Skip to main content

Advertisement

SpringerLink
Log in

Iodine-fortified toddler milk improves dietary iodine intakes and iodine status in toddlers: a randomised controlled trial

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

We aimed to evaluate the effectiveness of consuming iodine-fortified toddler milk for improving dietary iodine intakes and biochemical iodine status in toddlers.

Methods

In a 20-week parallel randomised controlled trial, healthy 12–20-month-old children were assigned to: Fortified Milk [n = 45; iodine-fortified (21.1 µg iodine/100 g prepared drink) cow’s milk], or Non-Fortified Milk (n = 90; non-fortified cow’s milk). Food and nutrient intakes were assessed with 3-day weighed food records at baseline, and weeks 4 and 20. Urinary iodine concentration (UIC) was measured at baseline and 20 weeks.

Results

At baseline, toddlers’ median milk intake was 429 g/day. There was no evidence that milk intakes changed within or between the groups during the intervention. Toddlers’ baseline geometric mean iodine intake was 46.9 µg/day, and the median UIC of 43 µg/L in the Fortified Milk group and 55 µg/L in the Non-Fortified Milk group indicated moderate and mild iodine deficiency, respectively, with this difference due to chance. During the intervention, iodine intakes increased by 136% (p < 0.001) and UIC increased by 85 µg/L (p < 0.001) in the Fortified Milk group compared to the Non-Fortified Milk group. The 20-week median UIC was 91 µg/L in the Fortified Milk group and 49 µg/L in the Non-Fortified Milk group.

Conclusions

Consumption of ≈ 1.7 cups of iodine-fortified toddler milk per day for 20 weeks can increase dietary iodine intakes and UIC in healthy iodine-deficient toddlers. This strategy alone is unlikely to provide sufficient intake to ensure adequate iodine status in toddlers at risk of mild-to-moderate iodine deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Zimmermann MB, Jooste PL, Pandav CS (2008) Iodine-deficiency disorders. Lancet 372:1251–1262. https://doi.org/10.1016/S0140-6736(08)61005-3

    Article  CAS  PubMed  Google Scholar 

  2. World Health Organization/United Nations International Children’s Emergency Fund/International Council for the Control of Iodine Deficiency Disorders (2007) Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers, 3rd edn. World Health Organization, Geneva

    Google Scholar 

  3. Food and Nutrition Board, Institute of Medicine (2001) Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academy Press, Washington

    Google Scholar 

  4. United Nations Children’s Fund (2011) The State of the World’s Children 2011: adolescence—an age of opportunity. United Nations Children’s Fund, New York

    Book  Google Scholar 

  5. Andersson M, Karumbunathan V, Zimmermann MB (2012) Global iodine status in 2011 and trends over the past decade. J Nutr 142:744–750. https://doi.org/10.3945/jn.111.149393

    Article  CAS  PubMed  Google Scholar 

  6. Pearce EN, Andersson M, Zimmermann MB (2013) Global iodine nutrition: where do we stand in 2013? Thyroid 23:523–528. https://doi.org/10.1089/thy.2013.0128

    Article  CAS  PubMed  Google Scholar 

  7. Lazarus JH (2014) Iodine status in Europe in 2014. Eur Thyroid J 3:3–6

    Article  Google Scholar 

  8. Gartner R (2016) Recent data on iodine intake in Germany and Europe. J Trace Elem Med Biol 37:85–89. https://doi.org/10.1016/j.jtemb.2016.06.012

    Article  CAS  PubMed  Google Scholar 

  9. Ministry of Health (2003) NZ food NZ children: key results of the 2002 national children’s nutrition survey. Ministry of Health, Wellington

    Google Scholar 

  10. Li M, Ma G, Boyages SC, Eastman CJ (2001) Re-emergence of iodine deficiency in Australia. Asia Pac J Clin Nutr 10:200–203

