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Nutrients
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Iodine Fortification in Food Production and Human Health
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Iodine Fortification in Food Production and Human Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (25 October 2024) | Viewed by 8959

Special Issue Editors

Dr. Caterina Mian

E-Mail Website
Guest Editor
Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
Interests: thyroid; iodine status; differentiated thyroid cancer; medullary thyroid cancer selenium; molecular aspects of thyroid cancer
Dr. Simona Censi

E-Mail Website
Guest Editor
Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
Interests: Iodine; thyroid; endocrinology; metabolism; thyroid cancer

Special Issue Information

Dear Colleagues, 

The importance of iodine in human nutrition is well known. Iodine is indeed a limiting element in thyroid hormone synthesis, derived exclusively from diet. The iodine prophylaxis campaign is based on different strategies, aiming to address the needs and characteristics of the population it is directed toward. It can be based on the promotion of iodized salt use (mandatory or voluntary), the use of iodized salt in bread, the use of iodine-containing cattle feeds (to make cow milk and dairy products a good source of iodine), the use of iodized oil (especially in low-income countries), iodized water and the use of iodize salt in industrial processes. Vegan and vegetarian diets are known to be at a high risk of iodine deficit, with cow milk and dairy products and fish being important secondary sources of iodine. Consequently, many strategies based on iodine-enriched products and/or seaweeds are expanding. The aim of the present Special Issue is to analyze the last progress in iodine fortification in food production. 

Dr. Caterina Mian
Dr. Simona Censi
Guest Editors

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Keywords

  • iodine
  • thyroid
  • iodized salt
  • iodine prophylaxis
  • cow milk

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Published Papers (6 papers)

