Search Results (349)

Background: Iodine nutrition requires continued surveillance after changes in salt iodization policy. This study evaluated iodine status and associated factors among children and adolescents in Zhejiang Province, ten years after the national salt iodization standard was lowered. Methods: A cross-sectional survey employing a stratified, multistage cluster sampling design was conducted in 2022. A total of 688 participants aged 6–17 years with complete data on urinary iodine concentration, household salt iodine concentration, geographic classification, and key questionnaire variables were included in the analysis. Multivariate logistic regression analysis was performed to identify factors independently associated with iodine sufficiency. Results: Among 688 participants, the median household salt iodine concentration was 21.50 mg/kg, and iodized salt coverage was 64.68%. The median urinary iodine concentration (UIC) was 191.4 μg/L; however, 15.26% of participants had UIC < 100 μg/L. Participants in coastal areas had lower UIC levels and lower household iodized salt coverage than those in inland areas. Multivariate logistic regression analysis identified age, geographic region, and household use of iodized salt as factors significantly associated with iodine sufficiency. Conclusions: The overall iodine nutritional status among children and adolescents aged 6–17 years in Zhejiang Province is adequate. However, a certain proportion of iodine deficiency persists. Continued, targeted monitoring and health education on the appropriate use of qualified iodized salt are warranted, particularly in coastal areas and among younger children. Full article

Background/Objectives: Heart transplant recipients are particularly at risk for micronutrient deficiencies due to chronic immunosuppression, metabolic disorders, gastrointestinal absorption disorders, and increased postoperative demand. Despite a growing body of evidence suggesting their clinical relevance, the prevalence, characteristics, and consequences of these deficiencies remain poorly defined. The aim of this review was to assess of selected micronutrient deficiencies in personnel after heart vaccination and risk factors for their control. Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute’s scope review methodology and presented in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, EBSCO, Web of Science, Google Scholar, and Cochrane Library (January–February 2026) identified studies assessing micronutrient deficiencies in adult heart transplant recipients. Original publications, meta-analyses, and reviews available in full text in English were eligible for the review. Data extraction was carried out independently by two reviewers; using the PCC (Population–Concept–Context) model. Results: Of the 35 pre-identified records, 12 studies met the inclusion criteria. The most commonly reported deficiencies included iron, vitamin D, and B vitamins, and their incidence varied widely due to heterogeneous diagnostic criteria. Iron deficiency—both absolute and functional—was common and often associated with inflammation and impaired hepcidin regulation. Vitamin D deficiency persisted before and after transplantation and was associated with impaired bone health, inflammation, and a potentially increased risk of infection. Elevated homocysteine levels associated with low levels of folic acid and vitamin B6 have been identified as potential contributing factors to atherosclerotic and thrombotic complications. Limited evidence also points to deficiencies in iodine, zinc, and other trace elements. Conclusions: Micronutrient deficiencies are common among heart transplant recipients and can adversely affect immune system function, cardiovascular risk, and overall clinical outcomes. Routine evaluation and targeted correction of deficiencies should be considered in post-transplant care. Further prospective, multicenter, and interventional studies are needed to establish standardized diagnostic criteria and evidence-based supplementation strategies. Full article

