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  1. Article ; Online: Symposium on ‘Geographical and geological influences on nutrition’ Iodine deficiency in industrialised countries

    Zimmermann, M.B.

    Proceedings of the Nutrition Society

    Conference on ‘Over- and undernutrition: challenges and approaches’ on 30 June–2 July 2009, The Summer Meeting of the Nutrition Society, was held at the University of Surrey, Guildford

    2010  Volume 69

    Abstract: Iodine deficiency is not only a problem in developing regions; it also affects many industrialised countries. Globally, two billion individuals have an insufficient iodine intake, and approximately 50% of continental Europe remains mildly iodine ... ...

    Abstract Iodine deficiency is not only a problem in developing regions; it also affects many industrialised countries. Globally, two billion individuals have an insufficient iodine intake, and approximately 50% of continental Europe remains mildly iodine deficient. Iodine intakes in other industrialised countries, including the USA and Australia, have fallen in recent years. Iodine deficiency has reappeared in Australia, as a result of declining iodine residues in milk products because of decreased iodophor use by the dairy industry. In the USA, although the general population is iodine sufficient, it is uncertain whether iodine intakes are adequate in pregnancy, which has led to calls for iodine supplementation. The few available data suggest that pregnant women in the Republic of Ireland and the UK are now mildly iodine deficient, possibly as a result of reduced use of iodophors by the dairy industry, as observed in Australia. Representative data on iodine status in children and pregnant women in the UK are urgently needed to inform health policy. In most industrialised countries the best strategy to control iodine deficiency is carefully-monitored salt iodisation. However, because approximately 90% of salt consumption in industrialised countries is from purchased processed foods, the iodisation of household salt only will not supply adequate iodine. Thus, in order to successfully control iodine deficiency in industrialised countries it is critical that the food industry use iodised salt. The current push to reduce salt consumption to prevent chronic diseases and the policy of salt iodisation to eliminate iodine deficiency do not conflict; iodisation methods can fortify salt to provide recommended iodine intakes even if per capita salt intakes are reduced to
    Keywords area ; children ; endemic goiter ; fetal neonatal life ; iodized salt ; moderate ; pregnant-women ; supplementation ; thyroid-function ; united-states
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 391142-1
    ISSN 1475-2719 ; 0029-6651
    ISSN (online) 1475-2719
    ISSN 0029-6651
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Prevalence of iodine deficiency in Europe in 2010.

    Zimmermann, M B / Andersson, M

    Annales d'endocrinologie

    2011  Volume 72, Issue 2, Page(s) 164–166

    Abstract: The adverse effects of iodine deficiency (ID) intellectual impairment, damaged reproduction, goiter and hypo- and hyperthyroidism are well known and easily corrected with salt iodization, but they continue to impair health and socioeconomic development, ... ...

    Abstract The adverse effects of iodine deficiency (ID) intellectual impairment, damaged reproduction, goiter and hypo- and hyperthyroidism are well known and easily corrected with salt iodization, but they continue to impair health and socioeconomic development, with more than two billion people at risk worldwide. During the major global expansion of salt iodization over the past four decades, much of Europe has remained iodine deficient. Although every European country endorsed the goal of eliminating iodine deficiency at the 1992 World Health Assembly, control of iodine deficiency has received low priority in much of Europe. However, there has been recent progress in the region and the number of children with low iodine intakes has decreased by ca. 30% since 2003. This paper presents an estimate of the prevalence of iodine deficiency in Europe in 2010, based on a systematic review to update the WHO Vitamin and Mineral Nutrition Information System (VMNIS) database.
    MeSH term(s) Child ; Deficiency Diseases/epidemiology ; Deficiency Diseases/prevention & control ; Europe/epidemiology ; Female ; Humans ; Infant ; Iodine/administration & dosage ; Iodine/deficiency ; Iodine/urine ; Pregnancy ; Prevalence ; Sodium Chloride, Dietary/administration & dosage ; Thyroid Diseases/epidemiology ; Thyroid Diseases/prevention & control
    Chemical Substances Sodium Chloride, Dietary ; iodized salt ; Iodine (9679TC07X4)
    Language English
    Publishing date 2011-04
    Publishing country France
    Document type Journal Article
    ZDB-ID 299-9
    ISSN 2213-3941 ; 0003-4266
    ISSN (online) 2213-3941
    ISSN 0003-4266
    DOI 10.1016/j.ando.2011.03.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring

    Zimmermann, M.B.