    Article  CAS  Google Scholar 

  11. Mann JI, Aitken E (2003) The re-emergence of iodine deficiency in New Zealand? N Z Med J 116:U351

    PubMed  Google Scholar 

  12. Santiago-Fernandez P, Torres-Barahona R, Muela-Martinez JA, Rojo-Martinez G, Garcia-Fuentes E, Garriga MJ, Leon AG, Soriguer F (2004) Intelligence quotient and iodine intake: a cross-sectional study in children. J Clin Endocrinol Metab 89:3851–3857. https://doi.org/10.1210/jc.2003-031652

    Article  CAS  PubMed  Google Scholar 

  13. Lombardi FA, Pinchera A, Antonangeli L, Rago T, Chiovato L, Bargagna S, Bertucelli B, Ferretti G, Sbrana B, Marcheschi M, Vitti P (1995) Mild iodine deficiency during fetal/neonatal life and neuropsychological impairment in Tuscany. J Endocrinol Invest 18:57–62. https://doi.org/10.1007/bf03349700

    Article  Google Scholar 

  14. Riaño Galán I, Sánchez Martinez P, Pilar Mosteiro Diaz M, Rivas Crespo MF (2005) Psycho-intellectual development of 3 year-old children with early gestational iodine deficiency. J Pediatr Endocrinol Metab 18:1265. https://doi.org/10.1515/JPEM.2005.18.S1.1265

    Article  PubMed  Google Scholar 

  15. Gordon RC, Rose MC, Skeaff SA, Gray AR, Morgan KM, Ruffman T (2009) Iodine supplementation improves cognition in mildly iodine-deficient children. Am J Clin Nutr 90:1264–1271. https://doi.org/10.3945/ajcn.2009.28145

    Article  CAS  PubMed  Google Scholar 

  16. Bougma K, Aboud FE, Harding KB, Marquis GS (2013) Iodine and mental development of children 5 years old and under: a systematic review and meta-analysis. Nutrients 5:1384–1416. https://doi.org/10.3390/nu5041384

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Zimmermann MB, Jooste PL, Mabapa NS, Mbhenyane X, Schoeman S, Biebinger R, Chaouki N, Bozo M, Grimci L, Bridson J (2007) Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth. J Clin Endocrinol Metab 92:437–442. https://doi.org/10.1210/jc.2006-1901

    Article  CAS  PubMed  Google Scholar 

  18. Vermiglio F, Lo Presti VP, Moleti M, Sidoti M, Tortorella G, Scaffidi G, Castagna MG, Mattina F, Violi MA, Crisa A, Artemisia A, Trimarchi F (2004) Attention deficit and hyperactivity disorders in the offspring of mothers exposed to mild-moderate iodine deficiency: a possible novel iodine deficiency disorder in developed countries. J Clin Endocrinol Metab 89:6054–6060. https://doi.org/10.1210/jc.2004-0571

    Article  CAS  PubMed  Google Scholar 

  19. Hauser P, Zametkin AJ, Martinez P, Vitiello B, Matochik JA, Mixson AJ, Weintraub BD (1993) Attention deficit-hyperactivity disorder in people with generalized resistance to thyroid hormone. N Engl J Med 328:997–1001. https://doi.org/10.1056/NEJM199304083281403

    Article  CAS  PubMed  Google Scholar 

  20. Alvarez-Pedrerol M, Ribas-Fito N, Torrent M, Julvez J, Ferrer C, Sunyer J (2007) TSH concentration within the normal range is associated with cognitive function and ADHD symptoms in healthy preschoolers. Clin Endocrinol 66:890–898. https://doi.org/10.1111/j.1365-2265.2007.02871.x

    Article  CAS  Google Scholar 

  21. Modesto T, Tiemeier H, Peeters RP, Jaddoe VW, Hofman A, Verhulst FC, Ghassabian A (2015) Maternal mild thyroid hormone insufficiency in early pregnancy and attention-deficit/hyperactivity disorder symptoms in children. JAMA Pediatr 169:838–845. https://doi.org/10.1001/jamapediatrics.2015.0498

