Search Results (43)

The thyroid gland plays a crucial role in regulating metabolism and supporting development through the production of the hormones T4 and T3. These hormones are essential during childhood for nervous system myelination, physical growth, puberty, skeletal and dental maturation, and overall metabolic balance. In early infancy, when the hypothalamic–pituitary–thyroid axis is still immature, thyroid dysfunction can result in a range of long-term complications. The metabolism and action of thyroid hormones depend not only on iodine but also on other vital micronutrients, particularly selenium (Se). This narrative review aims to comprehensively examine the role of selenium in maintaining thyroid health from fetal life through adolescence. Selenium is a key micronutrient involved in thyroid development, hormone synthesis, antioxidant defense, and immune regulation, especially during pregnancy and childhood. Inadequate selenium levels may contribute to the onset, progression, and clinical management of various thyroid disorders, particularly hypothyroidism and autoimmune thyroid diseases. Although scientific evidence supports selenium’s critical functions in hormone metabolism and antioxidant protection, public awareness and monitoring of selenium intake remain insufficient. Beyond the need for further research, there is an urgent call for integrated public health strategies, ranging from sustainable, food-based approaches to targeted clinical screening and educational programs. Promoting awareness of selenium’s importance and incorporating selenium status into maternal and pediatric care protocols could play a significant role in preventing deficiencies and supporting long-term endocrine and neurodevelopmental health. Full article

Iodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, impairing foetal brain development and leading to long-term deficits in cognitive function across childhood and adulthood. However, emerging evidence also suggests that excessive iodine intake may disrupt thyroid function, particularly in individuals with underlying thyroid autoimmunity, potentially leading to adverse neurodevelopmental outcomes. In this state-of-the-art review, we examine the effects of iodine nutrition during pregnancy and lactation on child cognitive outcomes. We provide an overview of the recent global iodine status, critically appraise the current evidence linking both iodine deficiency and excess to neurodevelopmental outcomes, and offer expert interpretation of the key findings. We further highlight areas of uncertainty, introduce emerging evidence from contemporary studies, and propose directions for future research to inform and optimise public health policies and clinical practice. Our findings highlight a U-shaped association, whereby both insufficient and excessive iodine exposure during pregnancy and lactation may impair optimal brain development in the offspring. Full article

Background/Objectives: Lactating mothers have increased nutritional requirements, but nutritional adequacy is difficult to achieve. Additionally, human milk (HM) composition depends on maternal diet. However, the nutritional intake and status of mothers with hospitalized very preterm infants (MHVPIs) (<32 weeks of gestational age) have rarely been assessed. Hence, the aim of the present study was to determine the intake of macronutrients, micronutrients, and lipids, as well as the nutritional status of MHVPIs. The results were compared with a group of HM donors (HMDs), and associations with HM composition were evaluated using multiple linear regression. Methods: For dietary assessment, a 5-day dietary record including supplement intake was completed by 15 MHVPIs and 110 HMDs. Vitamins and fatty acids (FA) were determined in plasma and erythrocytes; minerals and methylmalonic acid were determined in urine; and macronutrients, vitamins, minerals, and the lipid profile were determined in HM. Results: Considering dietary reference intakes, the dietary evaluation of MHVPIs revealed a high percentage of inadequate nutrient intake in relation to total energy, as well as for iodine and vitamins B8, B9, C, D, and E. A high protein intake was observed. The percentage of energy from carbohydrates was low, whereas the percentage of energy from fat was high. However, the diet of MHVPIs did not differ substantially from the diet of HMDs. Associations were observed between the study groups (MHVPI vs. HMD) and the HM concentration of protein, several micronutrients, and fatty acids independent from intake and status. Conclusions: Deficient nutrient intakes did not appear to be exclusively related to MHVPI but rather seemed to be widespread in both study groups. However, for preterm infants, an insufficient supply of nutrients is critical and should be addressed in order to improve preterm infant’s outcomes. Furthermore, we provided additional insights into the exploration of HM by relating its composition to prematurity. Full article