Background: Iodine deficiency during pregnancy remains a leading cause of preventable neurodevelopmental impairment worldwide, yet quantitative characterization of the dose–response relationship between maternal iodine status and child neurodevelopment is lacking. Methods: A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted for prospective cohort studies published up to February 2026 reporting associations between maternal iodine status and child neurodevelopmental outcomes across at least three exposure categories. All continuous effect estimates were converted to standardized mean differences (Hedges’ g) to permit pooling across heterogeneous assessment instruments, and meta-analyses were stratified by neurodevelopmental domain (cognitive, language, motor, behavior, academic). A two-stage dose–response meta-analysis was used to characterize non-linearity. Risk of bias was evaluated using the Newcastle–Ottawa Scale (NOS). Results: Ten prospective cohort publications corresponding to eight independent cohorts were included. After converting all continuous effect estimates to standardized mean differences (Hedges’ g) and consolidating the three overlapping MoBa publications into a single cohort, the pooled analysis revealed a significant negative association between suboptimal maternal iodine status and child neurodevelopmental performance (Hedges’ g = −0.13, 95% CI: −0.20 to −0.06, p < 0.001; I² = 95.2%). Domain-stratified analysis identified cognitive outcomes as most consistently affected (g = −0.22, 95% CI: −0.30 to −0.14; I² = 37.5%), followed by motor (g = −0.17; I² = 0%) and language outcomes (g = −0.16; I² = 92.5%), with between-domain heterogeneity explaining 38.6% of the total variance (p = 0.012). Binary outcome analysis confirmed increased odds of adverse neurodevelopmental outcomes (OR = 1.19, 95% CI: 1.03 to 1.39, p = 0.026). Subgroup analysis by iodine exposure indicator showed directionally consistent negative effects across dietary intake (g = −0.11), UIC (g = −0.11) and UI/Cr (g = −0.28), with no significant between-subgroup difference (p = 0.237). Exploratory dose–response modeling on the Hedges’ g scale suggested that neurodevelopmental performance in the fitted curves approached its maximum within a mid-range of dietary iodine intake (approximately 150–300 µg/d); however, the quadratic non-linearity terms did not reach statistical significance after cohort consolidation (p = 0.612 for dietary intake; p = 0.436 for UI/Cr), and these findings should therefore be interpreted as exploratory. Conclusions: Suboptimal maternal iodine status during pregnancy was associated with modest decrements in child neurodevelopmental performance, with exploratory dose–response analyses suggesting that the fitted curves approached their maximum within a mid-range of dietary iodine intake. Although statistical evidence for quadratic non-linearity was attenuated after consolidating overlapping cohorts, the directional pattern across indicators remained consistent with an inverted U-shaped relationship, supporting maintenance of adequate but not excessive iodine nutrition during pregnancy. Full article

Background/Objectives: Micronutrient malnutrition, particularly deficiencies in calcium, vitamin D, iron, zinc, and iodine, remains a significant public health issue among school-aged children in Morocco. Processed cheese, such as “The Laughing Cow” (TLC), has potential as a vehicle for fortification due to its widespread consumption and accessibility. This study aimed to evaluate the impact of fortified TLC on micronutrient intake and adequacy relative to the Recommended Dietary Allowances (RDA), among Moroccan children aged 6–12 years, and to explore differences in effects by socioeconomic status (SES). Methods: Data from the Moroccan Household Budget Survey (2013–2014) included 9266 children (39.4% TLC consumers). Dietary intake was assessed using 24 h recalls, and nutrient composition was analyzed using Ciqual 2020 tables and specialized software. Fortification scenarios were modelled to estimate potential impacts on micronutrient intake and compliance with RDAs. Results: Under the modelling scenarios, consumption of one portion/day of fortified TLC significantly improved RDAs compliance for iron, iodine, and zinc (p < 0.05). There was also an increase in RDA compliance for calcium and vitamin D, but differences were not significant. The impact of fortification on micronutrient intake and RDA compliance increased with socioeconomic status. Consumers of more than one portion/day showed the highest compliance with RDAs (p < 0.001). Fortification effects were consistent across age subgroups. Conclusions: Fortifying processed cheese represents a feasible strategy to address micronutrient deficiencies among Moroccan schoolchildren. This study highlights the potential of targeted fortification programmes to improve public health outcomes, particularly in vulnerable populations. Further research is needed to optimize fortification approaches and ensure sustainability. Full article

Iodine is an essential trace element for thyroid hormone synthesis, metabolic homeostasis, and fetal neurodevelopment. During pregnancy, maternal iodine requirements increase substantially, yet global recommendations are primarily based on population-level biomarkers rather than individualized physiological data. In this review, we examine current international guidelines for iodine adequacy in pregnancy, evaluate the limitations of population-based metrics—such as urinary iodine concentration (UIC) and serum thyroglobulin (Tg)—and highlight emerging evidence on physiological adaptations, functional biomarkers, and individualized risk factors. We incorporated data from population surveillance studies, mechanistic investigations of thyroid adaptation, and clinical outcome research identified through a literature search of PubMed/MEDLINE and Scopus (2016–2025). Evidence indicates that the widely adopted WHO range for iodine intake in pregnant women may overestimate the actual needs of gestation. There is a U-shaped relationship between iodine intake and thyroid outcomes, meaning both low and high iodine exposure adversely affect maternal thyroid function and fetal neurodevelopment, highlighting the narrow optimal intake window. Individualized considerations—including autoimmune thyroid disease, supplementation practices, environmental exposures, and coexisting micronutrient deficiencies—further modulate iodine requirements. Functional indices, such as the Thyroid Feedback Quantile-based Index (TFQI), may offer complementary tools for assessing iodine adequacy beyond traditional biomarkers. Full article

