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Increased risk of iodine deficiency with vegetarian nutrition

  • Thomas Remer (a1), Annette Neubert (a1) and Friedrich Manz (a1)


Observational studies primarily based on diet questionnaires or food records have reported that vegetarians can have a very low I intake. However, analytically ascertained data on the possible degree of I deficiency with this form of diet is lacking. Six healthy adult volunteers participated in the present controlled experimental diet study carried out in four separate 5 d diet periods. The study diets, normal, protein-rich, lactovegetarian, and repeat of the initial normal diet, were almost isoenergetic and contained no fish, sea food, iodized salt or processed foods fortified with I. During the last 48 h of each diet period two 24 h urine samples were obtained from each subject. I analyses were performed in the urine samples and in representative samples taken from all ingested diets. Urinary I excretion was significantly lower with the lactovegetarian diet (36·6 (sd 8·8) μg/d) than with the normal and the protein-rich diets (50·2 (sd 14·0) and 61·0 (sd 8·0) μg/d respectively). Accordingly, a markedly reduced I intake was confirmed analytically for the lactovegetarian diet (15·6 μg/d v. 35·2 and 44·5 μg/d respectively). Our results provide experimental confirmation of literature findings indicating that I supply is higher with non-vegetarian than with vegetarian diets. Specifically, the extremely low intake and urinary output of I as analytically determined for one exemplary vegetarian diet, demonstrate that dietary I may be limiting when strict forms of vegetarian dietary practices (no iodized salt, no I supplements) are followed. The present study is, therefore, the first diet-experiment-based pointer to the potential danger of I deficiency disorders due to strict forms of vegetarian nutrition, especially when fruits and vegetables grown in soils with low I levels are ingested.

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*Corresponding author: fax +49 231 711581, email


