Safety of new algorithms for premeal insulin boluses in high glycaemic index meals in persons with type 1 diabetes mellitus using insulin pumps

Aims: Consumption of glucose or foodstuffs with high glycaemic index (GI) in persons with type 1 diabetes mellitus (PWD1) is a hot topic in present diabetology. The aim of our pilot prospective study was to assess the efficiency of empirically suggested simple algorithms for premeal boluses in PWD1 using insulin pumps and continuous glucose monitoring (CGM). Methods: Six PWD1 (aged 46.2+/-15.09 y, diabetes duration 14.5+/-9.65 y, HbA1c/IFCC 6.3+/-1.59%, BMI 23.6+/-1.67 kg/m(2), mean+/-SD) on insulin pumps Paradigm 522/722 with RT-CGMS sensors (Medtronic MiniMed, Northridge, CA) underwent a 12-week CGM. In one week, subjects consumed 50g of carbohydrates in eleven alternative meals (rice squares, dark chocolate, white bread, honey, glucose, ravioli with meat and Eidam cheese, mashed potatoes with fish fingers, apricot dumplings with butter, spa waffles, spalta squares, and tomato soup with pasta) eaten for breakfasts, lunches, snacks and dinners in order to calculate their GI. The insulin boluses were adjusted according to empirically defined algorithms. Average glucose levels and daily insulin doses over three one-week periods (before testing, testing and after testing) were compared. Results: During the observational period, the weekly averages of glucose levels (9.1+/-2.33 mmol/l vs. 9.2+/-2.30 mmol/l vs. 9.0+/-2.43 mmol/l, respectively) and daily insulin doses (39.1+/- 8.14 IU/d vs. 39.7+/-10.7 IU/d vs. 38.6+/-9.97 IU/d, respectively) were similar. One-week consumption of high GI foodstuffs had only a negligeable effect on average glucose levels. Conclusion: The suggested algorithms for premeal insulin boluses appear to limit the risk of potential hyperglycaemia resulting from intake of high GI foodstuffs.     

Iodine Content in Meal Replacements in the United States

ObjectiveIodine is essential for thyroid hormone production. The recommended dietary allowance for iodine in nonpregnant adults is 150 μg/d. However, most product labels do not list the iodine content. Meal replacements are not required to contain specific vitamins and minerals. Nevertheless, they are often marketed as good and convenient sources of a balanced nutrition. In this study, we aimed to assess the iodine content in meal replacements to determine how they may contribute to iodine deficiency or excess.MethodsTwenty seven meal replacements from supermarkets in the Boston area were collected. The iodine concentration of each meal replacement was measured spectrophotometrically. Iodine content in meal replacements were compared according to form (liquid, bar, and powder) and type (vegan and nonvegan).ResultsThe overall mean ± SD iodine content was 49.7 ± 125.4 μg/serving. However, 1 meal replacement was an outlier and had 671.9 μg iodine per serving. Mean iodine content differed between forms and was highest for liquids (mean ± SD: 37.4 ± 6.5 μg/serving). Nonvegan meal replacements had a higher mean iodine content than vegan meal replacements (mean ± SD: 31.6 ± 15.78 μg/serving).ConclusionAll of the meal replacements contained detectible amounts of iodine regardless of whether it was listed on their labels (41% did not list iodine). Overall, the meal replacements in this study were found to be good sources of iodine. However, consumers should be aware that packaging labels may not accurately reflect the amount of iodine present.     

Influence of Levothyroxine With Recombinant Human Thyroid-Stimulating Hormone on Urinary Iodine Excretion Before Radioactive Iodine Administration

