Iodine intake and iodine status among lactating women and their children in the Saharawi refugee camps, Algeria





Høgskolen i Akershus



Master i samfunnsernæring


Background: People in the long-term refugee camps in the Algerian desert are exposed to high iodine intakes from water and animal milk. At the same time the goitre rate is very high, with a goitre prevalence of 18 % for the women and 11 % for school age children. Objectives: The main objective for this thesis was to examine iodine intake among lactating women, their iodine excretion in urine, and if high iodine intake for the women will give high level of iodine in breast-milk. And further how feeding practises and breast milk iodine concentrations is affecting the children’s iodine concentration in urine. Methods: 110 lactating women with their 110 children from 0 up to 7 months of age were included. The women’s iodine intake was assessed by interviewed information of the last 24-hours and 7 days intake of iodine rich foods. To assess the iodine intake, samples of public water (n=24), camel milk (n=34) and goat milk (n=13) were collected from the women, as well as spot-urine and breast milk samples. Spot-urine was collected from the children as well as data on feeding practises. Iodine concentration in water and urine samples was determined by Sandell-Kolthoff reaction, whereas milk samples were determined by the Inductively Coupled Plasma-Mass Spectrometry method. Results: Median (p25-p75) iodine concentrations of camel milk, goat milk and drinking water were 2020 (1502-4137) µg/L, 952 (801-1787) µg/ L and 102 (80-255) µg/L, respectively. Estimated dietary iodine intake for the women was 409 (234-709) µg/day, where water seemed to be the main contributor to the iodine intake. The women had a median urinary iodine concentration (UIC) of 349 (207-526) µg/L, and UIC were positively associated with BMI and camel milk iodine intake which explained 9,3% of the variation in UIC. The median breast milk iodine concentration (BMIC) was 479 (330-702) µg/L, and was positively associated with water- and goat milk iodine intake and UIC, which explained 15,8% of the variation in BMIC. Even though only 6% of the children were exclusively breast fed, no other foods or drinks but breast milk showed any association with the children’s UIC. BMIC explained 9,9% of the variation in children’s UIC. The children had a median urinary iodine concentration of 728 (401-1145) µg/L. Conclusion: The median BMIC was generally higher than the median UIC and seemed to be affected more by dietary iodine intake than UIC. There are no upper levels of UIC or iodine intake for lactating women by the WHO. But 74 % of the women had iodine intakes above their daily recommended intake of 250 µg/day (WHO), indicating a high iodine exposure. The breast milk iodine concentrations were not favourable for children 0-7 months of age, which have a daily recommended intake of 90 µg/day (WHO). The children’s urinary iodine concentrations indicate that the iodine intake from breast milk is very high, with 89% of the children having a urinary iodine concentration ≥ 300 µg/L, which is the upper limit used for an adult population (WHO). It is likely that the high iodine exposure may cause thyroid disorders for the women and their children


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