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Aumont, G & Tressol, J-C (1986) Improved routine method for the determination of total iodine in urine and milk Analyst 111, 841843.
Cao, X-YJiang, X-MKareem, ADou, Z-HRakeman, MAZhang, M-LMa, TO'Donnell, KDeLong, N & Delong, GR (1994) Iodination of irrigation water as a method of supplying iodine to a severely iodine-deficient population in Xinjiang, China Lancet 344, 107110.
Cobra, C, Muhilal, , Rusmil, K, Rustama, D, Djatnika, , Suwardi, SSPermaesih, D, Muherdiyantiningsih, , Martuti, S & Semba, RD (1997) Infant survival is improved by oral iodine supplementation Journal of Nutrition 127, 574578.
Crane, MGMullen, T & Lukens, R (1992) Iodine status of total vegetarians. Proceedings of the Second International Congress on Vegetarian Nutrition held in Arlington, Virginia, 1992. p. 15, Abstr.
Delange, F (1994) The disorders induced by iodine deficiency Thyroid 4, 107128.
Delange, FBenker, GCaron, PhEber, OPeter, FPodoba, JSimescu, MSzybinsky, ZVertongen, FVitti, PWiersinga, W & Zamravil, V (1997) Thyroid volume and urinary iodine in European schoolchildren: standardization of values for the assessment of iodine deficiency European Journal of Endocrinology 136, 180187.
DeLong, GRLeslie, PWWang, S-HJiang, X-MZhang, M-LRakeman, MAJiang, J-YMa, T & Cao, X-Y (1997) Effect on infant mortality of iodination of irrigation water in a severely iodine-deficient area of China Lancet 350, 771773.
Draper, ALewis, JMalhotra, N & Wheeler, E (1993) The energy and nutrient intakes of different types of vegetarian: a case for supplements? British Journal of Nutrition 69, 319.
Hampel, RGordalla, AZöllner, HKlinke, D & Demuth, M (1997) Alimentäre Jodzufuhr bei Jugendlichen in Mecklenburg-Vorpommern zwischen 1993 und 1996 gestiegen (Iodine intake of adolescents in Mecklenburg-Vorpommern increased between 1993 and 1996) Zeitschrift für Ernährungswiss-enschaft 36, 151154.
Hampel, RKühlberg, TZöllner, HKlinke, DKlein, KPichmann, E-G & Kramer, A (1996) Aktueller Stand der alimentären Jodversorgung in Deutschland (Current iodine status in Germany) Zeitschrift für Ernährungswissenschaft 35, 25.
Höhler, M Tölle H-G & Manz, F (1990) Seefischverzehr und Jodversorgung (Sea fish consumption and iodine status) Aktuelle Ernährungs-Medizin 15, 187193.
Holland, BWelch, AAUnwin, IDBuss, DHPaul, AA & Southgate, DAT (1991) McCance and Widdowson's The Composition of Foods, 5th ed. Cambridge: The Royal Society of Chemistry/Ministry of Agriculture, Fisheries and Food.
International Council for Control of Iodine Deficiency Disorders (1997) Africa struggles for independence from IDD. Report of the 1996 Harare Conference. IDD Newsletter 13, no. 2, 1730.
Lightowler, HJ & Davies, GJ (1996) Sources of iodine in the vegan diet Proceedings of the Nutrition Society 55, 13A.
Maberly, GFTrowbridge, FLYip, RSullivan, KM & West, CE (1994) Programs against micronutrient malnutrition: ending hidden hunger Annual Review of Public Health 15, 277301.
Manz, F (1992) Jodmangel. Gründe, Folgen und Vorbeugungsmaßnahmen (Iodine deficiency. Reasons, consequences, and preventive measures) Prävention 15, 111117.
Meng, W (1992) Anatomie und Physiologie (Anatomy and physiology). In Schilddrüsenkrankheiten: Pathyphysiologie, Diagnostik und Therapie (Diseases of the Thyroid: Pathophysiology, Diagnostic Investigation and Therapy), pp. 1839 [Meng, W, editor]. Stuttgart: Gustav Fischer Verlag.
Neubert, A & Remer, T (1996) Measurement of urinary iodine concentration (letter) Lancet 347, 14141415.
Park, YKHarland, BFVanderveen, JEShank, FR & Prosky, L (1981) Estimation of dietary iodine intake of Americans in recent years Journal of the American Dietetic Association 79, 1724.
Rauma, A-LTörmälä, M-LNenonen, M & Hänninen, O (1994) Iodine status in vegans consuming a living food diet Nutrition Research 14, 17891795.
Remer, T & Manz, F (1994a) Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein American Journal of Clinical Nutrition 59, 13561361.
Remer, T & Manz, F (1994b) The inadequacy of the urinary iodine–creatinine ratio for the assessment of iodine status during infancy, childhood, and adolescence Journal of Trace Elements and Electrolytes in Health and Disease 8, 217219.
Remer, TManz, F & Pietrzik, K (1995) Re-examination of the effect of hCG on plasma levels and renal excretion of dehydroepiandrosterone sulfate in healthy males Steroids 60, 204209.
Remer, TPietrzik, K & Manz, F (1996a) The short-term effect of dietary pectin on plasma levels and renal excretion of dehydroepiandrosterone sulfate Zeitschrift für Ernährungswiss-enschaft 35, 3238.
Remer, TPietrzik, K & Manz, F (1996b) A moderate increase in daily protein intake causing an enhanced endogenous insulin secretion does not alter circulating levels or urinary excretion of dehydroepiandrosterone sulfate Metabolism 45, 14831486.
Souci, SWFachmann, W & Kraut, H (1994) Food Composition and Nutrition Tables, 5th ed. Stuttgart: Medpharm Scientific Publishers.
Sullivan, KMMay, WNordenberg, DHouston, R & Maberly, GF (1997) Use of thyroid stimulating hormone testing in newborns to identify iodine deficiency Journal of Nutrition 127, 5558.
Wahl, RBreidt, M & Kallee, E (1998) Iodide supplementation: 200 μg daily or 1500 μg weekly? Zeitschrift für Ernährungswiss-enschaft 37, 1821.
Wawschinek, OEber, OPetek, WWakonig, P & Gürakar, A (1985) Bestimmung der Harnjodausscheidung mittels einer modifizierten Cer-Arsenitmethode (Determination of urinary iodine excretion using a modified cer-arsenite method) Berichte ÖGKC 8, 1315.



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