ObjectiveStimulation with recombinant human thyroid-stimulating hormone (rhTSH) before radioactive iodine administration for patients with thyroid cancer may increase the body iodine pool in the presence of continued levothyroxine; however, the precise significance of its influence remains unclear.MethodsThis was a prospective observational study conducted between March 2017 and August 2020. We measured the 24-hour urinary iodine excretion and urinary iodine-to-creatinine ratio in patients with thyroid cancer stimulated by rhTSH or thyroid hormone withdrawal (THW) before radioactive iodine administration. Oral iodine intake was controlled by a 7-day self-managed low iodine diet, followed by a strict 3-day low iodine diet while in the hospital.ResultsOverall, 343 subjects were included (rhTSH: n = 181; THW: n = 162). The mean levothyroxine dose in the rhTSH group was 115.2 μg daily. The median 24-hour urinary iodine and urinary iodine-to-creatinine ratio in the rhTSH group (71.0 [interquartile range, 57.5-88.0] μg/day and 80.0 [59.0-97.5] μg/gCr, respectively) were significantly higher than those in the THW group (42.0 [30.0-59.0] μg/day and 39.0 [28.0-61.3] μg/gCr, respectively; both P < .001). After propensity score matching by age, sex, body weight, and renal function (rhTSH: n = 106; THW: n = 106), consistent results for both values were observed for both methods. The increase in urinary iodine with the rhTSH method was smaller than the expected value calculated from the amount of levothyroxine.ConclusionUrinary iodine excretion was significantly higher among patients with rhTSH stimulation than those with THW, indicating that the rhTSH method slightly increases the body iodine pool.     

Iodine Deficiency and Excess in Children: Worldwide Status in 2013

ObjectiveAssessing iodine nutrition at the population level is usually done by measuring the urinary iodine concentration (UIC) and, in some countries, by estimating household coverage of adequately iodized salt (HHIS). Using these indicators, the objective of this review is to assess global and national iodine status in 2013.MethodsThe most recent data on HHIS were obtained from the United Nations Children's Fund. The most recent data on UICs were obtained from the International Council for the Control of Iodine Deficiency Disorders Global Network and the World Health Organization (WHO). Median UIC was used to classify national iodine status based on the current WHO classification system, with the following modification: the “adequate (100 to 199 μg/L)” and “more than adequate (200 to 299 μg/L)” categories of median UIC in school-aged children were combined into a single category of “adequate” iodine intake (100 to 299 μg/L).ResultsOver the past decade, the number of countries that are iodine deficient has fallen from 54 to 30. The number iodine-sufficient countries has increased from 67 to 112, while the number with excessive iodine intake has increased from 5 to 10. In most countries with excess intake, this is due to overiodization of salt and/or poor monitoring of salt iodization. Out of 128 countries with HHIS data, at least 90% of households in 37 countries consume adequately iodized salt, but in 39 countries, coverage rates are below 50%. Overall, about 70% of households worldwide have access to iodized salt.ConclusionThere has been substantial recent progress in the global effort to control iodine deficiency. However, iodized salt programs need to be carefully monitored to ensure adequate iodine intake while avoiding iodine excess. (Endocr Pract. 2013;19:839-846)     

Meal replacements and fibre supplement as a strategy for weight loss. Proprietary PGX® meal replacement and PGX® fibre supplement in addition to a calorie-restricted diet to achieve weight loss in a clinical setting

Meal replacements and viscous soluble fibre represent safe and sustainable aids for weight loss. Our purpose was to determine if PGX® meal replacements and PGX^® fibre complex in combination with a calorie-restricted diet would aid in weight loss in a clinical setting. Fifty-two overweight and obese participants (49 women, 3 men; average age 47.1 years) with a mean body mass index (BMI) of 33.8 ± 6.4 kg/m² consumed 57 g of proprietary PGX® meal replacement product at breakfast and another 57 g at lunch for 12 weeks. In addition to the meal replacements, they were also asked to consume 5 g/day of PGX® fibre in the form of granules, powder or capsules together with 250 mlwater. A registered dietician recommended low-fat, low-glycaemic-index foods for snacks and the dinner menus such that each volunteer was consuming a total of 1200 kcal/day. All participants (n = 52) lost a significant amount of weight from baseline (?4.69 ± 3.73 kg), which was further reflected in the reductions in their waist (?7.11 ± 6.35 cm) and hip circumference (?5.59 ± 3.58 cm) over the 12-week study (p < 0.0001). BMI scores (n = 51) were reduced by 1.6 ± 1.4 kg/m². The use of PGX® meal replacements and PGX^® fibre along with a controlled dietary caloric intake is of benefit for short-term weight loss.     