Iodine is an essential micronutrient required for the synthesis of thyroid hormones and the maintenance of metabolic, neurodevelopmental and immune function. As iodine cannot be synthesized endogenously, adequate intake depends on dietary sources and environmental availability. Despite decades of progress in improving iodine supply, both iodine deficiency and excess remain significant global public health challenges. This review summarizes iodine physiology, covering both its role in thyroid hormone synthesis and emerging evidence for extrathyroidal immunomodulatory and antioxidant actions. It summarizes major dietary sources, global intake patterns and current approaches to iodine status assessment, including urinary biomarkers, salivary iodide measurement and dietary screening tools. The clinical consequences of iodine imbalance are examined, ranging from goiter, hypothyroidism and impaired neurocognitive development associated with deficiency, to iodine-induced thyroid dysfunction, autoimmunity and adverse systemic effects linked to excess intake. Special attention is given to vulnerable populations, particularly pregnant women and infants. This review further evaluates public health strategies, including salt iodization and targeted supplementation, while addressing the emerging challenge posed by salt-reduction initiatives. Achieving optimal iodine intake remains essential for thyroid health and population well-being, underscoring the need for coordinated monitoring and policy adaptation. Full article

Background/Objectives: Iodine deficiency remains an important global public health concern. Although iodized salt is the primary strategy for iodine deficiency prevention, its effectiveness depends on adequate iodine concentrations in commercially available products. However, laboratory data on the iodine content of retail salt products in Hungary are currently lacking. Therefore, this study aimed to determine the iodine concentration of commercially available iodized table salts in Hungary and to assess their compliance with the WHO-recommended range of 20–40 ppm. Methods: Twenty different brands of iodized table salt were purchased from major retail outlets in Pécs, Hungary, representing the dominant food retail sector. According to product labels, ten salts were fortified with potassium iodate (KIO₃) and ten with potassium iodide (KI). Iodine concentrations were determined by iodometric titration following WHO-recommended laboratory methods. All measurements were performed in triplicate and expressed as mean values. In addition, a small exploratory wholesale micro-survey examined purchasing patterns of iodized and non-iodized salt in the regional supply chain. Results: Measured iodine concentrations varied substantially among products, ranging from 0 to 33.9 ppm. Overall, 65% of the analyzed salt samples contained less than 20 ppm iodine, while only 35% fell within the WHO-recommended range of 20–40 ppm. Notably, several products declared iodine concentrations below recommended levels on their labels. The wholesale micro-survey showed that ten times more iodized than non-iodized salt was ordered during the observation period. Conclusions: These results suggest that the presence of iodized salt on the market does not necessarily guarantee adequate iodine supply and highlight the potential relevance of considering iodine status during the differential diagnosis of hypothyroidism. Full article

As populations age, micronutrient deficiencies increase and are linked to frailty, functional decline, cognitive impairment, anemia, and a higher healthcare burden. This review synthesizes evidence from the past five years on adults ≥65 years, comparing residents of nursing homes/assisted-living facilities with community-dwelling peers. Community-dwelling older adults show high prevalence of deficiencies—particularly vitamin D, calcium, magnesium, folate, and zinc—while vitamin B12 deficiency is less common overall but increases with age due to malabsorption. Institutionalized adults face higher risk, driven by limited dietary variety, reduced sunlight exposure, greater multimorbidity, and polypharmacy. Reported rates include vitamin D deficiency in 70–94% of institutionalized adults (≈6.3-fold higher odds), zinc deficiency in 50–66% (vs. 31–49% in the community), iodine deficiency in 67–78% (vs. 22% in the community), and a Mini Nutritional Assessment classification of severe malnutrition/at risk in 67.9% (vs. 28% in the community). Consequences encompass frailty, falls, infections, higher costs, and increased institutionalization. Recommended actions include routine biomarker screening, improving access to vitamin D (supplementation/fortification), individualized care for micronutrient deficiencies—including vitamin B12 when relevant—multidisciplinary nutrition support, and long-term targeted research to guide best practices for healthy aging and equity. Full article

