Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Minerals, trace elements, Vit. D and bone health

Iodine status in schoolchildren living in northeast italy:the importance of iodized-salt use and milk consumption

European Journal of Clinical Nutrition volume 67, pages 366–370 (2013)Cite this article

Subjects

Abstract

Background:

The aims of the study were: (i) to determine iodine status of schoolchildren living in northeast Italy; (ii) to assess dietary habits and iodine status and (iii) to investigate the level of knowledge concerning iodine sufficiency and ways to ameliorate iodine status.

Methods:

One thousand three hundred seventy-five consecutive 12–13 year-old completed questionnaires collecting demographic data and information about the use of iodized salt and food frequency habits. Iodine concentration in urine samples (UIC) and in commercially available milk samples has been measured.

Results:

The median UIC was found to be 81 μg/l (95% confidence interval (CI) 74–87); 40% of the subjects had an UIC of ⩾100 μg/l. Iodine deficiency was prevalent in subjects living in hilly areas. Median iodine concentration in milk was 264 μg/l. Only the combined use of iodized salt plus daily milk normalized UIC, resulting into a median value of 108 μg/l. A logistic regression model confirmed independent associations between low UIC and low intake of milk, use of non-iodized salt and geographical location (P<0.0001). Only 45% of the subjects were aware of the importance of iodine.

Conclusions:

Northeast Italy is still characterized by mild iodine deficiency. An adequate iodine status was achieved only when iodized salt was combined with daily milk intake. The national iodine prophylaxis program has led to greater consumption of iodized salt and, it is now used in 60–70% of the Italian households. The low level of awareness highlights the need for public programs to promote knowledge and efforts to improve iodine status.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Zimmermann MB, Andersson M . Prevalence of iodine deficiency in Europe in 2010. Ann Endocrinol (Paris) 2011; 72: 164–166.

    Article  CAS  Google Scholar 

  2. WHO/UNICEF/ICCIDD. Assessment of Iodine Deficiency Disorders and Monitoring their Elimination. A Guide for Programme Managers. World Health Organization WHO: Geneva, 2008.

  3. WHO Secretariat,, Andersson M, de Benoist B, Delange F, Zupan J . Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-year-old: conclusions and recommendations of the technical consultation. Public Health Nutr 2007; 10: 1606–1611.

    Article  Google Scholar 

  4. De Benoist B, McLean E, Andersson M, Rogers L . Iodine deficiency in 2007: global progress since 2003. Food Nutr Bull 2008; 29: 195–202.

    Article  Google Scholar 

  5. World Health Organization WHO global database on iodine deficiency. Available at http://www.who.int/vmnis/database/iodine/en accessed on 7 May 2011.

  6. Zimmermann MB . Iodine deficiency. Endocr Rev 2009; 30: 376–408.

    Article  CAS  Google Scholar 

  7. Gordon RC, Rose MC, Skeaff SA, Gray AR, Morgan KM, Ruffman T . Iodine supplementation improves cognition in mildly iodine-deficient children. Am J Clin Nutr 2009; 90: 1264–1271.

    Article  CAS  Google Scholar 

  8. Zimmermann MB, Connolly K, Bozo M, Bridson J, Rohner F, Grimci L . Iodine supplementation improves cognition in iodine-deficient schoolchildren in Albania: a randomized, controlled, double-blind study. Am J Clin Nutr 2006; 83: 108–114.

    Article  CAS  Google Scholar 

  9. WHO/UNICEF/ICCIDD Indicators for assessing iodine deficiency disorders and their control through salt iodization. Available at http://whqlibdoc.who.int/hq/1994/WHO_NUT_94.6.pdf.

  10. Dunn JT . Iodine should be routinely added to complementary foods. J Nutr 2003; 133: 3008S–3010S.

    Article  Google Scholar 

  11. Pearce EN, Pino S, He X, Bazrafshan HR, Lee SL, Braverman LE . Sources of dietary iodine: bread, cows' milk, and infant formula in the Boston area. J Clin Endocrinol Metab 2004; 89: 3421–3424.

    Article  CAS  Google Scholar 

  12. Aghini-Lombardi F, Antonangeli L, Vitti P . Epidemiologia del gozzo endemico in Italia. Ann Ist Super Sanità 1998; 34: 311–314.

    CAS  PubMed  Google Scholar 

  13. Baschieri L, Costa A, Basile A Il Gozzo. Pozzi Editore, 1978.

    Google Scholar 

  14. Aghini-Lombardi F, Antonangeli L, Vitti P, Pinchera A . Status of iodine nutrition in Italy. In: Delange F, Dunn JT, Glinoer D, (eds) NATO ASI Series.Iodine Deficiency in Europe. A Continuing Concern. Plenum Press: New York, 1993, pp 403–408.

    Chapter  Google Scholar 

  15. Law N 55, 21 March 2005, ‘Disposizioni finalizzate alla prevenzione del gozzo endemico e di altre patologie da carenza iodica’, published in Gazzetta Ufficiale n. 91, 20 April 2005.

  16. Frigato F, Cerisara D, De Vido D, Garola E, Girelli ME, Insolia C et al. Epidemiological survey of goiter and iodine deficiency in Veneto region. J Endocrinol Invest 1996; 19: 734–738.