    American Journal of Clinical Nutrition

    a review

    2009  Volume 89, Issue 2

    Abstract: The World Health Organization (WHO) recently increased their recommended iodine intake during pregnancy from 200 to 250 µg/d and suggested that a median urinary iodine (UI) concentration of 150-249 µg/L indicates adequate iodine intake in pregnant women. ...

    Abstract The World Health Organization (WHO) recently increased their recommended iodine intake during pregnancy from 200 to 250 µg/d and suggested that a median urinary iodine (UI) concentration of 150-249 µg/L indicates adequate iodine intake in pregnant women. Thyrotropin concentrations in blood collected from newborns 3-4 d after birth may be a sensitive indicator of even mild iodine deficiency during late pregnancy; a 5 mU/L indicates iodine sufficiency. New reference data and a simple collection system may facilitate use of the median UI concentration as an indicator of iodine status in newborns. In areas of severe iodine deficiency, maternal and fetal hypothyroxinemia can cause cretinism and adversely affect cognitive development in children; to prevent fetal damage, iodine should be given before or early in pregnancy. Whether mild-to-moderate maternal iodine deficiency produces more subtle changes in cognitive function in offspring is unclear; no controlled intervention studies have measured long-term clinical outcomes. Cross-sectional studies have, with few exceptions, reported impaired intellectual function and motor skills in children from iodine-deficient areas, but many of these studies were likely confounded by other factors that affect child development. In countries or regions where
    Keywords brain ; children ; endemic cretinism ; goiter ; hormone ; newborns ; nutrition ; prevention ; thyroid-function ; women
    Subject code 610
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Iodine Deficiency

    Zimmermann, M.B.

    Endocrine Reviews

    2009  Volume 30, Issue 4

    Abstract: Iodine deficiency has multiple adverse effects in humans, termed iodine deficiency disorders, due to inadequate thyroid hormone production. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake, and South Asia and sub- ... ...

    Abstract Iodine deficiency has multiple adverse effects in humans, termed iodine deficiency disorders, due to inadequate thyroid hormone production. Globally, it is estimated that 2 billion individuals have an insufficient iodine intake, and South Asia and sub-Saharan Africa are particularly affected. However, about 50% of Europe remains mildly iodine deficient, and iodine intakes in other industrialized countries, including the United States and Australia, have fallen in recent years. Iodine deficiency during pregnancy and infancy may impair growth and neurodevelopment of the offspring and increase infant mortality. Deficiency during childhood reduces somatic growth and cognitive and motor function. Assessment methods include urinary iodine concentration, goiter, newborn TSH, and blood thyroglobulin. But assessment of iodine status in pregnancy is difficult, and it remains unclear whether iodine intakes are sufficient in this group, leading to calls for iodine supplementation during pregnancy in several industrialized countries. In most countries, the best strategy to control iodine deficiency in populations is carefully monitored universal salt iodization, one of the most cost-effective ways to contribute to economic and social development. Achieving optimal iodine intakes from iodized salt (in the range of 150–250 µg/d for adults) may minimize the amount of thyroid dysfunction in populations. Ensuring adequate iodine status during parenteral nutrition has become important, particularly in preterm infants, as the use of povidone-iodine disinfectants has declined. Introduction of iodized salt to regions of chronic iodine deficiency may transiently increase the incidence of thyroid disorders, but overall, the relatively small risks of iodine excess are far outweighed by the substantial risks of iodine deficiency
    Keywords binding protein-3 levels ; blood spot thyroglobulin ; endemic goiter region ; growth-factor-i ; maternal thyroid status ; messenger-ribonucleic-acid ; school-aged children ; total parenteral-nutrition ; universal salt iodization ; vitamin-a supplementation
    Subject code 630
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 603096-8
    ISSN 1945-7189 ; 0163-769X
    ISSN (online) 1945-7189
    ISSN 0163-769X
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Iodine

    Zimmermann, M.B.

