Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial

Zimmermann, Michael; Zeder, Christophe; Chaouki, Nourredine; Torresani, Toni; Saad, Ahmed S.; Hurrell, Richard F.

doi:10.1530/eje.0.1470747

Cited by 57 publications

(29 citation statements)

References 19 publications

(28 reference statements)

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“…No significant correlation was found between thyroid hormones and iron status. Zimmermann et al (2002) studied to determine if cofortification of iodized salt with Fe would improve the efficacy of iodine in goitrous children with a high prevalence of anemia. In a 9-month, randomized, double-blind trial, 6-15-year-old children (n ¼ 377) were given iodized salt (25 mg iodine/g salt) or dual-fortified salt with iodine (25 mg iodine/g salt) and Fe (1 mg Fe/g salt, as ferrous sulfate microencapsulated with partially hydrogenated vegetable oil).…”

Section: Resultsmentioning

confidence: 99%

Risk factors for goiter in primary school girls in Qom city of Iran

Mousavi

Tavakoli²,

Mardan³

2005

Eur J Clin Nutr

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Objective: Goiter is endemic in Iran. The iodine deficiency disorders program was begun a few years ago in Iran, and the coverage of iodized salt is sufficient now. But, in a periodic yearly medical examination of primary school girls in Qom, the prevalence of goiter was above 30% in 2002. This survey was designed to study the risk factors of goiter in those students. Design: The study was a randomized (multistage, proportional simple random sampling) case-control study. Subjects and interventions: We selected and performed thyroid examinations in 1050 girl students in primary schools in Qom city of Iran in 2002. We found 284 cases: girls in primary schools had goiter in accordance with the clinical exam of World Health Organization classification. Among students who did not present with goiter in the clinical exam, we randomly selected 288 students as the control group. We used a questionnaire to evaluate them for the risk factors of goiter. Results: The mean7s.d. ages of cases and controls were 8.771.3 and 8.971.3 years, respectively. There is no significant difference between the two groups regarding history of soya, kale, turnip, fish, daily iodized salt usage, education and job of mothers, monthly family income, nationality, immigration and residential situation. By using multinomial logistic regression, we found that storage of iodized salt in open containers, odds ratio (OR): 2.201 (1.412-3.428); P-value o0.0001, medium socioeconomic situation (SES) of family, OR: 2.099 (1.029-4.282), P-value ¼ 0.041, district 2 of Qom city, OR: 2.880 (1.376-6.027), P-value ¼ 0.005, and district 3 of Qom city, OR: 2.051(1.032-4.078), P-value ¼ 0.041, were the major risk factors for goiter in this population. Conclusions: In this study, the main risk factors for goiter were storage of iodized salt in open containers, medium SES and also living in specific districts of Qom city. As the coverage of iodinized salt is over 95% in Iran, we advise the education of the family about storage of iodized salt in closed containers. We also recommend the study of the other risk factors of goiter in the different geographical areas of Iran, because of differences in the SES and nutritional habits.

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Section: Resultsmentioning

confidence: 99%

Risk factors for goiter in primary school girls in Qom city of Iran

Mousavi

Tavakoli²,

Mardan³

2005

Eur J Clin Nutr

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“…Thus, rather than iron supplementation, combined fortification of salt with iron and iodine may be of value in geographical areas in which iodine deficiency is a problem. Several recent intervention studies have pointed to the efficacy and safety of this procedure (Diosady et al, 2002;Zimmermann et al, 2002Zimmermann et al, , 2004a.…”

Section: Discussionmentioning

confidence: 99%

Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls

et al. 2005

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Objective: To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls. Design: A double-blind randomized intervention study. Setting: The study was performed from 2002 through 2003 in the Islamic Republic of Iran. Subjects: 103 iron-deficient non-anaemic girls who fulfilled all inclusion criteria were included, and 94 subjects successfully completed the study. Interventions: Patients were randomly assigned to one of four groups and treated with a single oral dose of 190 mg iodine plus 300 mg ferrous sulphate 5 times/week (n ¼ 24), 300 mg ferrous sulphate 5 times/week (n ¼ 23), a single oral dose of 190 mg iodine (n ¼ 25), or a placebo (n ¼ 22) for 12 weeks. Results: All groups were comparable at baseline. After the intervention, there was a significant increase in ferritin and transferrin saturation in the iron þ iodine group (17.6 vs 8.7 mg/dl, and 18.8 vs 7.2%, respectively, Po0.001 for both) and in the iron group (Po0.001 for both). Urinary iodine doubled in the iron þ iodine group and in the iodine group (Po0.001 for both). Thyroid indices tT4, tT3 and T3RU increased and reverse RT3 decreased in the iron þ iodine group (10 vs 8.9 mg/dl, Po 0.001; 143 vs 138 mg/dl, Po0.05; 32.3 vs 28.4%, Po0.001 and 24.8 vs 44.2 ng/dl, Po0.001, respectively) and in the iron group. These two groups did not differ for any of the four indices, but both differed significantly from the iodine and placebo groups. Conclusions: Our results indicate that improvement of iron status was accompanied by an improvement in some indices of thyroid hormones.

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“…112,115 However, synergistic and antagonistic interactions between micronutrients have to be taken into consideration during the development of appropriate formulations. [115][116][117][118][119][120][121][122][123][124][125] A special kind of intervention is the provision of fat-based spreads (e.g., peanut butter) and "sprinkles" containing multiple micronutrients to be mixed with food. 15 A principle limitation of all these interventions (except dietary diversification, of course) is their orientation toward single nutrients rather than plant ingredients (e.g., phytosterols and fibre), despite the desirability of plant ingredients for the prevention of cancer and cardiovascular diseases.…”

Section: Management and Controlmentioning

confidence: 99%

Malnutrition and health in developing countries

Müller

Krawinkel²

2005

Canadian Medical Association Journal

919

715

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MALNUTRITION, WITH ITS 2 CONSTITUENTS of protein–energy malnutrition and micronutrient deficiencies, continues to be a major health burden in developing countries. It is globally the most important risk factor for illness and death, with hundreds of millions of pregnant women and young children particularly affected. Apart from marasmus and kwashiorkor (the 2 forms of protein– energy malnutrition), deficiencies in iron, iodine, vitamin A and zinc are the main manifestations of malnutrition in developing countries. In these communities, a high prevalence of poor diet and infectious disease regularly unites into a vicious circle. Although treatment protocols for severe malnutrition have in recent years become more efficient, most patients (especially in rural areas) have little or no access to formal health services and are never seen in such settings. Interventions to prevent protein– energy malnutrition range from promoting breast-feeding to food supplementation schemes, whereas micronutrient deficiencies would best be addressed through food-based strategies such as dietary diversification through home gardens and small livestock. The fortification of salt with iodine has been a global success story, but other micronutrient supplementation schemes have yet to reach vulnerable populations sufficiently. To be effective, all such interventions require accompanying nutrition-education campaigns and health interventions. To achieve the hunger- and malnutrition-related Millennium Development Goals, we need to address poverty, which is clearly associated with the insecure supply of food and nutrition

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Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial

Cited by 57 publications

References 19 publications

Risk factors for goiter in primary school girls in Qom city of Iran

Risk factors for goiter in primary school girls in Qom city of Iran

Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls

Malnutrition and health in developing countries

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