Dietary pattern and its association with iodine deficiency among school children in southwest Ethiopia; A cross-sectional study - PubMed (original) (raw)

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Dietary pattern and its association with iodine deficiency among school children in southwest Ethiopia; A cross-sectional study

Hamid Yimam Hassen et al. PLoS One. 2019.

Abstract

Background: Despite the universal iodization of salt in Ethiopia, iodine deficiency disorder remains a major public health problem and continued to affect a large segment of the population. It is thus essential to assess factors contributing to the unacceptably high endemic goiter rate in the country and avail evidence for further additional interventions. In line with this, we examined the association of dietary pattern and iodine deficiency among school-age children in Ethiopia.

Method: We conducted a school-based cross-sectional study among 767 children aged 6 to 12 in southwest Ethiopia. We collected socio-demographic and other important health related information using a pre-tested structured questionnaire through the interview. Dietary pattern of children was measured using modified Hellen Keller's food frequency questionnaire. We measured iodine deficiency using urinary iodine concentration level and total goiter rate, according to the World Health Organization threshold criteria. We used a multivariate linear regression model to identify dietary and sociodemographic factors that affect urinary iodine level among children.

Result: Out of the 767 children included in the study, 12% and 4% of children have grade 1 and grade 2 goiter respectively, making the total goiter rate 16%. While the prevalence of iodine deficiency based on urinary iodine concentration is 58.8% of which 13.7% had severe, 18.6% had moderate and 26.5% had mild form. The proportion of children who consumed godere/taro root/, banana, corn, Abyssinian cabbage, and potato, respectively at daily basis 57.8%, 53.1%, 37.9%, and 31.2%, respectively. Age (β = -0.7, 95%CI = -1.1, -0.4), sex (β = -22.3, 95%CI = -33.8, -10.8), consumption of taro root (β = -27.4, 95%CI = -22.9, -31.8), cabbage (β = -11.7, 95%CI = -5.7, -17.6), Abyssinian cabbage (β = 12.4, 95%CI = 6.7, 18.2), and banana (β = 5.6, 95%CI = 0.01, 11.2) significantly associated with urinary iodine level.

Conclusion: Iodine deficiency remains an important public health problem in southwest Ethiopia. Over-consumption of goitrogenic foods and under-consumption of iodine-rich foods were prevalent and associated with lower urinary iodine level. Therefore, dietary counseling apart from universal salt iodization is recommended.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1

Fig 1. Taro root consumption and urinary iodine level among school children.

Box plot diagram showing the urinary iodine excretion (UIC) level (μg/l) across the level of taro root consumption among school children in southwest Ethiopia. The box-plot shows, the UIC among children who consume taro root daily (n = 367, median = 68.4, IQR = (31.2, 105.3)), 3–6 days per week (n = 99, median = 70.6, IQR = (35.5, 117.6)), 1–2 days per week (n = 156, median = 91.8, IQR = (46.5, 172.6)), 1–3 days per month (n = 84, median = 141.1, IQR = (54.7, 210.3)), and less than 1 per month or never (n = 61, median = 173.4, IQR = (57.4, 173.4)).

Fig 2

Fig 2. Cabbage consumption and urinary iodine level among school children.

Box-plot diagram showing the urinary iodine excretion (UIC) level (μg/l) across level of cabbage consumption among school children in southwest Ethiopia. The box-plot shows, UIC among children who consume cabbage daily (n = 50, median = 68.3, IQR = (21.5, 107.4)), 3–6 days per week (n = 41, median = 74.0, IQR = (45.1, 140.5)), 1–2 days per week (n = 273, median = 66.1, IQR = (33.5, 134.9)), 1–3 days per month (n = 311, median = 87.8, IQR = (36.7, 153.9)), and less than 1 per month or never (n = 92, median = 85.1, IQR = (67.5, 135.3)).

Fig 3

Fig 3. Abyssinian cabbage consumption and urinary iodine level among school children.

Box-plot diagram showing the urinary iodine excretion (UIC) level (μg/l) across level of Abyssinian cabbage consumption among school children in southwest Ethiopia. The box-plot shows, UIC among children who consume Abyssinian cabbage daily (n = 291, median = 97.4, IQR = (52.0, 170.0)), 3–6 days per week (n = 186, median = 70.3, IQR = (38.9, 133.7)), 1–2 days per week (n = 240, median = 66.3, IQR = (32.0, 116.3)), 1–3 days per month (n = 21, median = 89.7, IQR = (40.8, 161.3)), and less than 1 per month or never (n = 29, median = 75.6, IQR = (23.1, 116.5)).

Fig 4

Fig 4. Fish consumption and urinary iodine level among school children.

Box-plot diagram showing the urinary iodine excretion (UIC) level (μg/l) across level of fish consumption among school children in southwest Ethiopia. The box-plot shows, UIC among children who consume fish 1–2 days per week (n = 16, median = 110.6, IQR = (29.2, 164.4)), 1–3 days per month (n = 46, median = 67.9, IQR = (30.3, 176.3)), and less than 1 per month or never (n = 705, median = 74, IQR = (36.8, 133.3)).

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