.9 (7.7) |
| Soy (37) | 37 | 3.4 (5.4) | 0 | - |
| Oat (27) | 24 | 2.0 (4.2) | 3 (11%) | 26.2 (17.6) |
| Almond (22) | 22 | 3.5 (4.0) | 0 | - |
| Rice (16) | 16 | 3.0 (2.7) | 0 | - |
| Hazelnut (5) | 5 | 1.8 (3.3) | 0 | - |
| Coconut (3) | 3 | 7.9 (2.7) | 0 | - |
| Combinations (18) | 17 | 4.1 (5.3) | 1 (6%) | 4.2 |
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. |
© 2025 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
Machado, S.I.; Machado, A.; Bordalo, A.A.; Roque, S.; Borges, N.; Palha, J.A. Mapping Iodine Sources for Human Nutrition in Portugal Considering Geography, Seasonality, and Processing: Milk and Plant-Based Milk Alternatives. Nutrients 2025, 17, 3606. https://doi.org/10.3390/nu17223606
Machado SI, Machado A, Bordalo AA, Roque S, Borges N, Palha JA. Mapping Iodine Sources for Human Nutrition in Portugal Considering Geography, Seasonality, and Processing: Milk and Plant-Based Milk Alternatives. Nutrients. 2025; 17(22):3606. https://doi.org/10.3390/nu17223606
Chicago/Turabian StyleMachado, Sarai Isabel, Ana Machado, Adriano A. Bordalo, Susana Roque, Nuno Borges, and Joana Almeida Palha. 2025. "Mapping Iodine Sources for Human Nutrition in Portugal Considering Geography, Seasonality, and Processing: Milk and Plant-Based Milk Alternatives" Nutrients 17, no. 22: 3606. https://doi.org/10.3390/nu17223606
APA StyleMachado, S. I., Machado, A., Bordalo, A. A., Roque, S., Borges, N., & Palha, J. A. (2025). Mapping Iodine Sources for Human Nutrition in Portugal Considering Geography, Seasonality, and Processing: Milk and Plant-Based Milk Alternatives. Nutrients, 17(22), 3606. https://doi.org/10.3390/nu17223606