    Gastroenterology

    It's Important in Patients that Require Parenteral Nutrition

    2009  Volume 137, Issue 5 (Suppl. 1)

    Abstract: Iodine deficiency has multiple adverse effects on growth and development because of inadequate thyroid hormone production. Four methods are generally recommended for assessment of iodine nutrition: urinary iodine concentration, thyroid size, and blood ... ...

    Abstract Iodine deficiency has multiple adverse effects on growth and development because of inadequate thyroid hormone production. Four methods are generally recommended for assessment of iodine nutrition: urinary iodine concentration, thyroid size, and blood concentrations of thyroid-stimulating hormone and thyroglobulin. Iodine intakes =1 mg/d are well tolerated by most adults, because the thyroid is able to adjust to a wide range of intakes. A daily dose of 1 µg iodine/kg body weight is recommended for infants and children receiving parenteral nutrition (PN), but this is far below their requirement. Daily iodine requirements in adults receiving enteral nutrition or PN are estimated to be 70–150 µg, but most PN formulations do not contain iodine. Despite this, deficiency is unlikely because absorption from iodine-containing skin disinfectants and other adventitious sources can provide sufficient iodine. However, if chlorhexidine replaces iodine-containing disinfectants for catheter care, iodine deficiency may occur during long-term PN, and periodic testing of thyroid functions may be prudent. Infants may be particularly vulnerable because of their small thyroidal iodine store, but available data do not yet support routine supplementation of preterm infants with iodine. Adults may be less vulnerable because thyroidal iodine stores may be able to support thyroid hormone production for several months. More studies to clarify this issue would be valuable
    Keywords blood spot thyroglobulin ; deficient area ; dietary iodine ; goiter prevalence ; iodized salt ; na+/i-symporter ; preterm infants ; reference values ; thyroid volume ; trace-elements
    Subject code 610
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Iron excess in recreational marathon runners.

    Mettler, S / Zimmermann, M B

    European journal of clinical nutrition

    2010  Volume 64, Issue 5, Page(s) 490–494

    Abstract: Background/objectives: Iron deficiency and anemia may impair athletic performance, and iron supplements are commonly consumed by athletes. However, iron overload should be avoided because of the possible long-term adverse health effects.: Methods: We ...

