EUthyroid Project Aims to Improve Iodine Uptake Across Europe

Marlene Busko

December 20, 2016

Ensuring that all Europeans — especially pregnant women — have adequate dietary intake of iodine will be a challenge, but in the past year, experts have taken the first steps toward determining how to do this.

This research is important, since iodine deficiency in pregnant mothers is associated with poorer cognition in their offspring, Sarah C Bath, PhD, RD, from the department of nutritional sciences, at the University of Surrey, in Guilford, United Kingdom, writes in a Comment published online December 6, 2016 in Lancet Diabetes & Endocrinology.

Currently, the uptake of iodine varies widely in different European countries because of differences in eating habits and variation in the iodine concentration of foods. Also, iodized salt programs, recommended by the World Health Organization to prevent deficiency, are inconsistent.

"For example, some countries are classified as iodine deficient in both the general population and in pregnant women (eg, the United Kingdom), some are iodine sufficient in both the general population and in pregnant women (eg, the Netherlands), whereas many are classified as iodine-sufficient but with deficiency in pregnant women (eg, Spain)," Dr Bath writes.

When asked what might explain the differences in iodine uptake in these three countries, Dr Bath told Medscape Medical News in an email that "in the United Kingdom, the main dietary source of iodine is milk (and dairy products); in the Netherlands, bread is made with iodized salt; and in the Netherlands and Spain, iodized salt is widely available and used."

The 3-year, European Union–funded EUthyroid project, which began June 1, 2015 and includes 24 EU member countries plus six additional countries (Iceland, Israel, Macedonia, Norway, Switzerland, and Turkey), aims to harmonize the iodine supply across Europe and ensure that all pregnant women have adequate levels of iodine.

"The EUthyroid project is the first pan-European initiative to take on the challenge of investigating the iodine intake of the European population," Dr Bath told Medscape Medical News.

The project aims to collect standardized data on iodine levels in the population and in pregnant women in the 30 countries; compare dietary sources and measures to improve iodine intake in different countries; perform a cost/benefit analysis of existing programs to ensure adequate iodine intake; develop a more consistent strategy to improve iodine intake; evaluate the usefulness of thyroglobulin as a biomarker of iodine status in pregnancy; and study birth cohorts from three countries with different levels of iodine intake (the United Kingdom, the Netherlands, and Spain).

"The effects of severe iodine deficiency on the developing brain are well-known, but the effect of mild to moderate iodine deficiency, which is more likely in European countries, is less certain," she writes. The study from pregnant women in these three countries will shed more light on this.

Experts from EUthyroid and others from Iodine Global Network met at a symposium to discuss how the EUthyroid project was progressing, just before the European Thyroid Association meeting in Copenhagen, Denmark, in September, Dr Bath reports.

This type of coordinated approach is necessary to tackle outstanding research questions and attempt to deal with the current disparity in iodine nutrition across Europe.

However, the experts also need make sure that this research framework can outlive the project. According to Dr Bath, "for iodine deficiency to be eliminated in Europe in the long term…frameworks and approaches need to be developed that will ensure adequate iodine nutrition across Europe long after the EUthyroid project ends in 2018."

The EUthyroid project has received funding from the European Union's Horizon 2020 Research and Innovation program. Dr Bath has received lecture fees from The Dairy Council.

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Lancet Diabetes Endocrinol. Published Online December 6, 2016. Abstract

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