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Iodine is an essential nutrient for human growth and development. The thyroid gland is dependent upon iodine for production of thyroid hormone. It is a common perception that iodine deficiency is not a major public health concern in mainland Australia, with sporadic studies carried out about a decade ago showing average urinary iodine excretion levels of around 200 microg/day. Recent evidence, however, has shown that the consumption of iodine is declining in Australia. A similar situation has occurred in the USA. The present study was designed to evaluate the urinary iodine excretion (UIE), as the indicator of iodine nutrition, in samples obtained from various demographic groups in the Sydney metropolitian area, namely: schoolchildren, healthy adult volunteers. pregnant women and patients with diabetes. Urinary iodine in spot urine sample was measured in a Technicon II autoanalyser using an in-house, semiautomated method. The results in this communication show that all four study groups had the median UIE below 100 microg/L. the criteria set by the World Health Organization for iodine repletion, and confirm what has been described previously, that iodine deficiency has reemerged in Sydney, Australia. One of the major causes of the reduced iodine intake is the reduction of iodine in milk since the dairy industry replaced iodine-rich cleaning solutions with other sanitisers. Secondly, less than 10% of the population are currently using iodised salt. A national survey into the iodine nutrition status in Australia is urgently required as part of the establishment of a systematic surveillance and legislation is required to iodise all edible salt.

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A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007–2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification) and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%–62%). A low intake of fish and seafood resulted in this food group contributing only 3%–8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring.

Thyroid disease in older Australian women is relatively common and may be undiagnosed. Ongoing monitoring of patients on thyroxine replacement therapy is important, given that 25% of treated patients had an abnormal TSH.

Aim: Iodine deficiency, which has adverse effects on health has re-emerged in Australia. The present study aimed to develop and validate a novel iodine-specific food frequency questionnaire for use in older Australians. Methods: A 49-item food frequency questionnaire that included iodine-rich foods was constructed and administered in 84 men and women aged 60-95 years with normal cognitive function. Dietary iodine intake assessed by the food frequency questionnaire was validated against three repeated 24-hour dietary recalls. Urinary spot iodine concentrations were selected as iodine intake biomarker. Agreement between the two dietary methods was determined using a Bland-Altman plot and intra-class coefficients. Correlations between dietary and urinary iodine were assessed. Forty-three participants repeated the questionnaire after 9 months for reproducibility. Results: Mean iodine intake measured by the food frequency questionnaire and 24-hour dietary recalls did not differ significantly (P = 0.870). The two methods were moderately correlated (r = 0.377; P < 0.05) and the Bland-Altman plots demonstrated an acceptable level of agreement (P = 0.870). Despite an association (r = 0.230; P < 0.05) between urinary iodine concentrations and 24-hour dietary recalls, the food frequency questionnaire was not associated with urinary iodine concentration (r = 0.094; P = 0.40). The method of triads showed coefficients of 0.238 (urinary iodine), 0.953(food frequency questionnaire), 0.396 (24-hour dietary recall) with the unknown true value. Conclusion: A short food frequency questionnaire to assess habitual dietary iodine intake in older Australians has been shown to be valid at the group level with regard to categorising individuals according to their habitual iodine intake. Reproducibility of the food frequency questionnaire remains to be demonstrated.

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Reducing population salt intake is a global public health priority due to the potential to save lives and reduce the burden on the healthcare system through decreased blood pressure. This implementation science research project set out to measure salt consumption patterns and to assess the impact of a complex, multi-faceted intervention to reduce population salt intake in Fiji between 2012 and 2016. The intervention combined initiatives to engage food businesses to reduce salt in foods and meals with targeted consumer behavior change programs. There were 169 participants at baseline (response rate 28.2%) and 272 at 20 months (response rate 22.4%). The mean salt intake from 24-h urine samples was estimated to be 11.7 grams per day (g/d) at baseline and 10.3 g/d after 20 months (difference: −1.4 g/day, 95% CI −3.1 to 0.3, p = 0.115). Sub-analysis showed a statistically significant reduction in female salt intake in the Central Division but no differential impact in relation to age or ethnicity. Whilst the low response rate means it is not possible to draw firm conclusions about these changes, the population salt intake in Fiji, at 10.3 g/day, is still twice the World Health Organization’s (WHO) recommended maximum intake. This project also assessed iodine intake levels in women of child-bearing age and found that they were within recommended guidelines. Existing policies and programs to reduce salt intake and prevent iodine deficiency need to be maintained or strengthened. Monitoring to assess changes in salt intake and to ensure that iodine levels remain adequate should be built into future surveys.