Background: Adequate iodine intake during pregnancy is essential for optimal maternal thyroid function and fetal neurodevelopment. Although universal salt iodization has been implemented in Turkey, pregnant women may remain vulnerable to iodine insufficiency. This study aimed to evaluate maternal thyroid function in relation to iodine status, and to comprehensively compare the diagnostic performance of spot urinary indices and creatinine-adjusted measures against measured 24 h urinary iodine excretion (24h-UIE) in pregnant women. Methods: A total of 227 pregnant women attending family health centers in Afyonkarahisar, Turkey, provided both spot urine samples and complete 24 h urine collections. Urinary iodine concentration (UIC), creatinine-corrected UIC (UIC/UCr), and 24h-UIE were measured. Thyroid function tests were interpreted using trimester-specific reference ranges. Correlations between urinary indices were assessed, and ROC analyses were performed using 24h-UIE as the operational reference. A structured questionnaire evaluated iodine-related dietary knowledge and salt-use practices. Results: The median spot UIC was 59.0 µg/L, indicating insufficient recent iodine intake at the population level. Based on 24h-UIE, 70% of participants had excretion levels below the Estimated Average Requirement (EAR) threshold (<144 µg/day). Spot UIC showed a weak correlation with 24h-UIE (rho = 0.270, p < 0.001), whereas UIC/UCr demonstrated a stronger correlation (rho = 0.491, p < 0.001). In ROC analyses, UIC/UCr yielded a significantly higher AUC than spot UIC (0.774 [95% CI: 0.707–0.841] vs. 0.670 [95% CI: 0.593–0.748]; DeLong p = 0.016). Overt hypothyroidism was not observed; subclinical hypothyroidism was present in 16.3% of participants. While no overall association was found between iodine indices and thyroid status, in the first trimester, those with subclinical hypothyroidism had higher 24h-UIE medians than euthyroid peers (134.2 vs. 100.3 µg/day, p = 0.037), although both groups remained below the EAR threshold. Knowledge regarding iodine-rich foods and iodized salt use was limited among the study population. Conclusions: Iodine insufficiency remains highly prevalent among pregnant women in this region despite salt iodization. While spot UIC alone showed limited agreement with 24h-UIE, creatinine-adjusted UIC may offer improved interpretability under conditions of variable urine dilution. Preserved thyroid function in the presence of iodine insufficiency highlights the silent nature of this condition during pregnancy. Strengthened pregnancy-specific iodine surveillance and targeted antenatal education are warranted. Full article

Thyroid disorders are common in pregnancy and if left untreated, they can have serious consequences. There is an ongoing debate as to whether thyroid screening in pregnancy should be universal. Current guidelines recommend a risk-based thyroid screening, which is a health strategy offering TSH measurement to higher-risk women only. Given the key role of risk stratification, in this narrative review, we aimed to (i) describe the established risk factors for thyroid disease in pregnancy; (ii) provide an update on the emerging risk factors; (iii) examine their overall potential utility. For this purpose, a comprehensive literature search was conducted across the PubMed, Scopus, and Web of Science databases, employing a combination of MeSH terms and relevant keywords, including ‘thyroid dysfunction’, ‘pregnancy’, ‘risk factors’, ‘screening’. In conclusion, the current literature confirms that thyroid autoimmunity and moderate-to-severe iodine deficiency remain the most consistent and reproducible predictors of thyroid dysfunction. Full article

In the current context of accelerating global warming, it is urgent to speed up actions to adapt to this problem. About one third of agri-food products are lost or underused, thus contributing further and unnecessarily to greenhouse gas emissions. This is a narrative review, based on exhaustive analysis of the literature dealing with the mechanisms, incidence, and historical aspects of hidden hunger, as well as technical and operational tools to fight it. The review gives an overview of the current situation regarding micronutrient deficiencies, called hidden hunger, in five minerals (iron, calcium, zinc, iodine, and selenium), and two vitamins (A and D), as well as a picture of overall mitigation actions and outcomes. Then, it gives a picture of available solutions regarding the raw material and the tools and methodologies currently used for agri-food waste valorization, with a focus on aquatic foodstuffs. Finally, a proposal for the use of agri-food waste to fight hidden hunger, food insecurity, and beyond, is advanced. Full article

Background: Ageing profoundly alters endocrine regulation and nutrient metabolism, predisposing older adults to thyroid dysfunction. Iodine, an essential micronutrient, lies at the center of this vulnerability due to its narrow physiological range and multiple interactions with nutrition, medications, renal function, and, presumably, gut microbiota. Objective: This narrative review integrates evidence on how ageing modifies iodine–thyroid homeostasis, emphasizing the roles of dietary intake, pharmacologic exposures, microbiota composition, and age-related metabolic alterations that influence iodine handling and thyroid hormone economy. Main Findings: Physiological ageing reduces renal iodine clearance, thyroidal reserve, and peripheral hormone conversion, while chronic inflammation and multimorbidity increase susceptibility to both iodine deficiency and excess. Polypharmacy, including amiodarone, lithium, and proton pump inhibitors, further destabilizes thyroid function. Age-related dysbiosis may impair micronutrient absorption and immune tolerance, linking gut ecology to thyroid autoimmunity. The gut microbiota may influence thyroid function through immune and metabolic pathways, although current evidence in older adults remains limited. Together, these factors shift the balance between iodine intake and utilization, heightening the risk of subclinical or overt hypothyroidism in older adults. Conclusions: Overall, variations in iodine intake emerge as one of the main determinants of thyroid dysfunction in ageing with nutritional, pharmacologic, and other modifiers primarily influencing iodine-related thyroid vulnerability. The adoption of age-adjusted thyroid reference ranges and preventive monitoring can reduce overtreatment and improve metabolic resilience in later life. Full article