    Abstract Background/objectives: Iron deficiency and anemia may impair athletic performance, and iron supplements are commonly consumed by athletes. However, iron overload should be avoided because of the possible long-term adverse health effects.
    Methods: We investigated the iron status of 170 male and female recreational runners participating in the Zürich marathon. Iron deficiency was defined either as a plasma ferritin (PF) concentration <15 microg/l (iron depletion) or as the ratio of the concentrations of transferrin receptor (sTfR) to PF (sTfR:log(PF) index) of > or =4.5 (functional iron deficiency).
    Results: After excluding subjects with elevated C-reactive protein concentrations, iron overload was defined as PF >200 microg/l. Iron depletion was found in only 2 out of 127 men (1.6% of the male study population) and in 12 out of 43 (28.0%) women. Functional iron deficiency was found in 5 (3.9%) and 11 (25.5%) male and female athletes, respectively. Body iron stores, calculated from the sTfR/PF ratio, were significantly higher (P<0.001) among male compared with female marathon runners. Median PF among males was 104 microg/l, and the upper limit of the PF distribution in males was 628 microg/l. Iron overload was found in 19 out of 127 (15.0%) men but only 2 out of 43 in women (4.7%). Gender (male sex), but not age, was a predictor of higher PF (P<0.001).
    Conclusions: Iron depletion was present in 28% of female runners but in <2% of males, whereas one in six male runners had signs of iron overload. Although iron supplements are widely used by athletes in an effort to increase performance, our findings indicate excess body iron may be common in male recreational runners and suggest supplements should only be used if tests of iron status indicate deficiency.
    MeSH term(s) Adult ; Anemia, Iron-Deficiency/blood ; Anemia, Iron-Deficiency/epidemiology ; Athletes ; Exercise/physiology ; Female ; Ferritins/blood ; Humans ; Iron/blood ; Iron/deficiency ; Iron Overload/blood ; Iron Overload/epidemiology ; Iron, Dietary/administration & dosage ; Iron, Dietary/metabolism ; Male ; Nutritional Status ; Prevalence ; Receptors, Transferrin/metabolism ; Running/physiology ; Sex Factors
    Chemical Substances Iron, Dietary ; Receptors, Transferrin ; Ferritins (9007-73-2) ; Iron (E1UOL152H7)
    Language English
    Publishing date 2010-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639358-5
    ISSN 1476-5640 ; 0954-3007
    ISSN (online) 1476-5640
    ISSN 0954-3007
    DOI 10.1038/ejcn.2010.16
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Iodine requirements and the risks and benefits of correcting iodine deficiency in populations

    Zimmermann, M.B.

    Journal of Trace Elements in Medicine and Biology

    2008  Volume 22, Issue 2

    Abstract: Iodine deficiency has multiple adverse effects on growth and development due to inadequate thyroid hormone production that are termed the iodine deficiency disorders (IDD). IDD remains the most common cause of preventable mental impairment worldwide. IDD ...

    Abstract Iodine deficiency has multiple adverse effects on growth and development due to inadequate thyroid hormone production that are termed the iodine deficiency disorders (IDD). IDD remains the most common cause of preventable mental impairment worldwide. IDD assessment methods include urinary iodine concentration, goiter, thyroglobulin and newborn thyrotropin. In nearly all iodine-deficient countries, the best strategy to control IDD is salt iodization, one of the most cost-effective ways to contribute to economic and social development. When salt iodization is not possible, iodine supplements can be targeted to vulnerable groups. Introduction of iodized salt to regions of chronic IDD may transiently increase the incidence of thyroid disorders, and programs should include monitoring for both iodine deficiency and excess. Although more data on the epidemiology of thyroid disorders caused by differences in iodine intake are needed, overall, the relatively small risks of iodine excess are far outweighed by the substantial risks of iodine deficiency.
    Keywords blood spot thyroglobulin ; child-development ; developing-countries ; goiter prevalence ; iodized salt ; nutrition ; pregnancy ; school-age ; supplementation ; thyroid volume
    Subject code 630
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 1236267-0
    ISSN 1611-602X ; 0946-672X
    ISSN (online) 1611-602X
    ISSN 0946-672X
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Research on iodine deficiency and goiter in the 19th and early 20th centuries

    Zimmermann, M.B.

    The Journal of Nutrition

    2008  Volume 138, Issue 11

    Abstract: In 1811, Courtois noted a violet vapor arising from burning seaweed ash and Gay-Lussac subsequently identified the vapor as iodine, a new element. The Swiss physician Coindet, in 1813, hypothesized the traditional treatment of goiter with seaweed was ... ...

