Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines

Young Sik Choi; Kwang-Hyuk Seok; Jong Jin Lee; Gina Jieun Hong; Pablo M. Afidchao; Bu Kyung Kim; Jee-Yeong Jeong

doi:10.7180/kmj.2018.33.1.64

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Choi, Seok, Lee, Hong, Afidchao, Kim, and Jeong: Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines

Original Article

Kosin Medical Journal 2018;33(1):64-74.

Published online: 21 January 2018

DOI: https://doi.org/10.7180/kmj.2018.33.1.64

Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines

Young Sik Choi^1,^*, Kwang-Hyuk Seok^2,^3,^*, Jong Jin Lee¹, Gina Jieun Hong⁴, Pablo M. Afidchao⁵, Bu Kyung Kim^1,^†, Jee-Yeong Jeong^2,^3,^†

¹Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

²Department of Biochemistry, Kosin University College of Medicine, Busan, Korea

³Cancer Research Institute, Kosin University College of Medicine, Busan, Korea

⁴Department of Molecular and Cellular Biology, University of California, Berkeley, CA, USA

⁵Department of Pharmacology and Biochemistry, Cagayan State University College of Medicine, Tuguegarao, Philippines

^†Corresponding Author: Bu kyung Kim, Department of Internal Medicine, College of Medicine, Kosin University, 262, Gamchen-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6532 Fax: +82-51-990-3065 E-mail: 79kyung@hanmail.net

^* These authors contributed equall

Received 5 September 201726 October 2017 Accepted 12 January 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Iodine deficiency causes multiple health problems. Previously we reported that 96% of high school students in Tuguegarao, Philippines had adequate iodine levels. However, iodine deficiency-associated problems remain among adults in the Philippines. Therefore, we evaluated iodine nutritional status and goiter prevalence among adults, including pregnant women, in Tuguegarao, Philippines.

Methods

A total of 245 adults, including 31 pregnant women, provided samples for urinary iodine analysis, and all pregnant women completed a questionnaire about iodine deficiency.

Results

The median urinary iodine level was 164.0 ± 138.4 g/L; 38.4% of the participants were iodine deficient, according to the International Council for Control of Iodine Deficiency Disorders (ICCIDD) criteria. No severe iodine deficiency was observed. Among the 31 pregnant women, 24 (77.5%) fell into the iodine deficient category defined by a stricter World Health Organization (WHO) guideline, in which iodine deficiency is considered when urinary iodine levels are below 150 g/L. Almost half (42%) of the pregnant women were unaware of the harmful effects of iodine deficiency on the human body and their fetus.

Conclusions

Although iodine nutritional status in the Philippines has improved, iodine deficiency still exists among adults, especially among pregnant women. Therefore, our study strongly suggests that a better strategy should be established to monitor iodine nutritional status among adults continually, and to focus on populations susceptible to iodine deficiency, including pregnant women and women of reproductive age, to achieve the total elimination of iodine deficiency.

Keywords: Adults, Awareness, Iodine deficiency, Pregnant women

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Fig. 1.

Iodine nutritional status of adults compared with previous surveys in same area, Tuguegarao, Philippines

Fig. 2.

Iodine nutritional status of pregnant women in Tuguegarao, Philippines

Table 1.

Definition of iodine nutritional status

Median (μg/L)	UIC*	Iodine nutritional status for general population
< 20		Severe iodine deficiency
20 - 49		Moderate iodine deficiency
50 - 99		Mild iodine deficiency
100 - 199		Optimal
200 - 299		More than adequate
≥ 300		Excessive
< 150		Insufficient
150 - 249		Adequate
250 - 499		More than adequate
≥ 500		Excessive

^* UIC, urinary iodine concentration

Table 2.

Clinical characteristics and UIC of men, women and pregnant women

	Men	Women	Pregnant women	P-value*
Number	49	188	31
Age (years)	50.29 ± 17.9	44.8 ± 16.4	25.9 ± 7.3	< 0.01
Height (cm)	164.5 ± 12.8	153.8 ± 6.1	155.8 ± 4.0	0.12
Body weight (kg)	57.9 ± 13.7	51.2 ± 10.6	57.0 ± 6.5	0.01
BMI (kg/m2)	21.3 ± 3.9	21.6 ± 3.8	23.4 ± 2.8	0.02
Median UIC (μg/L)	152.7 ± 174.5	180.8 ± 147.3	119.4 ± 94.9	0.02

^* P-values reflect comparison between women and pregnant women.

Table 3.

Awareness of iodine deficiency among pregnant women

Question	Answer	% (n)
1) Have you ever heard of the effects of iodine deficiency on the human body?	Yes	67.7 (21)
	No	32.3 (10)
2) Can you list some problems (disorders) that are the result of iodine deficiency? Which problems (disorders)?	Miscarriage/stillbirth	35.5 (11)
	Heart pain	41.9 (13)
	Retarded development of children	35.5 (11)
	Reduced immunity	45.2 (14)
	Memory loss	35.5 (11)
	Goiters	54.8 (17)
3) Where do you receive information about iodine deficiency disorders and preventing them?	Printed material	29.0 (9)
	Television, radio	38.7 (12)
	Medical worker	64.5 (20)
	Member of your family	38.7 (12)
	School	45.2 (14)
4) What do you need to improve iodine deficiency?	Play sports	25.8 (8)
	Improve the environment	38.7 (12)
	Consume seafood	54.8 (17)
	More and more com¬plete rest	48.4 (15)
	Consume iodized salt	41.9 (13)
	Consume vitamins	64.5 (20)
	Consume dairy products	58.1 (18)
5) Have you ever heard of iodized salt?	Yes	87.1 (27)
5) Have you ever heard of iodized salt?	No	12.9 (4)
6) Do you buy iodized salt?	Yes	80.6 (25)
6) Do you buy iodized salt?	No	19.4 (6)
6-1) If you answered ‘No’, why don’t you buy iodized salt?	I don’t know why it is necessary	(6)
	It is usually more expensive	(2)
	No one advisee me to (or I don’t want it)	(1)
	Other	(3)
7) Do you know the advantages of iodized salt over regular salt?	Yes	87.1 (27)
	No	12.9 (4)
8) What advantages are there?	Better taste	45.2 (12)
	Better digestion	32.3 (10)
	Reduces iodine deficiency in the human body	54.8 (17)
	Other	19.4 (6)

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