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Research

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11 pages, 910 KiB  
Article
Women with Autoimmune Thyroiditis Taking Levothyroxine During Pregnancy: Is Iodine Supplementation Needed?
by Simona Censi, Giulia Messina, Emma Feligiotti, Cristina Clausi, Ilaria Piva, Daniela Basso, Isabella Merante Boschin, Loris Bertazza, Fiammetta Battheu, Susi Barollo, Marta Camilot and Caterina Mian
Nutrients 2025, 17(3), 542; https://doi.org/10.3390/nu17030542 - 31 Jan 2025
Viewed by 947
Abstract
Background: Iodine is fundamental for the synthesis of thyroid hormones, which play a central role in foetal neurological development. The need for an iodine-containing supplement (ICS) in L-T4-treated women during pregnancy is still a subject of debate. Aim of the Study: The aim [...] Read more.
Background: Iodine is fundamental for the synthesis of thyroid hormones, which play a central role in foetal neurological development. The need for an iodine-containing supplement (ICS) in L-T4-treated women during pregnancy is still a subject of debate. Aim of the Study: The aim of the study is to investigate the iodine status in women with autoimmune thyroiditis (AT) who have or have not been treated with L-T4. Methods: This was a cross-sectional, observational study involving pregnant women with AT, treated with/without L-T4. Upon enrolment, women provided a urine sample (to measure the urinary iodine concentration (UIC), which was normalised to urinary creatinine values (UI/Creat)), and completed a questionnaire. TSH, FT4, and neonatal TSH were also obtained. Results: Among women taking an ICS, 74.1% had a UI/Creat level ≥ 150 μg/g, compared with only 46.2% of those not taking an ICS (p = 0.03). Among L-T4 users only, a UI/Creat level ≥ 150 μg/g was more frequent in ICS users than in non-ICS users (72.8% vs. 41.7%) (p = 0.03). In the multivariate analysis, ICS use was the only independent variable for UI/Creat ≥ 150 μg/g (OR: 3.4; CI: 1.1–10.9) (p = 0.04). There was a tendency towards higher UI/Creat levels as the L-T4 (µg/Kg) dosage increased, although no correlation was found. Newborns of women taking an ICS were found to have elevated neonatal TSH (2.8 mIU/L vs. 1.7 mIU/L) (p = 0.04). All newborns with a TSH >5 mUI/L were those of women taking supplements. Conclusions: Women with AT taking L-T4 still need iodine supplementation, although the amount should be regulated on the basis of their L-T4 dosage. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)
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15 pages, 2276 KiB  
Article
Mapping Consumer Preference for Vegan and Omnivorous Diets for the Sensory Attributes of Flour Products with Iodine-Fortified Plant-Based Ingredients
by Krystyna Szymandera-Buszka, Agata Jankowska and Anna Jędrusek-Golińska
Nutrients 2024, 16(24), 4392; https://doi.org/10.3390/nu16244392 - 20 Dec 2024
Viewed by 990
Abstract
Objectives: Flour products with iodine-fortified dried vegetables can be a good source of iodine. However, in addition to iodine stability, the sensory quality of these products is also important. Therefore, this study aimed to assess the effect of adding iodine-fortified dried vegetables to [...] Read more.
Objectives: Flour products with iodine-fortified dried vegetables can be a good source of iodine. However, in addition to iodine stability, the sensory quality of these products is also important. Therefore, this study aimed to assess the effect of adding iodine-fortified dried vegetables to flour products (gnocchi and ciabatta) on their sensory quality and map consumers (vegan/omnivore diets) as potential consumers of fortified flour products with iodine-fortified dried vegetables. Methods: A quantitative analysis of the sensory desirability and profiling were used to achieve the work objective. Results: It was confirmed that there was no relationship between the form of iodine (without iodine/KIO3/KI) and the intensity of all definite descriptors of colour, aroma, and taste. We also confirmed the relationship between the vegetable type and the descriptors’ intensity. It was confirmed that the positive attribute with the highest impact was the pumpkin taste, and the attribute with the most negative impact was the cauliflower aroma. This was true for consumers on vegan and omnivore diets, and they confirmed the most positive attitude toward the taste of pumpkin. Conclusions: Introducing dried iodine-fortified vegetables (gnocchi dumplings 24%; ciabatta rolls 5%) allows for the high sensory desirability of designed products. Introduced iodine (gnocchi dumplings 30 mg I/100 g; ciabatta rolls 9–11 mg I/100 g) does not change products’ sensory profiles. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)
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15 pages, 2304 KiB  
Article
Nutritional Adequacy of Flour Product Enrichment with Iodine-Fortified Plant-Based Products
by Agata Jankowska and Krystyna Szymandera-Buszka
Nutrients 2024, 16(24), 4261; https://doi.org/10.3390/nu16244261 - 10 Dec 2024
Cited by 1 | Viewed by 1129
Abstract
This study assessed the nutritional value of designed vegan flour products (Gnocchi and Ciabatta) by adding iodine-fortified dried vegetables. The KI and KIO3 constituted the sources of iodine. The pumpkin, cauliflower, carrot, broccoli and beetroot were used as a matrix for the [...] Read more.
This study assessed the nutritional value of designed vegan flour products (Gnocchi and Ciabatta) by adding iodine-fortified dried vegetables. The KI and KIO3 constituted the sources of iodine. The pumpkin, cauliflower, carrot, broccoli and beetroot were used as a matrix for the iodine applied. The nutritional value was tested based on iodine content and antioxidant activity. The content of thiamine was determined in samples of Ciabatta rolls. The antioxidant activity of Gnocchi dumplings and Ciabatta rolls was analysed before and after heat treatment (baking and cooking) and after storage. It was confirmed that the designed cereal products (Ciabatta rolls and Gnocchi dumplings) with the addition of iodine-fortified dried vegetables are a good source of iodine in the diet and can be used as an element of IDD prevention. Consuming 100 g of Ciabatta rolls (1 pc.) provides coverage of iodine demand at the level of ~6% RDA, while 100 g of Gnocchi dumplings (20 pcs.) provides ~19% RDA. The type of iodine carrier (KI or KIO3) and type of vegetable for iodine introduced into cereal products affect the content of selected nutritional value indicators, such as iodine and thiamine content and antioxidant properties of the product. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)
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16 pages, 2242 KiB  
Article
Household Consumption of Adequately Iodized Salt: A Multi-Country Analysis of Socioeconomic Disparities
by Daniela M. Sáez-Ramírez, Horacio Chacon-Torrico and Akram Hernández-Vásquez
Nutrients 2024, 16(21), 3787; https://doi.org/10.3390/nu16213787 - 4 Nov 2024
Viewed by 1574
Abstract
Background: Despite global efforts to promote universal salt iodization, iodine deficiency remains a public health issue in developing countries. Objectives: This study assessed the proportion and sociodemographic characteristics of households consuming adequately iodized salt in 49 low- and middle-income countries. Methods: Data from [...] Read more.
Background: Despite global efforts to promote universal salt iodization, iodine deficiency remains a public health issue in developing countries. Objectives: This study assessed the proportion and sociodemographic characteristics of households consuming adequately iodized salt in 49 low- and middle-income countries. Methods: Data from DHS surveys of 49 low- and middle-income countries (2005–2021) were used to analyze household iodized salt prevalence. R version 4.0 was employed for statistical analyses. A random-effects meta-analysis was conducted to estimate overall and regional prevalence. Results: We found that 83.4% of households consume adequately iodized salt, although with high heterogeneity (I2 = 100.0%). The East Asia and Pacific and the Europe and Central Asia regions showed high consumption rates of 87.6% and 87.7%, respectively, while Latin America and the Caribbean presented a significantly lower proportion of 30.8%. Conclusions: The study highlights the need for enhanced public health strategies to increase iodized salt consumption, especially in low-income and rural households. Addressing disparities in access, education, and affordability is crucial for improving iodine intake and preventing deficiency disorders, particularly among vulnerable populations like children and pregnant women. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)
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Review