The Influence of Weekday Eating Patterns on Energy Intake and BMI Among Female Elementary School Personnel

Many health practitioners recommend eating small, frequent meals for weight loss, yet the relationship of eating patterns, such as eating occasion frequency (EOF), to energy intake and body weight is controversial. Broad‐based efforts to promote worksite wellness programs increase the importance of this issue, as many work environments inherently restrict eating patterns. The eating patterns of school personnel are understudied, but are of particular interest, not only because they have limited eating opportunities during the day but also because their diet and weight outcomes are likely to influence behaviors of a much larger population. We examined relationships between weekday EOF and energy intake and BMI among female elementary school personnel in 22 schools in a suburban county of southeastern Louisiana. Two 24‐h dietary recalls were administered to randomly‐selected employees (n = 329) on nonconsecutive days by registered dietitians. Measured heights and weights were used to calculate BMI (weight/height²). On average, employees consumed 2.2 of their total 5.9 meals and snacks during the school day, accounting for 37% of daily energy. In multiple regression models controlling for demographic and health variables, EOF as well as separate counts of meal and snack frequency were each positively and significantly associated with energy intake. However, neither the number of meals, snacks, nor overall EOF was associated with BMI. The proportion of energy consumed during the school day and the positive association of weekday EOF with energy intake suggest an important role for worksite wellness programs that target the dietary improvement of elementary school personnel.     

Geographical and seasonal variation in iodine content of cow’s milk in the UK and consequences for the consumer´s supply

BackgroundDairy products provide a crucial source of dietary iodine for the majority of the UK population, contributing approximately 30–40 % of daily intake. Fluctuations in the iodine content of purchased milk both seasonally and annually implies potential fragility of iodine supply likely through fluctuating supplementation practices in cow herds. We set out to establish the level of national variation in herds and identify factors which might impact milk iodine content.MethodsMilk samples were obtained from 98 herds across the UK via the National Milk Laboratories in August and December 2016. Iodine concentration of samples was measured using ICP-MS. Milk samples and feed intake data were additionally taken from 22 cows from the University of Nottingham (UON) dairy herd.ResultsThere was considerable variation in milk iodine content from < 0.012 (Limit of Detection) to 1558 μg L⁻¹, with a summer median of 197 μg L⁻¹ and winter median 297 μg L⁻¹. Overall, winter values were higher than summer counterparts (P < 0.001) and this held true for samples taken from the North West (P = 0.002) and South West (P = 0.006) but not for other regions studied. Data from the UON herd showed a negative relationship between iodine content and milk yield (P = 0.03) and we found that milk iodine content varied considerably despite apparently similar iodine intakes.ConclusionsRegional differences in milk iodine concentration between summer and winter suggests that feeding practices are far from uniform across the country. The negative association observed between iodine concentration and milk yield in UON samples, suggests that reduced summer values may be influenced by dilution in addition to seasonal differences in concentrate feed provision.     

Estimating daily intakes of manganese due to breast milk,infant formulas,or young child nutritional beverages in the United States and France: Comparison to sufficiency and toxicity thresholds

BackgroundAlthough manganese (Mn) is an essential nutrient, recent research has revealed that excess Mn in early childhood may have adverse effects on neurodevelopment.MethodsWe estimated daily total Mn intake due to breast milk at average body weights by reviewing reported concentrations of breast milk Mn and measurements of body weight and breast milk intake at 3 weeks, 4.25 months, 7 months, and 18 months. We compared these figures to the Mn content measured in 44 infant, follow-up, and toddler formulas purchased in the United States and France. We calculated Mn content of formula products made with ultra-trace elemental analysis grade water (0 μg Mn/L) and with water containing 250 μg Mn/L, a concentration which is relatively high but less than the World Health Organization Health-based value of 400 μg Mn/L or the United States Environmental Protection Agency Health Advisory of 350 μg Mn/L.ResultsEstimated mean daily Mn intake from breast milk ranged from 1.2 μg Mn/kg/day (3 weeks) to 0.16 μg Mn/kg/day (18 months), with the highest intakes at the youngest age stage we considered, 3 weeks. Estimated daily Mn intake from formula products reconstituted with 0 μg Mn/L water ranged from 130 μg Mn/kg/day (3 weeks) to 4.8 μg Mn/kg/day (18 months) with the highest intakes at 3 weeks. Formula products provided 28–520 times greater than the mean daily intake of Mn from breast milk for the 4 age stages that we considered. Estimated daily Mn intake from formula products reconstituted with water containing 250 μg Mn/L ranged from 12 μg Mn/kg/day to 170 μg Mn/kg/day, which exceeds the United States Environmental Protection Agency Reference Dose of 140 μg Mn/kg/day for adults.ConclusionsMn deficiency is highly unlikely with exclusive breast milk or infant formula feeding, but established tolerable daily intake levels for Mn may be surpassed by some of these products when following labeled instructions.     