    Article  PubMed  Google Scholar 

  22. Skeaff SA, Ferguson EL, McKenzie JE, Valeix P, Gibson RS, Thomson CD (2005) Are breast-fed infants and toddlers in New Zealand at risk of iodine deficiency? Nutrition 21:325–331

    Article  Google Scholar 

  23. Thomson CD (2004) Selenium and iodine intakes and status in New Zealand and Australia. Br J Nutr 91:661–672. https://doi.org/10.1079/bjn20041110

    Article  CAS  PubMed  Google Scholar 

  24. Food Standards Australia New Zealand (2009) Australian User Guide. Mandatory iodine fortification: implementing the requirements of mandatory fortification with iodised salt under standard 2.1.1—cereals and cereal products. Food Standards Australia New Zealand, Wellington, New Zealand

  25. Ministry for Primary Industries, Ministry of Health (2016) Mandatory iodine fortification in New Zealand: supplement to the Australian Institute of Health and Welfare 2016 report—monitoring the health impacts of mandatory folic acid and iodine fortification. MPI Technical Paper No: 2016/32. Ministry for Primary Industries, Wellington, New Zealand

  26. Brough L, Gunn CA, Weber JL, Coad J, Jin Y, Thomson JS, Mauze M, Kruger MC (2017) Iodine and selenium intakes of postmenopausal women in New Zealand. Nutrients 9:254. https://doi.org/10.3390/nu9030254

    Article  CAS  PubMed Central  Google Scholar 

  27. Miller JC, MacDonell SO, Gray AR, Reid MR, Barr DJ, Thomson CD, Houghton LA (2016) Iodine status of New Zealand elderly residents in long-term residential care. Nutrients 8:445. https://doi.org/10.3390/nu8080445

    Article  CAS  PubMed Central  Google Scholar 

  28. Jones E, McLean R, Davies B, Hawkins R, Meiklejohn E, Ma ZF, Skeaff S (2016) Adequate iodine status in New Zealand school children post-fortification of bread with iodised salt. Nutrients 8:298. https://doi.org/10.3390/nu8050298

    Article  CAS  PubMed Central  Google Scholar 

  29. Skeaff SA, Lonsdale-Cooper E (2013) Mandatory fortification of bread with iodised salt modestly improves iodine status in schoolchildren. Br J Nutr 109:1109–1113. https://doi.org/10.1017/S0007114512003236

    Article  CAS  PubMed  Google Scholar 

  30. Ministry for Primary Industries (2018) 2016 New Zealand Total Diet Study. Ministry for Primary Industries, Wellington

    Google Scholar 

  31. Ministry for Primary Industries (2016) First quarter analytical results for the 2016 New Zealand total diet study. MPI Technical Paper No: 2016/34. Ministry for Primary Industries, Wellington, New Zealand

  32. Ministry for Primary Industries (2016) Third quarter analytical results for the 2016 New Zealand total diet study. MPI Technical Paper No: 2016/68. Ministry for Primary Industries, Wellington, New Zealand

  33. Szymlek-Gay EA, Ferguson EL, Heath ALM, Gray AR, Gibson RS (2009) Food-based strategies improve iron status in toddlers: a randomized controlled trial. Am J Clin Nutr 90:1541–1551. https://doi.org/10.3945/ajcn.2009.27588

    Article  CAS  PubMed  Google Scholar 

  34. Morgan EJ, Heath A-LM, Szymlek-Gay EA, Gibson RS, Gray AR, Bailey KB, Ferguson EL (2010) Red meat and a fortified manufactured toddler milk drink increase dietary zinc intakes without affecting zinc status of New Zealand toddlers. J Nutr 140:2221–2226. https://doi.org/10.3945/jn.109.120717

    Article  CAS  PubMed  Google Scholar 

  35. Houghton LA, Gray AR, Szymlek-Gay EA, Heath A-LM, Ferguson EL (2011) Vitamin D-fortified milk achieves the targeted serum 25-hydroxyvitamin D concentration without affecting that of parathyroid hormone in New Zealand toddlers. J Nutr 141:1840–1846. https://doi.org/10.3945/jn.111.145052

