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Original Article
Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines
Young Sik Choi1,*, Kwang-Hyuk Seok2,3,*, Jong Jin Lee1, Gina Jieun Hong4, Pablo M. Afidchao5, Bu Kyung Kim1,†, Jee-Yeong Jeong2,3,†
Kosin Medical Journal 2018;33(1):64-74.
DOI: https://doi.org/10.7180/kmj.2018.33.1.64
Published online: January 21, 2018

1Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

2Department of Biochemistry, Kosin University College of Medicine, Busan, Korea

3Cancer Research Institute, Kosin University College of Medicine, Busan, Korea

4Department of Molecular and Cellular Biology, University of California, Berkeley, CA, USA

5Department of Pharmacology and Biochemistry, Cagayan State University College of Medicine, Tuguegarao, Philippines

†Corresponding Author: Bu kyung Kim, Department of Internal Medicine, College of Medicine, Kosin University, 262, Gamchen-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6532 Fax: +82-51-990-3065 E-mail: 79kyung@hanmail.net
*These authors contributed equall
• Received: September 5, 2017   • Accepted: January 12, 2018

Copyright © 2018 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Iodine deficiency causes multiple health problems. Previously we reported that 96% of high school students in Tuguegarao, Philippines had adequate iodine levels. However, iodine deficiency-associated problems remain among adults in the Philippines. Therefore, we evaluated iodine nutritional status and goiter prevalence among adults, including pregnant women, in Tuguegarao, Philippines.
  • Methods
    A total of 245 adults, including 31 pregnant women, provided samples for urinary iodine analysis, and all pregnant women completed a questionnaire about iodine deficiency.
  • Results
    The median urinary iodine level was 164.0 ± 138.4 g/L; 38.4% of the participants were iodine deficient, according to the International Council for Control of Iodine Deficiency Disorders (ICCIDD) criteria. No severe iodine deficiency was observed. Among the 31 pregnant women, 24 (77.5%) fell into the iodine deficient category defined by a stricter World Health Organization (WHO) guideline, in which iodine deficiency is considered when urinary iodine levels are below 150 g/L. Almost half (42%) of the pregnant women were unaware of the harmful effects of iodine deficiency on the human body and their fetus.
  • Conclusions
    Although iodine nutritional status in the Philippines has improved, iodine deficiency still exists among adults, especially among pregnant women. Therefore, our study strongly suggests that a better strategy should be established to monitor iodine nutritional status among adults continually, and to focus on populations susceptible to iodine deficiency, including pregnant women and women of reproductive age, to achieve the total elimination of iodine deficiency.
  • Keywords: Adults; Awareness; Iodine deficiency; Pregnant women
Fig. 1.
Iodine nutritional status of adults compared with previous surveys in same area, Tuguegarao, Philippines
kmj-33-64f1.jpg
Fig. 2.
Iodine nutritional status of pregnant women in Tuguegarao, Philippines
kmj-33-64f2.jpg
Table 1.
Definition of iodine nutritional status
Median (μg/L) UIC* Iodine nutritional status for general population
< 20 Severe iodine deficiency
20 - 49 Moderate iodine deficiency
50 - 99 Mild iodine deficiency
100 - 199 Optimal
200 - 299 More than adequate
≥ 300 Excessive
< 150 Insufficient
150 - 249 Adequate
250 - 499 More than adequate
≥ 500 Excessive

*UIC, urinary iodine concentration

Table 2.
Clinical characteristics and UIC of men, women and pregnant women
Men Women Pregnant women P-value*
Number 49 188 31
Age (years) 50.29 ± 17.9 44.8 ± 16.4 25.9 ± 7.3 < 0.01
Height (cm) 164.5 ± 12.8 153.8 ± 6.1 155.8 ± 4.0 0.12
Body weight (kg) 57.9 ± 13.7 51.2 ± 10.6 57.0 ± 6.5 0.01
BMI (kg/m2) 21.3 ± 3.9 21.6 ± 3.8 23.4 ± 2.8 0.02
Median UIC (μg/L) 152.7 ± 174.5 180.8 ± 147.3 119.4 ± 94.9 0.02

*P-values reflect comparison between women and pregnant women.