Iodine Nutrition During Pregnancy in Toronto,Canada

ObjectiveTo evaluate the status of iodine nutrition among pregnant women presenting for routine antenatal care in Toronto, Canada, as determined by the median urine iodine concentration (UIC) of this population.MethodsA cross-sectional, observational study was conducted involving 142 pregnant women recruited from four low-risk antenatal outpatient clinics in Toronto, Canada. Subjects completed a questionnaire and provided a spot urine sample for the measurement of iodine concentration.ResultsMean maternal age was 33.8 ± 4.3 years. Mean gestational age was 29.3 ± 7.8 weeks. The median UIC was 221 μg/L (interquartile range, 142 to 397 μg/L). Six women (4.2%) had urine iodine levels <50 μg/L, and 36 women (25.4%) had levels between 50 and 150 μg/L.ConclusionThis cohort of primarily Caucasian, well-educated, and relatively affluent pregnant women in Toronto, Canada, are iodine sufficient, perhaps due to universal salt iodization and/or other dietary and lifestyle factors. (Endocr Pract. 2013;19:206-211)     

Influence of sex and immunocastration on feed intake behavior,skatole and indole concentrations in adipose tissue of pigs

Feed intake behavior was studied between 9 weeks of age and slaughter in a total of 36 gilts, 32 immunocastrates, 33 surgically castrated barrows and 33 boars from 36 litters. Consequences for the concentration of substances contributing to off odor of pork (skatole, indole) were evaluated. Animals were kept in groups of 12 pigs of the same sex and treatment and fed ad libitum (13.4 MJ ME, 17% CP, 1.1% lysine). Individual feed intake behavior was recorded continuously by an electronic feeder. Immunocastration was carried out with two injections of Improvac with at least 4 weeks between both injections (1st: 12 to 17 weeks of age, 2nd: 19 to 21 weeks of age). Feed intake/day increased from an average of 0.91 ± 0.02 kg/day up to 3.15 ± 0.04 kg/day before slaughter. This increase was associated with a 50% reduction in the number of meals/day (from 15.8 ± 0.44 to 7.2 ± 0.29 meals/day). The larger meal sizes resulted from an increase in both, the duration of feed intake/meal and the feed intake rate (g/min). In addition, sex and treatment differences were observed: Feed intake in boars was lower than in all other groups due to a reduction in the number of meals/day and in the time spent feeding/day. In females, time spent feeding/day was quite similar to boars, but resulted from a higher number of meals of shorter duration. Barrows had a significantly higher feed intake because of a higher number of meals/day resulting in more time spent feeding/day. The feed intake rate was similar in boars, gilts and barrows and showed an increasing trend during the study, starting from about 15 g/min up to four times the amount. Immunocastration affected feed intake behavior severely, especially the meal size increased dramatically because of higher feed intake rate, which exceeded that of all other groups by 25% at the end of the study. The number of meals/day was not influenced by immunocastration and was almost identical to that of boars. Highest skatole concentrations were measured in fat of boars, whereas indole concentrations were higher in immunocastrates than in all other groups. In gilts and barrows, skatole concentrations were related to growth rate. Additionally, the feeding rate was an important factor explaining the variability in skatole/indole concentrations in adipose tissue. The physiological mechanisms however need further clarification.     