    Article  CAS  PubMed  Google Scholar 

  36. Szymlek-Gay EA, Gray AR, Heath AM, Ferguson EL, Skeaff CM (2018) Red meat consumption and serum lipids and fatty acids in toddlers: secondary outcomes of a randomized controlled trial. J Pediatr Gastroenterol Nutr 67:395–400. https://doi.org/10.1097/MPG.0000000000002018

    Article  CAS  PubMed  Google Scholar 

  37. Soh P, Ferguson EL, McKenzie JE, Homs MY, Gibson RS (2004) Iron deficiency and risk factors for lower iron stores in 6–24-month-old New Zealanders. Eur J Clin Nutr 58:71–79

    Article  CAS  Google Scholar 

  38. Lohman TG, Roche AF, Martorell R (1988) Anthropometric standardization reference manual. Human Kinetics Publications, Champaign

    Google Scholar 

  39. World Health Organization WHO Anthro 2005, beta version 17 February 2006: software for assessing growth and development of the world’s children. Geneva, Switzerland. https://www.who.int/childgrowth/software/en/. Accessed 20 June 2006

  40. Szymlek-Gay EA, Ferguson EL, Heath A-LM, Fleming EA (2010) Quantities of foods consumed by 12- to 24-month-old New Zealand children. Nutr Diet 67:244–250. https://doi.org/10.1111/j.1747-0080.2010.01471.x

    Article  Google Scholar 

  41. Marshall-Seeley R. Diet Cruncher for Macintosh, version 1.2.0. Dunedin, New Zealand: Way Down South Software; 1999–2001.

  42. New Zealand Institute for Crop and Food Research (2004) FOODfiles. Data files of the New Zealand Food Composition Database. New Zealand Institute for Crop and Food Research, Palmerston North, New Zealand

  43. New Zealand Institute for Crop and Food Research (2008) FOODfiles (8th edn). Data files of the New Zealand food composition database. New Zealand institute for crop and food research, Palmerston North, New Zealand

  44. Ministry of Agriculture and Forestry (2011) 2009 New Zealand total diet study. Ministry of Agriculture and Forestry, Wellington

    Google Scholar 

  45. van Stuijvenberg ME, Kvalsvig JD, Faber M, Kruger M, Kenoyer DG, Benade AJ (1999) Effect of iron-, iodine-, and beta-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial. Am J Clin Nutr 69:497–503. https://doi.org/10.1093/ajcn/69.3.497

    Article  PubMed  Google Scholar 

  46. Nga TT, Winichagoon P, Dijkhuizen MA, Khan NC, Wasantwisut E, Furr H, Wieringa FT (2009) Multi-micronutrient-fortified biscuits decreased prevalence of anemia and improved micronutrient status and effectiveness of deworming in rural Vietnamese school children. J Nutr 139:1013–1021. https://doi.org/10.3945/jn.108.099754

    Article  CAS  PubMed  Google Scholar 

  47. Winichagoon P, McKenzie JE, Chavasit V, Pongcharoen T, Gowachirapant S, Boonpraderm A, Manger MS, Bailey KB, Wasantwisut E, Gibson RS (2006) A multimicronutrient-fortified seasoning powder enhances the hemoglobin, zinc, and iodine status of primary school children in North East Thailand: a randomized controlled trial of efficacy. J Nutr 136:1617–1623

    Article  CAS  Google Scholar 

  48. Solon FS, Sarol JN Jr, Bernardo AB, Solon JA, Mehansho H, Sanchez-Fermin LE, Wambangco LS, Juhlin KD (2003) Effect of a multiple-micronutrient-fortified fruit powder beverage on the nutrition status, physical fitness, and cognitive performance of schoolchildren in the Philippines. Food Nutr Bull 24:S129–140. https://doi.org/10.1177/15648265030244s210

