title: Improvement in iodine status of pregnant Australian women 3 years after introduction of a mandatory iodine fortification programme.
abstract: BACKGROUND
  In order to address population-level mild iodine deficiency in Australia, a mandatory iodine fortification programme of salt used in bread was introduced in late 2009.
  
  
  METHODS
  A before-after study was conducted to assess changes in median urinary iodine concentration (MUIC) measurements, according to supplement use, in convenience samples of pregnant women attending a public antenatal clinic in a regional area of New South Wales, Australia in 2008 (n=139), 2011 (n=147) and 2012 (n=114). Knowledge and practices related to iodine nutrition were investigated in 2012, using self-administered questionnaires.
  
  
  RESULTS
  The mild iodine deficiency confirmed pre-fortification (MUIC (IQR)=87.5 (62-123.5; n=110)) has steadily improved to 145.5 μg/L (91-252) in 2011 (n=106) and 166 (97-237) in 2012 (n=95) (sufficiency ≥ 150 μg/L). However, only women taking supplements containing iodine had MUIC indicative of sufficiency in both years surveyed post fortification (2011: 178 μg/L vs. 109 μg/L, P<0.001; 2012: 202 μg/L vs. 124 μg/L, P<0.05). Despite bread being the vehicle for iodine fortification, dairy foods remained major contributors to total iodine intake (58%). Overall knowledge regarding health implications of iodine deficiency was poor.
  
  
  CONCLUSIONS
  Iodine status of women has improved since the introduction of mandatory iodine fortification; however supplementation is indicated during pregnancy.
authors.affiliation: School of Health Sciences, University of Wollongong, NSW 2500, Australia. karenc@uow.edu.au
authors.forename: Karen E
authors.initials: KE
authors.lastname: Charlton
authors.forename: Heather
authors.initials: H
authors.lastname: Yeatman
authors.forename: Erin
authors.initials: E
authors.lastname: Brock
authors.forename: Catherine
authors.initials: C
authors.lastname: Lucas
authors.forename: Luke
authors.initials: L
authors.lastname: Gemming
authors.forename: Alison
authors.initials: A
authors.lastname: Goodfellow
authors.forename: Gary
authors.initials: G
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D003677:Deficiency Diseases / Q000628:therapy*; D005260:Female; D005527:Food, Fortified; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000172:deficiency / Q000652:urine; D037141:Mandatory Programs; D008875:Middle Aged; D009517:New South Wales; D011247:Pregnancy; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014131:Trace Elements / Q000008:administration & dosage* / Q000172:deficiency; D055815:Young Adult
chemical_list: D014131:Trace Elements; D007455:Iodine