Iodine Status of Preterm Infants Born in an Area of Iodine Sufficiency: Are They at Risk of Iodine Deficiency?

ObjectiveTo the assess the iodine status of preterm infants born in an area of iodine sufficiency using the urinary iodine concentration (UIC) and thyroid-stimulating hormone (TSH) levels and compare these values across different feeding practices during the first 7 days of life.MethodsIn this cross-sectional study, 88 preterm infants born at 30 to 34 weeks of gestation and admitted to the neonatal intensive care unit of a referral hospital in Tehran (Iran) were included. The infant UIC and TSH levels and breast milk iodine concentration in mothers who were exclusively breastfeeding were measured.ResultsMedian (interquartile range [IQR]) UIC and TSH levels in the study population were 81 (39-189) μg/L and 1.60 (0.80-2.85) mIU/L, respectively. When preterm infants were stratified by the type of feeding, the median (IQR) UICs were 64 (42-126) μg/L in parenteral nutrition, 125 (41-195) μg/L in exclusively breastfeeding, 57 (28-123) μg/L in formula feeding, and 45 (35-132) μg/L in mixed feeding, with no statistically significant difference between the groups (P = .31). The median (IQR) breast milk iodine concentration was 271 (177-521) μg/L in preterm infants exclusively fed their mothers’ own milk. There was no significant difference in the proportion of the TSH levels of >5 mIU/L between preterm infants who received enteral and parenteral nutrition (P = .27).ConclusionPreterm infants are at risk of iodine deficiency even in an area where the general population has adequate iodine. Only the preterm infants who received exclusively their mothers’ own milk had marginally adequate iodine status. Further studies are warranted to determine the necessity of iodine supplementation for this vulnerable group.     

Utilisation of iodine from different sources in pigs

Balance experiments have demonstrated that growing pigs fed a ration consisting of wheat, barley, extracted soya meal, dicalciumphosphate, and iodine‐free feeding salt utilised 48.8% of the received iodine.

The tested supplementary iodine sources included potassium iodide (KI), ethylenediamine dihydroiodide (EDDI), iodine humate (HUI) prepared from iodine acid (HIO₃), and the product P containing 0.004% iodine in an oil base (P). The amount of the supplemented iodine was in all cases 1 mg per 1 kg feed.

The utilisation of iodine from the supplements reached 93.6, 92.6, 90.7, and 67.9% for KI, EDDI, P, and HUI, respectively. The values were significantly higher compared with controls (P < 0.01). Compared with KI and EDDI, the utilisation of iodine from HUI was significantly lower (P < 0.01). The lower availability of iodine from HUI was probably due to the high binding capacity of humate.

The amount of urinary iodine excreted by control pigs receiving in the non‐supplemented ration 147.5 μg iodine per day, was 40.3 μg per day (27.3%). In the pigs receiving in the supplemented ration 1647.5 μg iodine per day, the amount of urinary iodine reached 734.9 to 805.0 μg per day (44.6 to 48.9%). The corresponding values of faecal excretion were 75.6 μg iodine per day (51.2%) for the control pigs and 106.2 to 121.1 μg iodine per day (6.45 to 7.35%) for the pigs fed the supplemented rations. A high amount of 528.6 μg iodine per day (32.1%) was excreted in the faeces by pigs of the group HUI.     

Alteration of dietary fat intake to prevent weight gain: Jayhawk Observed Eating Trial

