Assessment of iodine nutrition in populations: past, present, and future

Iodine status has been historically assessed by palpation of the thyroid and reported as goiter rates. Goiter is a functional biomarker that can be applied to both individuals and populations, but it is subjective. Iodine status is now assessed using an objective biomarker of exposure, i.e., urinary...

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Bibliographic Details
Published in:Nutrition reviews 2012-10, Vol.70 (10), p.553-570
Main Authors: Zimmermann, Michael B, Andersson, Maria
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers
Biomarkers - urine
Dietary minerals
estimated average requirement
Feeding. Feeding behavior
Fundamental and applied biological sciences. Psychology
goiter
Goiter - epidemiology
Humans
Iodine - administration & dosage
Iodine - deficiency
Iodine - urine
iodine intake
Nutrition
Nutrition Assessment
Nutritional Status
Population biology
Prevalence
salt iodization
Sodium Chloride, Dietary - administration & dosage
thyroglobulin
Thyroid diseases
Thyroid Gland - pathology
Thyrotropin - blood
Thyroxine - blood
urinary iodine concentration
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vitamin deficiency
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Summary:Iodine status has been historically assessed by palpation of the thyroid and reported as goiter rates. Goiter is a functional biomarker that can be applied to both individuals and populations, but it is subjective. Iodine status is now assessed using an objective biomarker of exposure, i.e., urinary iodine concentrations (UICs) in spot samples and comparison of the median UIC to UIC cut‐offs to categorize population status. This has improved standardization, but inappropriate use of the crude proportion of UICs below the cut‐off level of 100 µg/L to estimate the number of iodine‐deficient children has led to an overestimation of the prevalence of iodine deficiency. In this review, a new approach is proposed in which UIC data are extrapolated to iodine intakes, adjusted for intraindividual variation, and then interpreted using the estimated average requirement cut‐point model. This may allow national programs to define the prevalence of iodine deficiency in the population and to quantify the necessary increase in iodine intakes to ensure sufficiency. In addition, thyroglobulin can be measured on dried blood spots to provide an additional sensitive functional biomarker of iodine status.
ISSN:0029-6643
1753-4887
DOI:10.1111/j.1753-4887.2012.00528.x