    Article  PubMed  Google Scholar 

  49. Nazeri P, Mirmiran P, Tahmasebinejad Z, Hedayati M, Delshad H, Azizi F (2017) The effects of iodine fortified milk on the iodine status of lactating mothers and infants in an area with a successful salt iodization program: a randomized controlled trial. Nutrients 9:180. https://doi.org/10.3390/nu9020180

    Article  CAS  PubMed Central  Google Scholar 

  50. Edmonds JC, McLean RM, Williams SM, Skeaff SA (2016) Urinary iodine concentration of New Zealand adults improves with mandatory fortification of bread with iodised salt but not to predicted levels. Eur J Nutr 55:1201–1212. https://doi.org/10.1007/s00394-015-0933-y

    Article  CAS  PubMed  Google Scholar 

  51. Bouhouch RR, Bouhouch S, Cherkaoui M, Aboussad A, Stinca S, Haldimann M, Andersson M, Zimmermann MB (2014) Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2:197–209. https://doi.org/10.1016/S2213-8587(13)70155-4

    Article  CAS  PubMed  Google Scholar 

  52. Bougma K, Aboud FE, Lemma TM, Frongillo EA, Marquis GS (2018) Introduction of iodised salt benefits infants’ mental development in a community-based cluster-randomised effectiveness trial in Ethiopia. Br J Nutr 119:801–809. https://doi.org/10.1017/S0007114517003658

    Article  CAS  PubMed  Google Scholar 

  53. Dold S, Zimmermann MB, Jukic T, Kusic Z, Jia Q, Sang Z, Quirino A, San Luis TOL, Fingerhut R, Kupka R, Timmer A, Garrett GS, Andersson M (2018) Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: a cross-sectional multicenter study. J Nutr 148:587–598. https://doi.org/10.1093/jn/nxy015

    Article  PubMed  Google Scholar 

  54. Andersson M, Aeberli I, Wust N, Piacenza AM, Bucher T, Henschen I, Haldimann M, Zimmermann MB (2010) The Swiss iodized salt program provides adequate iodine for school children and pregnant women, but weaning infants not receiving iodine-containing complementary foods as well as their mothers are iodine deficient. J Clin Endocrinol Metab 95:5217–5224. https://doi.org/10.1210/jc.2010-0975

    Article  CAS  PubMed  Google Scholar 

  55. WHO Secretariat, Andersson M, de Benoist B, Delange F, Zupan J (2007) Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the technical consultation. Public Health Nutr 10:1606–1611. https://doi.org/10.1017/S1368980007361004

    Article  Google Scholar 

  56. Hurrell RF (1997) Bioavailability of iodine. Eur J Clin Nutr 51(Suppl 1):S9–12

    PubMed  Google Scholar 

  57. Purves HD (1974) The aetiology and prophylaxis of endemic goitre and cretinism. The New Zealnd experience. N Z Med J 80:477–479

    CAS  PubMed  Google Scholar 

  58. Joerin M, Bowering A (1972) The total iodine content of cow’s milk. NZ Dairy Sci Tech 7:155–158

    CAS  Google Scholar 

  59. Sutcliffe E (1990) Iodine in New Zealand milk. Food Tech NZ 7:32–38

    Google Scholar 

  60. Knowles S, Lee J, Grace N (1997) Metabolism of trace elements in lactating dairy cows: perspectives of selenium and iodine in animal health and human nutrition. Proc Nutr Soc NZ 22:174–183

    CAS  Google Scholar 

  61. Vannoort R (2003) 2003/04 New Zealand Total Diet Survey: analytical results—Q1. New Zealand Food Safety Authority, Wellington

    Google Scholar 

  62. Vannoort R (2004) 2003/04 New Zealand Total Diet Survey: analytical results—Q3. New Zealand Food Safety Authority, Wellington