Objective: To examine the effects of ad libitum diets with three distinct levels of fat intake for the prevention of weight gain in sedentary, normal‐weight and overweight men and women. Methods and Procedures: Three hundred and five participants were randomized to one of three diets. The diets targeted <25% of energy from fat (low fat (LF)), between 28 and 32% of energy from fat (moderate fat (MF)), or >35% of energy from fat (high fat (HF)). Participants consumed two meals per day on weekdays and one meal per day on weekends in a university cafeteria over a 12‐week period. Energy and nutrient content of cafeteria foods were measured by digital photography. All meals and snacks consumed outside the cafeteria were measured by dietary recall. All analysis of energy and nutrient content was completed using Nutrition Data System for Research (NDS‐R) version 2005. Results: Two hundred and sixty participants completed the study. LF gained 0.1 ± 3.1 kg, MF gained 0.8 ± 2.5 kg, and HF gained 1.0 ± 2.2 kg and there was no gender or age effect. Longitudinal mixed modeling indicated a significant difference among the groups in weight over time (P = 0.0366). When adjusting for total energy intake, which was a significant predictor of weight over time, the global effect for the group was eliminated. Thus, increasing weight was a function of increasing energy but not increasing percentage of fat intake. Discussion: Energy intake, but not percentage of energy from fat, appears responsible for the observed weight gain. LF diets may contribute to weight maintenance and HF diets may promote weight gain due to the influence of fat intake on total energy intake.     

Randomized placebo-controlled pilot clinical trial on the efficacy of ayurvedic treatment regime on COVID-19 positive patients

BackgroundSpecific treatment for COVID-19 is still an unmet need. Outcomes of clinical trials on repurposed drugs have not been yielding success. Therefore, it is necessary to include complementary approaches of medicine against COVID-19.PurposeThis study was designed to evaluate the impact of traditional Indian Ayurvedic treatment regime on asymptomatic patients with COVID-19 infection.Study designIt is a placebo controlled randomized double-blind pilot clinical trial.MethodsThe study was registered with Clinical Trial Registry-India (vide Registration No. CTRI/2020/05/025273) and conducted at the Department of Medicine in National Institute of Medical Sciences and Research, Jaipur, India. 1 g of Giloy Ghanvati (Tinospora cordifolia) and 2 g of Swasari Ras (traditional herbo-mineral formulation) and 0.5 g each of Ashwagandha (Withania somnifera) and Tulsi Ghanvati (Ocimum sanctum) were given orally to the patients in treatment group twice per day for 7 days. Medicines were given in the form of tablets and each tablet weighed 500 mg. While, Swasari Ras was administered in powdered form, 30 min before breakfasts and dinners, rest were scheduled for 30 min post-meals. Patients in the treatment group also received 4 drops of Anu taila (traditional nasal drop) in each nostril every day 1 h before breakfast. Patients in the placebo group received identical-looking tablets and drops, post randomization and double blinded assortments. RT-qPCR test was used for the detection of viral load in the nasopharyngeal and oropharyngeal swab samples of study participants during the study. Chemiluminescent immunometric assay was used to quantify serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and high sensitivity C-reactive protein (hs-CRP) on day 1 and day 7 of the study.ResultsBy day 3, 71.1 % and 50.0 % patients recovered in the treatment and placebo groups, respectively. Treatment group witnessed 100 % recovery by day 7, while it was 60.0 % in the placebo group. Average fold changes in serum levels of hs-CRP, IL-6 and TNF-α in treatment group were respectively, 12.4, 2.5 and 20 times lesser than those in the placebo group at day 7. There was 40 % absolute reduction in the risk of delayed recovery from infection in the treatment group.ConclusionsAyurvedic treatment can expedite virological clearance, help in faster recovery and concomitantly reduce the risk of viral dissemination. Reduced inflammation markers suggested less severity of SARS-CoV-2 infection in the treatment group. Moreover, there was no adverse effect observed to be associated with this treatment.     

Excessive iodine intake and thyroid dysfunction among lactating Saharawi women

ObjectivesExcessive iodine intake may lead to thyroid dysfunction, which may be particularly harmful during pregnancy and lactation. The main objective was to describe iodine status and the prevalence of thyroid dysfunction among lactating women in areas with high iodine (HI) and very high iodine (VHI) concentrations in drinking water.Design and methodsA cross-sectional survey was performed among 111 lactating women in the Saharawi refugee camps, Algeria. Breast milk iodine concentration (BMIC), urinary iodine concentration (UIC) and the iodine concentration in the most commonly consumed foods/drinks were measured. A 24-h dietary recall was used to estimate iodine intake. Thyroid hormones and antibodies were measured in serum.ResultsMedian UIC, BMIC and iodine intake across both areas was 350 μg/L, 479 μg/L and 407 μg/day, respectively. In multiple regression analyses, we discovered that being from VHI area was associated with higher UIC and BMIC. BMIC was also positively associated with iodine intake. Thyroid dysfunction and/or positive thyroid antibodies were found in 33.3% of the women, of which 18.9% had hypothyroidism and 8.1% had hyperthyroidism and 6.3% had positive antibodies with normal thyroid function. Elevated thyroid antibodies were in total found in 17.1%. We found no difference in distribution of thyroid dysfunction or positive antibodies between HI and VHI areas. BMI, BMIC and elevated thyroglobulin (Tg) predicted abnormal thyroid function tests.ConclusionsThe high prevalence of thyroid dysfunction may be caused by excessive iodine intake over several years.     