    Article  CAS  Google Scholar 

  17. Busnardo B, Nacamulli D, Frigato F, Vianello-Dri A, De Vido D, Mian C et al. Normal values for thyroid ultrasonography, goitre prevalence, and urinary iodine concentration in schoolchildren of the Veneto Region, Italy. J Endocrinol Invest 2003; 26: 991–996.

    Article  CAS  Google Scholar 

  18. Naozuka J, Mesquita MA, da Veiga S, Oliveira PV, de Oliveira E . Determination of chlorine, bromine and iodine in milk samples by ICP-OES. J Anal At Spectrom 2003; 18: 917–921.

    Article  CAS  Google Scholar 

  19. Mian C, Vitaliano P, Pozza D, Barollo S, Pitton M, Callegari G et al. Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol (Oxf) 2009; 70: 776–780.

    Article  CAS  Google Scholar 

  20. Vanderpump MP, Lazarus JH, Smyth PP, Laurberg P, Holder RL, Boelaert K et al. Iodine status of UK schoolgirls: a cross-sectional survey. Lancet 2011; 377: 2007–2012.

    Article  CAS  Google Scholar 

  21. Pearce EN . Effects of iodine deficiency in pregnancy. J Trace Elem Med Biol 2012; 26: 131–133.

    Article  CAS  Google Scholar 

  22. Girelli ME, Coin P, Mian C, Nacamulli D, Zambonin L, Piccolo M et al. Milk represents an important source of iodine in schoolchildren of the Veneto region, Italy. J Endocrinol Invest 2004; 27: 709–713.

    Article  CAS  Google Scholar 

  23. Andersson M, de Benoist B, Darnton-Hill I, Delange F Iodine Deficiency in Europe: A Continuing Public Health Problem. WHO Press: Geneva, 2007.

    Google Scholar 

  24. Phillips DI . Iodine, milk and the elimination of endemic goitre in Britain: the story of an accidental public health triumph. J Epidemiol Community Health 1997; 51: 391–393.

    Article  CAS  Google Scholar 

  25. Rasmussen LB, Ovesen L, Bulow I, Jorgensen T, Knudsen N, Laurberg P et al. Dietary iodine intake and urinary iodine excretion in a Danish population: effect of geography, supplements and food choice. Br J Nutr 2002; 87: 61–69.

    Article  CAS  Google Scholar 

  26. Soriguer F, Gutierrez-Repiso C, Gonzales-Romero S, Olveira G, Garriga MJ, Velasco I et al. Iodine concentration in cow’s milk and its relation with urinary iodine concentrations in the population. Clin Nutr 2011; 30: 44–48.

    Article  CAS  Google Scholar 

  27. Brantsæter AL, Haugen M, Julshamn K, Alexander J, Meltzer HM . Evaluation of urinary iodine excretion as a biomarker for intake of milk and dairy products in pregnant women in the Norwegian Mother and Child Cohort Study (MoBa). Eur J Clin Nutr 2009; 63: 347–354.

    Article  Google Scholar 

  28. National Research Council. Nutrient Requirements of Dairy Cattle. 6th revised edn., National Academy Press: Washington, 1989.

  29. EFSA. Opinion of the scientific panel on additives and products or substances used in animal feed on the request from the commission on the use of iodine in feedingstuffs. (Question N EFSA-Q-2003-058). EFSA J 2005; 168: 1–42.

    Google Scholar 

  30. Bertoli P . Contributo allo studio del gozzismo nelle regioni alpine (Cadore). Annali di Igiene. Roma 1932; 4: 231–237.

    Google Scholar 

  31. Frasson U, Serafini L . Il gozzo nella zona di Schio. G Sci Med 1947; 1–16.

Download references

Acknowledgements

We thank Linda Inverso for text editing. This research was supported by a grant from Azienda Ospedaliera di Padova (Protocol N° 22078 to FM).

Author information

Authors and Affiliations

  1. Department of Medicine-DIMED, Endocrinology Unit, University of Padua, Padua, Italy

    S Watutantrige Fernando, S Barollo, D Nacamulli, D Pozza, M E Girelli, F Mantero & C Mian

  2. Operative Unit of Medicine, ULSS 5, Vicenza, Italy

    M Giachetti

  3. Endocrinology Unit, ULSS 12, Venice, Italy

    F Frigato

  4. Department of Molecular Medicine, University of Padua, Padua, Italy

    M Redaelli

  5. Department of Pharmaceutical Sciences, University of Padua, Padua, Italy

    G Zagotto

Authors
  1. S Watutantrige Fernando
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Barollo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D Nacamulli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D Pozza
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Giachetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F Frigato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M Redaelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G Zagotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M E Girelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. F Mantero
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C Mian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C Mian.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Watutantrige Fernando, S., Barollo, S., Nacamulli, D. et al. Iodine status in schoolchildren living in northeast italy:the importance of iodized-salt use and milk consumption. Eur J Clin Nutr 67, 366–370 (2013). https://doi.org/10.1038/ejcn.2013.44

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2013.44

Keywords

This article is cited by

Search

Advanced search

Quick links