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17 pages, 335 KiB  
Review
Salt Reduction and Iodine Fortification Policies Are Compatible: Perspectives for Public Health Advocacy
by Jessica Rigutto-Farebrother and Michael B. Zimmermann
Nutrients 2024, 16(15), 2517; https://doi.org/10.3390/nu16152517 - 1 Aug 2024
Cited by 3 | Viewed by 2713
Abstract
Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many [...] Read more.
Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many countries globally. Strategies proposed to aid effective salt reduction policy include product reformulation, front of pack labelling, behavioural change campaigns and establishing a low-sodium-supportive environment. Yet, salt for household and processed food use is, in countries wholly or partially adopting a universal salt iodisation policy, the principal vehicle for population-wide iodine fortification. With salt reduction policies in place, there is concern that iodine deficiency disorders may re-emerge. Recognising the urgency to tackle the rising prevalence of NCDs yet not risk the re-emergence and detrimental effect of inadequate iodine intakes, this review lays out the feasibility of integrating both salt reduction and salt iodine fortification strategies. Reducing the burden of health risks associated with an excessive sodium intake or inadequate iodine through population-tailored, cost-effective strategies involving salt is both feasible and achievable, and represents an opportunity to improve outcomes in public health. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)

Other

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10 pages, 406 KiB  
Commentary
Thyroid Autoimmunity During Universal Salt Iodisation—Possible Short-Term Modulation with Longer-Term Stability
by Navoda Atapattu, Renuka Jayatissa, Harendra de Silva, Mohamed A. Adlan, Emmanuel K. Obuobie and Lakdasa D. Premawardhana
Nutrients 2024, 16(24), 4299; https://doi.org/10.3390/nu16244299 - 12 Dec 2024
Cited by 1 | Viewed by 1070
Abstract
Universal salt iodisation (USI) plays an essential role in the provision of iodine (I) to populations worldwide. Countries adopting USI programmes, adhering to strict criteria laid down by expert organisations such as the Iodine Global Network, are estimated to have reduced the prevalence [...] Read more.
Universal salt iodisation (USI) plays an essential role in the provision of iodine (I) to populations worldwide. Countries adopting USI programmes, adhering to strict criteria laid down by expert organisations such as the Iodine Global Network, are estimated to have reduced the prevalence of I deficiency by 75% (protecting 720 million individuals worldwide). Despite this success, doubts have been raised as to the desirability of continuing such programmes because of (a) the need to reduce salt intake for cardiovascular prevention and (b) the induction of thyroid autoimmunity. We present current evidence from cross-sectional studies in several disparate populations of the possible short-term modulation of thyroid autoimmune markers, thyroid peroxidase (TPOAb) and thyroglobulin antibodies (TgAb), with minimal disruption of biochemical thyroid function. We also present evidence from longer term, mainly cross-sectional studies, that indicate a reduction in the prevalence of TPOAb and TgAb, and the persistence of normal biochemical thyroid function over as long as two decades of USI. We believe these studies indicate that USI is safe, and that long-term salt iodisation does not cause an increase in autoimmune thyroid disease in the populations studied and should not be a safety concern based on current evidence. More long-term and better-designed studies are required. Full article
(This article belongs to the Special Issue Iodine Fortification in Food Production and Human Health)
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