Objective: Maintaining adequate iodine intake during pregnancy contributes to achieving a viable fetus with proper neuropsychological development. Because of the lack of national data regarding the assessment of iodine status in pregnant women—conducted through urinary iodine determination in perimarine regions, geographical areas characterized by sufficient iodine intake—this study was undertaken. Materials and Methods: The study evaluated iodine status in a cohort of pregnant women from southeastern region of Romania, perimarine area, assessing iodine intake indicators and the severity of iodine deficiency levels. Results: Iodine nutritional status, based on urinary iodine concentration values adjusted to urinary creatinine, was insufficient in 47.3% of pregnancies. Moderate iodine deficiency was found in 43.2%, while severe iodine deficiency was identified in only 4.1%. Conclusions: Although this is a non-endemic region for iodine deficiency disorders, the perimarine area of Romania presents a moderate iodine deficiency among special population groups such as pregnant women. This situation necessitates iodine intake adaptation and periodic monitoring to prevent maternal-fetal thyroid dysfunctions. Full article

Background/Objectives: Iodine deficiency disorders remain a global public health concern, as acknowledged by the World Health Organization (WHO). Adequate maternal iodine intake during pregnancy is essential for normal fetal development, yet the relationship between maternal iodine status and fetal growth remains controversial. Urinary Iodine Concentration (UIC) is a commonly used marker for assessing iodine status. This study evaluates the association between maternal UIC and neonatal anthropometric parameters. Methods: This prospective single-center cohort study included 202 pregnant women without known or reported thyroid disease, recruited between 2018 and 2021. Maternal iodine status was assessed by UIC from spot urine samples collected at the time of recruitment. Correlations were analyzed between maternal UIC and neonatal anthropometric measures, including birth weight (g), length (cm), and head circumference (cm). Analyses stratified by fetal sex were also performed. Results: No statistically significant association was found between UIC and neonatal anthropometric measures. Analysis of these correlations, stratified by fetal sex, did not reveal any statistically significant associations either. Conclusions: Maternal UIC showed no association with neonatal anthropometric outcomes in this study, regardless of fetal sex. Further research is needed to investigate the additional effects of maternal iodine status in healthy, euthyroid pregnant women on neonatal outcomes. Full article

Background/Objectives: Breast milk is a dynamic, personalized nutrition source, influenced by maternal diet, lifestyle, and environmental factors, which shape its composition and impact infant health. This review synthesizes evidence on the associations between maternal lifestyles (e.g., diet, physical activity, smoking), breast milk composition, and child health, offering insights for interventions to optimize breastfeeding benefits. Methods: We searched Web of Science, Medline, Embase, and PubMed for studies published up to March 2024 using predefined terms. Results: Out of 5244 articles, 20 studies met the inclusion criteria. Maternal Body Mass Index and macronutrient intake significantly affected breast milk fatty acid composition, influencing infant growth, cognitive development, and metabolic health. Micronutrient intake, particularly iodine, omega-3 fatty acids, and vitamins, was linked to better neurodevelopment and reduced atopic risks. Maternal diet and supplementation improved breast milk nutrient profiles and infant outcomes, though exposure to toxins like ochratoxin A raised concerns. Smoking was associated with altered milk composition, including lower osteopontin levels, potentially affecting infant immunity and growth. Conclusions: This review emphasizes that adequate intake of key nutrients is essential for infant development, highlighting the need for policies that address nutritional deficiencies, promote healthy lifestyles, and reduce socio-economic barriers. These efforts can improve outcomes for both mothers and children, enhancing public health and reducing disparities. Full article

An increasing number of studies highlight the critical role of both maternal and paternal nutrition and body weight before conception in shaping offspring health. Traditionally, research has focused on maternal factors, particularly in utero exposures, as key determinants of chronic disease development. However, emerging evidence underscores the significant influence of paternal preconception health on offspring metabolic outcomes. While maternal health remains vital, with preconception nutrition playing a pivotal role in fetal development, paternal obesity and poor nutrition are linked to increased risks of metabolic disorders, including type 2 diabetes and cardiovascular disease in children. This narrative review aims to synthesize recent findings on the effects of both maternal and paternal preconception health, emphasizing the need for integrated early interventions. The literature search utilized PubMed, UNF One Search, and Google Scholar, focusing on RCTs; cohort, retrospective, and animal studies; and systematic reviews, excluding non-English and non-peer-reviewed articles. The findings of this review indicate that paternal effects are mediated by epigenetic changes in sperm, such as DNA methylation and non-coding RNA, which influence gene expression in offspring. Nutrient imbalances during preconception in both parents can lead to low birth weight and increased metabolic disease risk, while deficiencies in folic acid, iron, iodine, and vitamin D are linked to developmental disorders. Additionally, maternal obesity elevates the risk of chronic diseases in children. Future research should prioritize human studies to explore the influence of parental nutrition, body weight, and lifestyle on offspring health, ensuring findings are applicable across diverse populations. By addressing both maternal and paternal factors, healthcare providers can better reduce the prevalence of metabolic syndrome and its associated risks in future generations. Full article

