Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population?

Abstract

Objective: The monitoring of the populations’ iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland. Design: The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women). Setting: The study was conducted in 2017 within the National Health Programme in five regions of Poland. Participants: The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6–12 years). Results: In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l. Conclusions: Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.

Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008–2012 Survey

“…A more recent (2014–2017) UK survey in 2845 adults and children showed that the median UIC exceeded 100 µg/L only in regular consumers of cow milk, whereas the median UIC was lower in consumers of alternative types of milk [ 33 ]. Finally, the study of Trofimiuk-Müldner et al on children of school age ( n = 1000) and pregnant ( n = 300) and breastfeeding women ( n = 100) living in Poland showed that the mandatory sale of iodized salt to customers in the supermarkets markedly improved the iodine status in children but was not sufficient for pregnant and breastfeeding women [ 34 ].…”

Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* questionnaire survey of Polish physicians. *THESIS: Treatment of hypothyroidism in Europe by specialists: an international survey

“…Nevertheless, in clinical practice the trend to prescribe selenium in autoimmune thyroiditis is noticeable among physicians in Europe [34]. Although mandatory iodization of household salt in Poland has led to a sustainable optimization of iodine status in the general population, iodine supplementation is still necessary in pregnant women [35]. Poland is considered as a selenium deficient country, and this may partially explain the use of dietary supplements in clinical practice [36].…”

Preharvest iodine sprays at high rates are more effective in biofortification of apples than soil application

“…It is estimated that nearly 2 billion people in the world are at risk of IDD (Ittermann et al 2020;World Health Organization 2014). Approximately 50% of the European population is mildly to moderately I deficient (Trofimiuk-Müldner et al 2020).…”