Effects of Different Dietary Fat Types on Postprandial Appetite and Energy Expenditure

Objective: Observational studies suggest that monounsaturated (MUFA) and trans fatty acids (TRANS) are more fattening than polyunsaturated fatty acids (PUFA). Therefore, the aim of this study was to investigate the acute effect of intake of PUFA, MUFA, or TRANS on appetite and energy expenditure (EE). Research Methods and Procedures: Three test meals were randomly given in a cross‐over design to 19 overweight (BMI: 26.8 ± 0.4 kg/m²), young (25.2 ± 0.7 years) men. The fat‐rich breakfasts (0.8 g fat/kg body weight, 60% energy from fat) varied only in the source of C:18‐fat. EE was measured continuously in a respiration chamber, and appetite sensations were rated by visual analog scales before and every 30 minutes, for 5 hours, after the meal. After 5 hours, an ad libitum meal was served, and energy intake was registered. Sensory evaluations of all meals were given using visual analog scales. Data were analyzed by two‐way ANOVA. Results: There were no differences in basal or postprandial values of appetite ratings and EE, in subsequent ad libitum energy intake, or in the sensory evaluation of the test meals among the 3 test days. Discussion: Giving acutely large amounts of MUFA, PUFA, or TRANS did not impose any differences in appetite and EE in overweight humans. However, studies with extended protocols and other subject groups are warranted to investigate the long‐term effect of dietary fat quality on the regulation of energy balance and body weight.     

Reduction of iodate in iodated salt to iodide during cooking with iodine as measured by an improved HPLC/ICP–MS method

Background: Iodate is a strong oxidant, and some animal studies indicate that iodate intake may cause adverse effects. A key focus of the safety assessment of potassium iodate as a salt additive is determining whether iodate is safely reduced to iodide in food. Objective: To study the reduction of iodate in table salt to iodide and molecular iodine during cooking. Materials and Methods: Fifteen food samples cooked with and without iodated salt were prepared in duplicate. The iodine in the cooked food was extracted with deionized water. The iodine species in the extracts were determined by using an improved high-performance liquid chromatography/inductively coupled plasma–mass spectrometry (HPLC/ICP–MS). The cooking temperature and the pH of the food were determined. Results: The conversion rate of iodate in iodated salt to iodide and molecular iodine was 96.4%±14.7% during cooking, with 86.8%±14.5% of the iodate converted to iodide ions and 9.6% ±6.2% converted to molecular iodine to lose. The limit of detection, limit of quantification, relative standard deviation and recovery rate of the method HPLC/ICP–MS were 0.70 μg/L for I⁻ (0.69 μg/L for IO₃⁻), 2.10 μg/L for I⁻ (2.06 μg/L for IO₃⁻), 2.6% and 101.6%±2.6%, respectively. Conclusion: Almost all iodate added to food was converted into iodide and molecular iodine during cooking. The improved HPLC/ICP–MS was reliable in the determination of iodine species in food extracts.     