Background: Pregnancy is a crucial period for maternal and fetal health, and in Lebanon, where cultural and economic factors influence dietary practices, there is an urgent need to evaluate the food consumption patterns and diet quality of pregnant women. Aim: To evaluate the food consumption patterns, energy intake, as well as macro- and micro-nutrient intake among a nationally representative sample of Lebanese pregnant women aged 18–49 years old. Methods: A cross-sectional study was carried out from March to October 2023, involving 500 pregnant women from all eight Lebanese governorates. Sociodemographic and medical information was gathered, food consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) and three 24-h recall, and anthropometric measurements were recorded. Results: The current population did not meet the USDA healthy pattern recommendations for whole grain, seafood, dairy, nuts, seeds and soy products consumption but exceeded the guidelines for vegetables, meats, poultry, eggs, oils, and refined grains. According to Mediterranean diet guidelines, the sample fell short in recommended intakes for fruits, olives/nuts/seeds, eggs, and olive oil, while surpassing the recommended levels for potatoes, legumes, pulses, sweets, red meat, processed meat, and fish and seafood. None of the participants met the energy requirements for their trimester and age group. In terms of macronutrient intake, the requirements for protein, unsaturated fats, and fiber were not met, while intakes of fats and sugars were exceeded. Regarding micronutrients, the recommended levels were not fully achieved, with particularly low intakes of vitamin D and iodine, as well as inadequate adherence to recommendations for iron, calcium, vitamin A, vitamin E, zinc, and choline. Additionally, a third of the participants did not meet the recommended intakes for folate and vitamin B12. Conclusions: The findings reveal significant dietary inadequacies among the current population, with participants failing to meet essential recommendations for whole grains and key food groups, alongside insufficient energy intake for their trimesters and age groups. Critical micronutrient deficiencies, particularly in vitamin D, iodine, and B vitamins, highlight the urgent need for targeted nutritional interventions and public health initiatives to improve dietary practices among pregnant women in Lebanon. Full article

Thyroid hormones (THs) require iodine for biosynthesis and play critical roles in brain development. Perchlorate is an environmental contaminant that reduces serum THs by blocking the uptake of iodine from the blood to the thyroid gland. Using a pregnant rodent model, we examined the impact of maternal exposure to perchlorate under conditions of dietary iodine deficiency (ID) on the brain and behavior of offspring. We observed modest reductions in thyroxine (T4) in the serum of dams and no effect on T4 in pup serum in response to maternal exposure to 300 ppm of perchlorate in the drinking water. Likewise, serum T4 was reduced in ID dams, but, as with perchlorate, no effects were evident in the pup. However, when ID was coupled with perchlorate, reductions in pup serum THs and transcriptional alterations in the thyroid gland and pup brain were detected. These observations were accompanied by reductions in the number of cortical inhibitory interneurons containing the calcium-binding protein parvalbumin (Pvalb). Alterations in Pvalb expression in the neonatal brain were associated with deficits in the prepulse inhibition of acoustic startle in adult male offspring and enhanced fear conditioning in females. These findings support and extend structural defects in the brain previously reported in this model. Further, they underscore the critical need to consider additional non-chemical stressors in the determination of hazards and risks posed by environmental contaminants that affect the thyroid system. Full article

Promoting optimal nutrition in pregnant and lactating women is crucial for maternal and infant health. This study evaluated their nutritional status and dietary habits, assessing macro and micronutrient intake based on recommendations. A descriptive study with Spanish participants examined social, obstetric, dietary, and anthropometric data using quantitative and qualitative methods. The analysis of fatty acids by gas chromatography revealed significant variability, with notable deviations in specific fatty acids like C:10:0 and C:12:0. Despite some differences, the overall composition aligns with standards. During pregnancy, 53.8% consumed five meals/day. Grilling (92.3%) and baking (76.9%) were common. Food consumption frequency differed from recommendations. Lactating mothers’ mean energy intake was 2575.88 kcal/day ± 730.59 standard deviation (SD), with 45% from carbohydrates and 40% from lipids, including 37.16 g ± 10.43 of saturated fatty acids. Diets during pregnancy lacked fruits, vegetables, legumes, nuts, and cereals. Lactating mothers partially met nutritional objectives, with an energy distribution skewed towards lipids and deficiencies in calcium, iodine, vitamin D, E, and folic acid. Promoting proper nutrition during pregnancy and lactation is essential to safeguard health and prevent chronic diseases. Full article

