title: Consumption of iodized salt may not represent a reliable indicator of iodine adequacy: Evidence from a cross-sectional study on schoolchildren living in an urban area of central Italy.
abstract: OBJECTIVE
  It has been established that iodine prophylaxis prevents endemic goiter. In this study we reported the amount of iodized salt sold by the retailers of Cassino, a city of central Italy. The aim of the study was to evaluate the effects of an iodine prophylaxis program started in 2005 on urinary iodine concentration (UIC) and thyroid volume (TV), and their correlation with anthropometric parameters in a population of schoolchildren.
  
  
  METHODS
  The study included 234 schoolchildren (119 girls and 115 boys) ages 13 to 14 y. Each student provided a morning urine sample for UIC determination, and TV was evaluated by ultrasonography. Body weight and height also were measured. Each participant completed a questionnaire reporting the presence of thyroid disease and the consumption of iodized salt and iodine-rich food.
  
  
  RESULTS
  The percentage of iodized salt sold by local markets was 42.4%. Median UIC in schoolchildren was 133.9 μg/L (range 33.2-819.5 μg/L), with 71 children having mild (range 50.1-99.9 μg/L) and 10 moderate (range 33.2-48.8 μg/L) iodine deficiency. Eleven children showed excessive iodine intake (range 300.4-819.5 μg/L). Median UIC was higher in children using iodized salt or consuming milk. Goiter prevalence was 3.8%. A positive correlation between TV and body weight, height, and surface was observed.
  
  
  CONCLUSIONS
  The data reported may suggest the presence of an adequate iodine intake in the population of Cassino despite the low percentage of iodized salt sold by local retailers. This indicates that silent iodine prophylaxis through the consumption of iodine-rich or iodine-enriched food is of importance in the prevention of iodine deficiency disorders.
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Coccaro
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Tuccilli
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Natalie
authors.initials: N
authors.lastname: Prinzi
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: D'Armiento
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Pepe
authors.affiliation: Nursing School of Cassino, "Sapienza" University of Rome and University of Cassino and South Lazio, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Maestro
authors.affiliation: UOC of Radiology, Department of Diagnostic, ASL Frosinone, "Santa Scolastica" Hospital, Cassino, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cacciola
authors.affiliation: UOC of Radiology, Department of Diagnostic, ASL Frosinone, "Santa Scolastica" Hospital, Cassino, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Forlini
authors.affiliation: UOC of Radiology, Department of Diagnostic, ASL Frosinone, "Santa Scolastica" Hospital, Cassino, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Verdolotti
authors.affiliation: Nursing School of Cassino, "Sapienza" University of Rome and University of Cassino and South Lazio, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bononi
authors.affiliation: UOC of Nephrology and Dialysis, ASL Frosinone, "Santa Scolastica" Hospital, Cassino, Italy.
authors.forename: Remo
authors.initials: R
authors.lastname: Nacca
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Enke
authors.initials: E
authors.lastname: Baldini
authors.affiliation: UOC of Clinical Pathology, ASL Frosinone, "Santa Scolastica" Hospital, Cassino, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cirillo
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Italy. Electronic address: salvatore.ulisse@uniroma1.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ulisse
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006042:Goiter / Q000453:epidemiology* / Q000517:prevention & control / Q000652:urine; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000652:urine*; D007558:Italy / Q000453:epidemiology; D008297:Male; D009929:Organ Size; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000652:urine; D011795:Surveys and Questionnaires; D013961:Thyroid Gland / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000378:metabolism; D014463:Ultrasonography; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine
keywords: Iodine deficiency; Iodine prophylaxis; Iodized salt; Thyroid volume; Urinary iodine concentration