Iodine Status of Young Burkinabe Children Receiving Small-quantity Lipid-based Nutrient Supplements and Iodized Salt

Abstract

Objectives: To assess the impact of supplementing local complementary foods with LNS on iodine status in young Burkinabe children exposed to iodized salt. Methods: In a partially masked, placebo-controlled, randomized trial, 34 communities were assigned to immediate (II) or non-intervention (NI). II children were randomly assigned to receive 20 g LNS/d containing 90 µg iodine with 0 or 10 mg zinc, and NI children received no LNS. Urinary iodine (UI) was assessed in spot samples and thyroxin (T4) and thyroid-stimulating hormone (TSH) concentrations in dried blood spots at 9 and 18 mo among a subset of 123 II children and 56 DI children. Salt samples (n=106) were collected at homes of randomly selected participants for assessment of iodine content by titration. Results: Mean iodine content of salt samples was 37±15 ppm (range 5-86 ppm). 37% had an iodine content <30ppm. At baseline and 18 mo, UI, T4 and TSH did not differ among groups. At 18 mo, median (IQR) UI was 334.8 (193.9-555.7) µg/L, T4 114 (99-138) nmol/L and TSH 0.76 (0.49-1.09) mU/L in all groups combined. While no child had elevated TSH at 18 mo, more children in NI (8.9%) had low T4 (<65 nmol/L) than in II (1.6%) (p=0.0325). Conclusions: Although the majority of household salt samples contained iodine above the target of 30 ppm, provision of iodine in LNS significantly reduced the percentage of children with abnormally low T4 concentrations at 18 mo.