It is crucial to provide adequate iodine nutrition to infants and toddlers for proper thyroid function and subsequent brain development. Infants are particularly vulnerable to iodine deficiency during the transition from a milk-based diet (breast milk and/or infant formula) to solid food. This study examines the current iodine levels of children during their first two years of life and investigates the association between these levels and feeding behaviors and the iodine status of their mothers in Shanghai, a city located in eastern China. A hospital-based cohort study was conducted to enroll mother–child pairs, where the child is aged 6–23 months, who visited community health service centers in the 16 districts of Shanghai, China. Data on socio-demographic factors and feeding behavior data were collected from the participants. The urinary iodine concentration (UIC) in both the young children and their mothers were analyzed. A total of 2282 mother–child pairs were included in this analysis. The median (p25–p75) UIC for lactating women, weaning women, and children were 121.3 μg/L (68.1–206.4 μg/L), 123.4 μg/L (58.4–227.2 μg/L), and 152.1 μg/L (75.8–268.3 μg/L), respectively. The UIC in children was found to be higher than that in their mothers (p < 0.001). Children who consumed less than 500 mL per day of formula milk in the last week had lower UICs compared with those who consumed 500 mL per day or more (p = 0.026). Furthermore, the children’s UIC was positively correlated with the maternal UIC (r_s = 0.285, p < 0.001). Multiple quantile regression analysis revealed a statistically significant positive association between maternal UIC and children’s UIC between the 0.1 and 0.9 quantiles (all p < 0.001). We found that the iodine status of infants and toddlers, as well as of mothers, was sufficient. However, a large minority of children and mothers may be at risk of iodine deficiency. Furthermore, no associations between children’s UIC and feeding behaviors were observed. Moreover, there was a positive correlation between the UIC of young children and their mothers. Full article

There has been a scarcity of evidence about iodine nutrition knowledge among women during pregnancy and lactation. The aim of this study was to determine women’s iodine knowledge and the relationship between knowledge and iodine status during pregnancy and lactation. Women were recruited from a hospital in the western part of China in the third trimester of pregnancy and followed until the end of the first week of lactation. The women’s iodine status was measured by their urinary iodine concentration (UIC) and an iodine-specific, validated food frequency questionnaire (FFQ). Iodine nutrition knowledge was assessed using an iodine nutrition knowledge questionnaire. A total of 200 women (mean age of 29.0 ± 4.2 years) completed the whole study. The majority of the women did not consume enough iodine during both pregnancy and lactation (231.89 vs. 237.26 µg/day). The overall mean iodine knowledge scores in our sample of women during pregnancy and lactation were 4.77 and 4.87, indicating low iodine knowledge. The use of iodized salt and a higher education level were significantly associated with an increased iodine knowledge score. In conclusion, this study reported poor iodine nutrition knowledge in women, highlighting a public health concern. Therefore, the iodine knowledge of women should be improved, possibly via maternal health campaigns to avoid the consequences of iodine deficiency disorders in newborns. Full article

Environmental contaminants are often flagged as thyroid system disruptors due to their actions to reduce serum thyroxine (T4) in rodent models. The presence of a periventricular heterotopia (PVH), a brain malformation resulting from T4 insufficiency, has been described in response to T4 decrements induced by pharmaceuticals that reduce the hormone synthesis enzyme thyroperoxidase. In this report, we extend these observations to the environmental contaminant perchlorate, an agent that interferes with thyroid status by inhibiting iodine uptake into the thyroid gland. Pregnant rat dams were administered perchlorate in their drinking water (0, 30, 100, 300, 1000 ppm) from gestational day (GD) 6 until the weaning of pups on postnatal day (PN) 21. Serum T4 was reduced in dams and fetuses in late gestation and remained lower in lactating dams. Pup serum and brain T4, however, were not reduced beyond PN0, and small PVHs were evident in the brains of offspring when assessed on PN14. To emulate the developmental time window of the brain in humans, a second study was conducted in which pups from perchlorate-exposed dams were administered perchlorate orally from PN0 to PN6. This treatment reduced serum and brain T4 in the pup and resulted in large PVH. A third study extended the period of serum and brain TH suppression in pups by coupling maternal perchlorate exposure with maternal dietary iodine deficiency (ID). No PVHs were evident in the pups from ID dams, small PVHs were observed in the offspring of dams exposed to 300 ppm of perchlorate, and very large PVHs were present in the brains of pups born to dams receiving ID and perchlorate. These findings underscore the importance of the inclusion of serum hormone profiles in pregnant dams and fetuses in in vivo screens for thyroid-system-disrupting chemicals and indicate that chemical-induced decreases in fetal rat serum that resolve in the immediate postnatal period may still harbor considerable concern for neurodevelopment in humans. Full article