Background: The Carnivore Diet (CD) is an almost exclusively animal-based dietary pattern that has gained increasing popularity on social media. Despite numerous health-related claims, a standardized definition is lacking, and scientific evidence regarding the long-term effects of this diet remains unclear. Methods: The literature search for this scoping review was conducted in accordance with PRISMA guidelines (PRISMA-ScR) using the databases PubMed, LIVIVO, Web of Science, and the Cochrane Library. Results: Nine human studies were included. Individual publications reported positive effects of the CD, such as weight reduction, increased satiety, and potential improvements in inflammatory or metabolic markers. At the same time, potential risks of nutrient deficiencies, particularly in vitamins C and D, calcium, magnesium, iodine, and dietary fiber, as well as elevated low-density-lipoprotein (LDL-) and total cholesterol (TC) levels, were identified, along with one case describing a deterioration in health status. Overall, the quality of evidence is very limited due to small sample sizes, short study durations, and the absence of control groups. Conclusions: The CD may offer short-term health benefits but carries substantial risks of nutrient deficiencies, reduced intake of health-promoting phytochemicals, and the development of cardiovascular disease. At this time, long-term adherence to a CD cannot be recommended. Full article

Iodine deficiency remains a global public health concern. Preliminary studies confirmed that cauliflower can serve as a carrier for iodine salts. However, the influence of its endogenous goitrogenic compounds (phenolic compounds and glucosinolates) on iodine utilisation is not fully understood. This study aimed to assess the potential for enhancing cauliflower’s effectiveness as an iodine carrier through various thermal pre-treatment methods, and to examine how these methods, along with the plant’s endogenous goitrogens, affect iodine stability. Cauliflower was cooked by steaming or boiling (covered or uncovered) and fortified with KI or KIO₃. Iodine content, selected phenolic compounds (sinigrin, progoitrin, glucobrassicin, gluconapin, indole-3-carbinol) and antioxidant activity (ABTS^●+, DPPH^●) were analysed immediately after fortification and after 90 days of storage at 4, 21, or 40 °C under controlled humidity and darkness. The results showed that both the heat-treatment method and storage temperature significantly affected iodine retention and were associated with changes in goitrogenic compounds and antioxidant capacity. Cauliflower demonstrated favourable stability as a carrier of iodine, although phytochemical composition influenced fortification outcomes. These findings suggest that the initial heat treatment of cauliflower significantly affects its effectiveness as a matrix for iodine fortification, likely due to differences in the content of goitrogenic compounds. Full article

Iodine is essential for thyroid hormone synthesis and is particularly critical during pregnancy, where excess and mainly its deficiencies can impair fetal neurodevelopment and increase maternal complications. Bromine has also gained attention due to its potential to interfere with iodine metabolism and contribute to adverse health effects when present in excess. Monitoring iodine and bromine in biological samples, especially urine and serum, is therefore important for assessing thyroid function and population health. This work presents a simple and robust ICP-MS method for simultaneous determination of bromine and iodine in urine and serum. The procedure uses a 20-fold dilution with 10 mmol L⁻¹ ammonia containing 0.1% (w/w) EDTA-2Na, ensuring solution stability, minimizing sample-to-sample variability, and eliminating the need for matrix-matched calibration. EDTA-2Na effectively prevents precipitation of metal species at high pH, avoiding blockages in the sample introduction system. Method accuracy was confirmed through certified reference materials and spike-recovery experiments, both showing suitable agreement for the two analytes. Precision was consistently strong (RSD < 6%), and low detection limits were achieved (0.78 μg L⁻¹ for Br and 0.24 μg L⁻¹ for I). The use of a high-efficiency nebulizer enabled analysis with only 50 µL of sample, making the method suitable for limited-volume specimens. Overall, this approach provides a sensitive, accurate, and practical solution for large-scale population studies and clinical applications. Full article