Poster Topical Area: Community and Public Health Nutrition

Location: Auditorium

Poster Board Number: 15

P12-051 - Constituent analysis of iodine intake in Armenia

Monday, Jun 11
8:00 AM – 3:00 PM

Objectives: Armenia implemented a universal salt iodization (USI) strategy in 2004, requiring iodization of table salt and salt used in food processing. We sought to assess the outcome of that strategy by characterizing iodine intake from naturally occurring dietary iodine, salt-derived iodine in processed foods, and salt-derived iodine in household-prepared foods among school-age children (SAC), pregnant women (PW), and non-pregnant women of reproductive age (WRA).

Methods: In a nationwide survey of iodine nutrition, we collected samples of urine and table salt from SAC, PW, and WRA. Approximately 20% of participants provided repeat urine samples. Urine samples were analysed for iodine and sodium concentrations (UIC and UNaC), and salt samples were analysed for iodine concentration (SI). Repeat UIC and UNaC were used to adjust raw measurements to more closely approximate habitual levels. SI and adjusted UNaC measurements were used as explanatory variables in multi-variate linear regression analysis with adjusted UIC as the dependent variable. Regression parameters were used to approximate the portions of dietary iodine attributable to native iodine, processed food salt, and household salt.

Results: From 13 sites in Armenia, representing all provinces, we collected urine and table salt samples from 1125 participants, of whom 958 provided sufficient quantity for laboratory analysis: 315 SAC, 316 PW, 327 WRA. Findings revealed significant differences in constituent analyses between groups, with percentage of intake from native iodine ranging from a high of 82% in PW to a low of 42% in SAC, and the contribution of iodine from table salt ranging from 19% in SAC to a low of 1% in PW.

Conclusions: The remarkable differences between groups likely reflect differences in dietary habits. The minimal impact of household salt and the significant contribution of native iodine on the intake of pregnant women may be a result of adherence to low-salt diets, as is commonly recommended by clinicians for pregnancy, and the use of iodine-containing nutritional supplements. In all 3 groups, the contributions of household salt and salt from processed foods comprise a significant component of total iodine intake, and highlight the success and importance of the USI strategy in ensuring sufficient intake for the entire population.

Funding Source: Fulbright US Student Program, Iodine Global Network, Columbia University Center for Global and Population Health, Columbia University College of Physicians & Surgeons Student Research Stipend, Boston University Medical Center (in kind), John & Hasmik Foundation, the Anna and Hirair Hovnanian Foundation, and with the collaboration of the Ministries of Health, of Education, and of Territorial Affairs of the Republic of Armenia.
Figure 1: Constituent Components of Urinary Iodine Concentration

Figure 2: Constituent Components of Urinary Iodine Concentration (percentage)

CoAuthors: Nicholas Hutchings – Columbia University and Yerevan State Medical University; Elena Aghajanova, MD PhD – Yerevan State Medical University; Mushegh Qefoyan, MD MPH – Armenia National Institute of Health; Sisak Baghdasaryan, MD MPH – Management Mix; Catherine Sulivan, MD – Boston Medical Center; Xuemei He, PhD – Boston Medical Center; Frits van der Haar, PhD – Rollins School of Public Health of Emory University; Lewis Braverman, MD – Boston University; John Bilezikian, MD PhD (Hon) – Columbia University College of Physicians & Surgeons

Rachel Criswell

Resident Physician
Maine-Dartmouth Family Medicine Residency
Mount Vernon, Maine