Background: Severe maternal iodine deficiency has profound consequences for the developing brain; however, the impact of mild to moderate deficiency is less clear, and findings from observational studies have been mixed. Aim: The purpose of this study is to assess the relationship between maternal iodine status in early pregnancy and infant neurological development in an Irish maternal–infant cohort. Methods: Maternal–infant dyads of the Improved Pregnancy Outcomes by Early Detection (IMPROvED) and the Cork Nutrition and Development (COMBINE) cohorts (n 456) were followed during pregnancy and from birth to 2 years of age. Participants completed detailed a clinical and questionnaire-based assessments (including Bayley’s Scale of Infant Development (BSID-III) at 24 months; n 295). Maternal urinary iodine concentration (UIC) was quantified at 15 weeks of gestation by the Sandell–Kolthoff (S-K) method, and urinary creatinine (Cr) was quantified by the Jaffe rate method using the RX Monaco Clinical Chemistry Analyser (Randox Laboratories Ltd.). Statistical analysis was performed using IBM SPSS Version 27 (IBM Corp., Armonk, NY, USA). Results: The median (IQR) maternal age at delivery was 32 (5) years, and the median (IQR) BMI at 15 weeks of gestation was 25.1 (5.0) kg/m². Three-quarters completed third-level education, 95% were in a relationship and 7% were smokers. Median (IQR) UIC was 118 (132) µg/L, and 65% had UIC < 150 µg/L. At 24 months, median (IQR) cognitive, language and motor composite scores were 105 (15), 103 (20) and 103 (14), respectively. Cognitive, language and motor developmental delay was indicated in 6.0, 7.8 and 0.4% of children, respectively. Though a slightly higher prevalence of developmental language delay was observed among infants of mothers with UI:Cr < 150 µg/g for language (11 versus 6%) and a combined cognitive/language outcome (10 versus 4%), when adjusted for education, marital status, gestational age and birthweight, UI:Cr was not associated with language delay (aOR (95% CI): 1.7 (0.6, 4.7)). Among non-users of iodine supplements (29% of sample; median (IQR) UIC: 84 (96) µg/L; 75% < 150 µg/L), for every 10 µg/L increase in UIC, we observed a 23% and 19% reduction in odds of cognitive and language delay, respectively (aOR (95% CI): 0.77 (0.71, 0.97), p = 0.029; 0.81 (0.66, 0.99), p = 0.035). Our findings highlight the importance of sufficient iodine status in early pregnancy. Full article

Mild-to-moderate iodine deficiency during pregnancy is prevalent worldwide, but its consequences for maternal and child health are not clear. We aimed to investigate the impact of maternal iodine intake during pregnancy on the child’s growth and neurodevelopment. This study involved a cohort of 11-year-old children (n = 70) whose mothers had participated in an iodine intake survey during pregnancy. Gestational, neonatal, anthropometric, intelligence quotient (IQ), and socioeconomic parameters were analyzed according to maternal urinary iodine concentration (UIC). There was a positive linear trend of current height Z-score, full-scale IQ, verbal IQ, family income, maternal education, and a negative trend of neonatal TSH levels with increasing maternal UIC levels. However, regression analysis indicated that maternal UIC was not an independent predictor of any gestational, neonatal, or childhood development parameter. Only maternal school education was positively associated with child height and IQ. In conclusion, we did not find any evidence of a direct effect of maternal iodine intake during pregnancy on the long-term growth and neurodevelopment of children. The results suggest that socioeconomic factors are important confounding factors that affect both maternal iodine intake and child development and must be considered when investigating the association between maternal iodine intake and child outcomes. Full article