    Abstract In 1811, Courtois noted a violet vapor arising from burning seaweed ash and Gay-Lussac subsequently identified the vapor as iodine, a new element. The Swiss physician Coindet, in 1813, hypothesized the traditional treatment of goiter with seaweed was effective because of its iodine content and successfully treated goitrous patients with iodine. Two decades later, the French chemist Boussingault, working in the Andes Mountains, was the first to advocate prophylaxis with iodine-rich salt to prevent goiter. The French chemist Chatin was the first to publish, in 1851, the hypothesis that iodine deficiency was the cause of goiter. In 1883, Semon suggested myxedema was due to thyroid insufficiency and the link between goiter, myxedema, and iodine was established when, in 1896, Baumann and Roos discovered iodine in the thyroid. In the first 2 decades of the 20th century, pioneering studies by Swiss and American physicians demonstrated the efficacy of iodine prophylaxis in the prevention of goiter and cretinism. Switzerland's iodized salt program has been operating uninterrupted since 1922. Today, control of the iodine deficiency disorders is an integral part of most national nutrition strategies.
    Keywords prevention ; switzerland
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 218373-0
    ISSN 1541-6100 ; 0022-3166
    ISSN (online) 1541-6100
    ISSN 0022-3166
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Methods to assess iron and iodine status

    Zimmermann, M.B.

    British Journal of Nutrition

    2008  Volume 99, Issue Suppl. 3

    Abstract: Four methods are recommended for assessment of iodine nutrition: urinary iodine concentration, the goitre rate, and blood concentrations of thyroid stimulating hormone and thyroglobulin. These indicators are complementary, in that urinary iodine is a ... ...

    Abstract Four methods are recommended for assessment of iodine nutrition: urinary iodine concentration, the goitre rate, and blood concentrations of thyroid stimulating hormone and thyroglobulin. These indicators are complementary, in that urinary iodine is a sensitive indicator of recent iodine intake (days) and thyroglobulin shows an intermediate response (weeks to months), whereas changes in the goitre rate reflect long-term iodine nutrition (months to years). Spot urinary iodine concentrations are highly variable from day-to-day and should not be used to classify iodine status of individuals. International reference criteria for thyroid volume in children have recently been published and can be used for identifying even small goitres using thyroid ultrasound. Recent development of a dried blood spot thyroglobulin assay makes sample collection practical even in remote areas. Thyroid stimulating hormone is a useful indicator of iodine nutrition in the newborn, but not in other age groups. For assessing iron status, haemoglobin measurement alone has low specificity and sensitivity. Serum ferritin remains the best indicator of iron stores in the absence of inflammation. Measures of iron-deficient erythropoiesis include transferrin iron saturation and erythrocyte zinc protoporphyrin, but these often do not distinguish anaemia due to iron deficiency from the anaemia of chronic disease. The serum transferrin receptor is useful in this setting, but the assay requires standardization. In the absence of inflammation, a sensitive method to assess iron status is to combine the use of serum ferritin as a measure of iron stores and the serum transferrin receptor as a measure of tissue iron deficiency.
    Keywords blood spot thyroglobulin ; body iron ; deficiency anemia ; erythrocyte protoporphyrin ; goiter prevalence ; iodized salt ; reference values ; serum transferrin receptor ; thyroid volume ; zinc protoporphyrin
    Subject code 630
    Language English
    Publishing country nl
    Document type Article ; Online
    ZDB-ID 280396-3
    ISSN 1475-2662 ; 0007-1145
    ISSN (online) 1475-2662
    ISSN 0007-1145
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Book ; Online: Global control of micronutrient deficiencies

    Zimmermann, M.B.

    divided they stand, united they fall

    2007  

    Abstract: Dr. Zimmermann is appointed as honorary professor Micronutrients and International Health at Wageningen University. ...

    Abstract Dr. Zimmermann is appointed as honorary professor Micronutrients and International Health at Wageningen University.
    Keywords deficiency diseases ; developing countries ; food security ; malnutrition ; trace element deficiencies ; vitamin deficiencies ; gebreksziekten ; ontwikkelingslanden ; slechte voeding ; sporenelementtekorten ; vitaminetekorten ; voedselzekerheid
    Language English
    Publisher Wageningen University
    Publishing country nl
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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