    Google Scholar 

  63. Dold S, Zimmermann MB, Baumgartner J, Davaz T, Galetti V, Braegger C, Andersson M (2016) A dose-response crossover iodine balance study to determine iodine requirements in early infancy. Am J Clin Nutr 104:620–628. https://doi.org/10.3945/ajcn.116.134049

    Article  CAS  PubMed  Google Scholar 

  64. Goellner MH, Ziegler EE, Fomon SJ (1981) Urination during the first 3 years of life. Nephron 28:174–178. https://doi.org/10.1159/000182168

    Article  CAS  PubMed  Google Scholar 

  65. Zimmermann MB (2006) The influence of iron status on iodine utilization and thyroid function. Annu Rev Nutr 26:367–389. https://doi.org/10.1146/annurev.nutr.26.061505.111236

    Article  CAS  PubMed  Google Scholar 

  66. Taylor PN, Okosieme OE, Dayan CM, Lazarus JH (2014) Therapy of endocrine disease: impact of iodine supplementation in mild-to-moderate iodine deficiency: systematic review and meta-analysis. Eur J Endocrinol 170:R1–R15. https://doi.org/10.1530/eje-13-0651

    Article  CAS  PubMed  Google Scholar 

  67. Statistics New Zealand. https://nzdotstat.stats.govt.nz. Accessed 5 Feb 2019

  68. Webb K, Rutihauser I, Knezevic N (2008) Foods, nutrients and portions consumed by a sample of Australian children aged 16–24 months. Nutr Diet 65:56–65

    Article  Google Scholar 

  69. Atkins LA, McNaughton SA, Campbell KJ, Szymlek-Gay EA (2016) Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program. Br J Nutr 115:285–293. https://doi.org/10.1017/S0007114515004286

    Article  CAS  PubMed  Google Scholar 

  70. Siega-Riz AM, Deming DM, Reidy KC, Fox MK, Condon E, Briefel RR (2010) Food consumption patterns of infants and toddlers: where are we now? J Am Diet Assoc 110:S38–51. https://doi.org/10.1016/j.jada.2010.09.001

    Article  PubMed  Google Scholar 

  71. Lennox A, Sommerville J, Ong K, Henderson H, Allen R (2013) Diet and nutrition survey of infants and young children, 2011. Department of Health and Food Standards Agency, London

    Google Scholar 

Download references

Funding

Supported by the Health Research Council of New Zealand; Meat and Livestock Australia; Meat and Wool New Zealand; and the University of Otago. The study funders had no role in: study design or conduct; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

    Ewa A. Szymlek-Gay

  2. Biostatistics Unit, Dean’s Office, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Andrew R. Gray

  3. Department of Human Nutrition, University of Otago, Dunedin, New Zealand

    Anne-Louise M. Heath, Tyson Edwards & Sheila A. Skeaff

  4. Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK

    Elaine L. Ferguson

Authors
  1. Ewa A. Szymlek-Gay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew R. Gray
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne-Louise M. Heath
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elaine L. Ferguson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tyson Edwards
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sheila A. Skeaff
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A-LMH and ELF conceptualised the study; EAS-G, ARG, A-LMH, ELF, and SAS designed the study; EAS-G collected the data; SAS was responsible for the urinary iodine concentration analysis; TE developed the database of iodine content of foods; EAS-G carried out statistical analyses, with advice from ARG; and EAS-G wrote the manuscript. All authors critically reviewed the manuscript and approved the final version as submitted.

Corresponding author

Correspondence to Ewa A. Szymlek-Gay.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The trial was approved by the Human Ethics Committee of the University of Otago (03/141) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed written consent was obtained from the parent or legal guardian of each toddler.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Szymlek-Gay, E.A., Gray, A.R., Heath, AL.M. et al. Iodine-fortified toddler milk improves dietary iodine intakes and iodine status in toddlers: a randomised controlled trial. Eur J Nutr 59, 909–919 (2020). https://doi.org/10.1007/s00394-019-01950-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-019-01950-5

Keywords

Search

Navigation