High prevalence of TPO-Abs and subclinical hypothyroidism in iodine-sufficient pregnant women in Northern Algeria

BackgroundIodine is a trace element whose adequate intakes are essential during gestation to promote the correct growth and development of the fetus. Historically, endemic goiter and cretinism affected northern regions of Algeria, and iodized salt was introduced in 1990. However, there has been no national study of iodine nutrition in Algeria since 1994. The aim of this study was to assess the iodine status and thyroid function of women of reproductive age (WRA) and pregnant women (PW) in northern Algeria.MethodsHealthy WRA and PW were recruited from an urban area (Algiers) and healthy WRA from a rural area (Tizi-Ouzou). Spot urine and venous blood samples were collected to assess iodine status (urinary iodine concentration, UIC) and serum thyroid hormones (TSH, FT4), thyroglobulin (Tg), and anti-thyroid peroxidase antibodies (TPO-Ab) concentrations.ResultsThe median UIC in WRA was 256 μg/L (IQR: 166−354 μg/L; n = 151) in Algiers and 253 μg/L (167−341 μg/L; n = 150) in Tizi-Ouzou. The median UIC for the PW in Algiers was 233 μg/L (IQR: 157−326 μg/L; n = 173).Thirty-five percent of WRA and 30% of PW had an UIC > 300 μg/L. Median TSH, FT4 and Tg concentrations were within reference ranges in all groups of women. Among PW, 72.7%, 75.4% and 75.5% in the first, second and third trimester were TPO-Ab+. Among TPO-Ab + PW in the first, second and third trimesters, 18.7%, 13% and 10.3% had subclinical hypothyroidism.ConclusionIn northern Algeria, median UICs in PW indicate iodine sufficiency, and in WRA indicate more than adequate intakes. About 75% of PW are TPO-Ab + and the prevalence of subclinical hypothyroidism is high. Monitoring and surveillance of iodine fortification programs is vital to avoid both iodine deficiency and excess. There is an urgent need for a comprehensive national iodine status survey including school-age children and other vulnerable population groups in Algeria.     

Selenium intake and status of postpartum women and postnatal depression during the first year after childbirth in New Zealand – Mother and Infant Nutrition Investigation (MINI) study

BackgroundSelenium (Se) plays an important role in selenoproteins as an antioxidant, and is involved in thyroid function, mental health and child development. Selenium is low in the local food supplies in NZ. Low selenium intake has been reported in women of childbearing age and postmenopausal women, however, there is little research relating to breastfeeding women and their infants.PurposeThe study investigates maternal and infant selenium intake and status during the first year postpartum, and possible relationships to postnatal depression and anxiety.Basic proceduresThe Mother and Infant Nutrition Investigation (MINI) study is an observational longitudinal cohort study. In total 87 breastfeeding mother-infant pairs were recruited and followed up at 3, 6 and 12 months postpartum. Maternal selenium intake was estimated from a four-day diet diary (4DDD). Selenium concentrations were measured in maternal spot urine, breastmilk and plasma; and infant spot urine samples. Postnatal depression was screened by the Edinburgh Postnatal Depression Scale (EPDS) questionnaire.Main findingsMedian maternal selenium intake was 62 (50, 84) μg/day, with 56 % below the Estimated Average Requirement (EAR) of 65 μg/day. At 3, 6, and 12 months postpartum, median maternal urinary selenium:creatinine ratios were 29.0 (22.4, 42.0), 29.5 (23.1, 28.4), and 30.9 (24.3, 35.3) μg/g; median infant urinary selenium concentrations (IUSC) were 8 (6,13), 11 (6, 15), and 24 (10, 40) μg/L; median breastmilk selenium concentrations (BMSC) were 13 (11, 14), 11 (9, 11) and 12 (11, 13) μg/L; 18 %, 11 % and 14 % of women reported probable minor depression based on the EPDS scores equal or above 10. Estimated median infant selenium intake at 3 and 6 months were 9 (8, 11) and 8 (7, 10) μg/day with 85 % and 93 % below the Adequate Intake of 12 μg/day. Median maternal plasma selenium was 105.8 μg/L at 6 months postpartum. Minor depression at three months postpartum was significantly different across tertiles of plasma selenium concentrations (p = 0.041).Principle conclusionsSuboptimal selenium intake was observed among breastfeeding mothers and their infants in the MINI study. Potentially, some women had insufficient selenium status. Relation between selenium status and risk of postnatal depression and anxiety was inconclusive.Further research is required to explore effects on maternal thyroid function and infant neurodevelopment among women with inadequate selenium intake and status.