Table 3.
Awareness of iodine deficiency among pregnant women
Question Answer % (n)
1) Have you ever heard of the effects of iodine deficiency on the human body? Yes 67.7 (21)
No 32.3 (10)
2) Can you list some problems (disorders) that are the result of iodine deficiency? Which problems (disorders)? Miscarriage/stillbirth 35.5 (11)
Heart pain 41.9 (13)
Retarded development of children 35.5 (11)
Reduced immunity 45.2 (14)
Memory loss 35.5 (11)
Goiters 54.8 (17)
3) Where do you receive information about iodine deficiency disorders and preventing them? Printed material 29.0 (9)
Television, radio 38.7 (12)
Medical worker 64.5 (20)
Member of your family 38.7 (12)
School 45.2 (14)
4) What do you need to improve iodine deficiency? Play sports 25.8 (8)
Improve the environment 38.7 (12)
Consume seafood 54.8 (17)
More and more com¬plete rest 48.4 (15)
Consume iodized salt 41.9 (13)
Consume vitamins 64.5 (20)
Consume dairy products 58.1 (18)
5) Have you ever heard of iodized salt? Yes 87.1 (27)
No 12.9 (4)
6) Do you buy iodized salt? Yes 80.6 (25)
No 19.4 (6)
6-1) If you answered ‘No’, why don’t you buy iodized salt? I don’t know why it is necessary (6)
It is usually more expensive (2)
No one advisee me to (or I don’t want it) (1)
Other (3)
7) Do you know the advantages of iodized salt over regular salt? Yes 87.1 (27)
No 12.9 (4)
8) What advantages are there? Better taste 45.2 (12)
Better digestion 32.3 (10)
Reduces iodine deficiency in the human body 54.8 (17)
Other 19.4 (6)
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        Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines
        Kosin Med J. 2018;33(1):64-74.   Published online January 21, 2018
        DOI: https://doi.org/10.7180/kmj.2018.33.1.64
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      Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines
      Image Image
      Fig. 1. Iodine nutritional status of adults compared with previous surveys in same area, Tuguegarao, Philippines
      Fig. 2. Iodine nutritional status of pregnant women in Tuguegarao, Philippines

      Fig. 1.

      Fig. 2.

      Iodine nutritional status and awareness of iodine deficiency among adults, including pregnant women, in Tuguegarao, Philippines

      Definition of iodine nutritional status

      Median (μg/L) UIC* Iodine nutritional status for general population
      < 20 Severe iodine deficiency
      20 - 49 Moderate iodine deficiency
      50 - 99 Mild iodine deficiency
      100 - 199 Optimal
      200 - 299 More than adequate
      ≥ 300 Excessive
      < 150 Insufficient
      150 - 249 Adequate
      250 - 499 More than adequate
      ≥ 500 Excessive

      Clinical characteristics and UIC of men, women and pregnant women

      Men Women Pregnant women P-value*
      Number 49 188 31
      Age (years) 50.29 ± 17.9 44.8 ± 16.4 25.9 ± 7.3 < 0.01
      Height (cm) 164.5 ± 12.8 153.8 ± 6.1 155.8 ± 4.0 0.12
      Body weight (kg) 57.9 ± 13.7 51.2 ± 10.6 57.0 ± 6.5 0.01
      BMI (kg/m2) 21.3 ± 3.9 21.6 ± 3.8 23.4 ± 2.8 0.02
      Median UIC (μg/L) 152.7 ± 174.5 180.8 ± 147.3 119.4 ± 94.9 0.02

      Awareness of iodine deficiency among pregnant women

      Question Answer % (n)
      1) Have you ever heard of the effects of iodine deficiency on the human body? Yes 67.7 (21)
      No 32.3 (10)
      2) Can you list some problems (disorders) that are the result of iodine deficiency? Which problems (disorders)? Miscarriage/stillbirth 35.5 (11)
      Heart pain 41.9 (13)
      Retarded development of children 35.5 (11)
      Reduced immunity 45.2 (14)
      Memory loss 35.5 (11)
      Goiters 54.8 (17)
      3) Where do you receive information about iodine deficiency disorders and preventing them? Printed material 29.0 (9)
      Television, radio 38.7 (12)
      Medical worker 64.5 (20)
      Member of your family 38.7 (12)
      School 45.2 (14)
      4) What do you need to improve iodine deficiency? Play sports 25.8 (8)
      Improve the environment 38.7 (12)
      Consume seafood 54.8 (17)
      More and more com¬plete rest 48.4 (15)
      Consume iodized salt 41.9 (13)
      Consume vitamins 64.5 (20)
      Consume dairy products 58.1 (18)
      5) Have you ever heard of iodized salt? Yes 87.1 (27)
      No 12.9 (4)
      6) Do you buy iodized salt? Yes 80.6 (25)
      No 19.4 (6)
      6-1) If you answered ‘No’, why don’t you buy iodized salt? I don’t know why it is necessary (6)
      It is usually more expensive (2)
      No one advisee me to (or I don’t want it) (1)
      Other (3)
      7) Do you know the advantages of iodized salt over regular salt? Yes 87.1 (27)
      No 12.9 (4)
      8) What advantages are there? Better taste 45.2 (12)
      Better digestion 32.3 (10)
      Reduces iodine deficiency in the human body 54.8 (17)
      Other 19.4 (6)
      Table 1. Definition of iodine nutritional status

      UIC, urinary iodine concentration

      Table 2. Clinical characteristics and UIC of men, women and pregnant women

      P-values reflect comparison between women and pregnant women.

      Table 3. Awareness of iodine deficiency among pregnant women

      Table 1.

      Table 2.

      Table 3.

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