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Purpose: Mild-to-moderate iodine deficiency was present in large parts of Germany up to the beginning 1990s and improved from then on. Current epidemiological data on spot urine iodine measurements in German children strongly suggest the re-occurrence of an impaired iodine status. We thus examined whether this re-occurrence is identifiable in more detail, through iodine analyses of 24-h urine samples of a well-characterized cohort of German children in whom samples have been systematically collected from 1985 onward. As iodized salt is a major source for iodine supply, urinary sodium excretion was additionally studied. Methods: Daily iodine and sodium excretions were measured in 2600 24-h urine samples collected between 1985 and 2018 by 677 healthy children aged 6–12 years (participants of the DONALD study). These data were compared with 24-h iodine and sodium excretion estimates obtained from spot urine samples collected in the representative German Health Interview and Examination Surveys for Children and Adolescents KiGGS-baseline (2003–2006) and KiGGS-wave-2 (2014–2017). Results: Between 1985 and1992, DONALD participants started with a median daily iodine excretion level of 40.1 µg/d. Then, during 1993–2003, iodine excretions mounted up to an approximate plateau (~ 84.8 µg/d). This plateau lasted until 2012. Thereafter, iodine concentrations started to decrease again resulting in a median iodine excretion of only 58.9 µg/d in 2018. Sodium excretion, however, had increased. The marked decrease in iodine status along with an abundant sodium excretion corresponded closely with nationwide KiGGS data. Conclusions: As exemplified for the clearly worsening iodine status in German children, longitudinal cohort studies collecting detailed biomarker-based prospective data have the potential to reliably capture health-relevant nutritional changes and trends, applicable on a more comprehensive and even representative population level. [ABSTRACT FROM AUTHOR]

Purpose: There are epidemiologic studies indicating a positive correlation between high sodium and low potassium intake and body mass index. Therefore, this study was conducted in a cross-sectional sample of Iranian children and adolescents to evaluate the link between 24-h urinary Na:K ratio and risk of obesity. Methods: In this cross-sectional study, 374 participants aged 11–18 years were included. One 24-h urine sample was collected by each participant to estimate Na:K ratio. Anthropometric measurements were carried out and overweight/obesity was defined as a BMI ≥ 85th percentile and abdominal obesity as a waist:height ratio (WHtR) of more than 0.5. Results: As expected, 24-h urinary Na:K ratio showed significant associations with risk of overweight/obesity. Risk of adiposity assessed by WC and PBF was significantly associated with Na:K ratio after adjusting for SSBs consumption and calorie intake. Urinary Na:K ratio showed significant association with risk of adiposity assessed by WC only in girls in the highest tertile group with OR of 2.71 (95% CI 1.14–6.43), only after the addition of calorie intake. Adiposity assessed by PBF was only associated with Na:K ratio among boys with OR of 4.47 (95% CI 1.44–9.87) and 3.87 (95% CI 1.20–8.48), after adjusting for SSBs consumption and calorie intake, respectively. Conclusion: Our findings suggest that reducing Na and increasing K intake could be used as a useful approach to lower the risk of obesity and associated burden of disease in Iran. However, more studies are warranted. [ABSTRACT FROM AUTHOR]

Purpose: It is often reported that Na intake levels are higher in Japan than in western countries. Detailed analysis of food intake and its association with Na intake are necessary for supporting further decreases in Na consumption in Japan. We investigated the association between Na and food intake by food group using data from the Japanese participants of the INTERMAP Study. Method: Results from the Japanese participants of the INTERMAP Study who did not use antihypertensive medication and/or consume a reduced Na diet were used (531 men and 518 women, aged 40-59 years), obtained from four 24-h dietary recalls and two 24-h urine collections from each participant. We developed a classification system with 46 food group classifications; food consumption and Na intake from these groups were compared across quartiles of participants determined by 24-h urinary Na excretion per unit of body weight (UNa/BW). Results: Average daily Na intake from Japanese high-Na foods was 2552 mg/day. Participants with a higher UNa/BW consumed a significantly greater amount of high-Na Japanese foods, such as salted fish ( P = 0.001) and miso soup ( P < 0.001). They also had greater amount of rice ( P = 0.001). Participants with lower UNa/BW consumed a significantly greater amount of western foods, such as bread ( P < 0.001) and milk and dairy products ( P < 0.001). Conclusions: Detailed analyses of various Japanese and western food intakes in addition to Na intake were performed. These results can be used to help draw up effective programs for the reduction in Na intake and prevention of prehypertension/hypertension in the Japanese population. [ABSTRACT FROM AUTHOR]

Purpose: A biomarker for dietary flavonoid intake from fruit and vegetables (FlavFV) is needed to elucidate the relevance of flavonoids from these sources for the prevention of chronic diseases. Urinary hippuric acid (HA)-a major metabolite of flavonoids-is promising in this respect as it was shown to satisfyingly indicate fruit and vegetable consumption in different age groups. Therefore, we validated urinary HA as a biomarker for intake of FlavFV. Methods: Analyses included data from 287 healthy adolescents of the DONALD Study (aged 9-16 years) for whom a minimum of two pairs of HA measurements from 24-h urine samples (test method) and FlavFV intake estimated from 3-day weighed dietary records (reference method) existed. Agreement between both methods was assessed by Spearman correlation and cross-classification analyses. Possible confounders of the association were identified by linear regression models. Analyses were performed using a split-sample approach allowing for consecutive exploration ( n = 192) and confirmation ( n = 95) of results. Results: Agreement between urinary HA excretion and FlavFV intake was moderate according to correlation analysis in the exploratory sample ( r = 0.47, P < 0.0001). Yet, 79 % of the subjects were classified into same/adjacent quartiles, and only 5 % were misclassified into opposite quartiles. These findings were corroborated by analyses in the confirmatory sample ( r = 0.64; 88 % in same/adjacent vs. 4 % in opposite quartiles). Body surface area (BSA) was the only relevant covariate in the exploratory sample, and its adjustment improved cross-classification estimates in both subsamples. Conclusions: BSA-adjusted 24-h urinary HA excretion represents a suitable biomarker of habitual FlavFV intake in healthy adolescents. [ABSTRACT FROM AUTHOR]