Ji, Chen (Researcher in medicine) (2013) Salt intake and iodine status around the world. PhD thesis, University of Warwick.

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Abstract

Background: Salt reduction and universal salt iodisation programmes are
implemented worldwide to prevent cardiovascular disease and iodine deficiency
disorders, respectively. Concerns have been raised regarding the potential policy
conflicts, and a programme coalition is proposed by the World Health Organization
to optimise salt and iodine intakes at population level. This study aimed 1) to
estimate population salt intake and iodine status in index countries; 2) to investigate
the association between salt and iodine intakes; 3) to assess the impact of salt intake
modification on iodine status; 4) to estimate the determinants of and potential
geographical variation in salt and iodine intakes where data are available; and 5) to
provide suggestions to policy makers.
Data and Methods: In the ecological analysis, national estimations of salt and
iodine intakes were extracted from international organisation databases and
published papers. Three case studies used population level data obtained from the
Kumasi Salt Reduction Study in Ghana, the Third United States National Health and
Nutrition Examination Survey (NHANES III) and the 2000-01 UK National Diet and
Nutrition Survey 19-64 years (NDNS). Linear regression was used in the Kumasi
analysis, and Bayesian geo-additive models were used in the other two analyses by
accounting for the spatial effect and important linear and nonlinear risk factors.
Results: Salt intake varied between countries, with Kumasi lower than the western
countries. Iodine status also varied by country, but with no consistent association
with salt intake. A moderate salt reduction programme is unlikely to have a major impact on iodine status in countries committed to universal salt iodisation, provided
that iodine concentration is titrated to actual salt intake, maximum coverage is
achieved as in China and iodised salt becomes part of food processing. At least in
Britain, high salt intake is associated with low socioeconomic status, irrespective of
geographic location.
Conclusions: Policy-makers may therefore need to adjust iodine content in salt in
accordance with each country’s context. The Bayesian geo-additive models are
useful for monitoring and evaluating salt reduction and iodine supplementation.

Item Type:	Thesis (PhD)
Subjects:	Q Science > QP Physiology
Library of Congress Subject Headings (LCSH):	Salt -- Physiological effect, Salt in the body, Iodized salt, Iodine in the body, Iodine -- Physiological effect, World Health Organization
Official Date:	February 2013
Dates:	Date Event February 2013 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Cappuccio, Francesco P.; Kandala, Ngianga-Bakwin
Extent:	xx, 304 leaves : illustrations, maps.
Language:	eng

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