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Iodine Status and Growth In 0–2-Year-Old Infants With Cow's Milk Protein Allergy

Thomassen, Rut Anne*; Kvammen, Janne Anita*; Eskerud, Mari Borge; Júlíusson, Pétur Benedikt; Henriksen, Christine§; Rugtveit, Jarle*

Journal of Pediatric Gastroenterology & Nutrition: May 2017 - Volume 64 - Issue 5 - p 806–811
doi: 10.1097/MPG.0000000000001434
Original Articles: Nutrition

Objectives: The aim of the present article was to investigate iodine status and growth in cow's milk protein allergic infants and to identify potential predictors of iodine status and growth.

Methods: Fifty-seven infants under 2 years of age were included in an observational cross-sectional study. Two spot urine samples were collected and analyzed for iodine, together with a 3-day food record and a food frequency questionnaire. Urine iodine concentrations were compared with the WHO cut-off values for iodine deficiency. Measurements of weight, length, and head circumference at birth and study inclusion were converted to standard deviation scores. Subgroup analyses were performed on different feeding patterns, according to weaning status.

Results: Median age was 9 months. Median urinary iodine concentration was 159 ug/L. One third of the children had urine iodine concentrations indicating iodine deficiency. Infants who were mainly breastfed were at highest risk and 58% were classified as deficient. Dietary factors positively associated with iodine excretion were intake of enriched baby cereals and meeting the dietary requirement for iodine. Stunting was present in 5%. Underweight and wasting was frequent at 11% and this was associated with food refusal and poor appetite, but not with iodine status. Growth failure was detected among boys.

Conclusions: The present study suggests that cow's milk protein allergy children have high prevalence of iodine deficiency and poor growth, however the 2 conditions were not associated. The subgroup of mainly breastfed infants was at higher risk of iodine deficiency compared to weaned infants. Subjects with feeding problems had increased risk of malnutrition.

*Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital

Department of Internal Medicine, Clinical Nutrition, Lovisenberg Diaconal Hospital, Oslo

Department of Clinical Science, University of Bergen, Bergen

§Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo.

Address correspondence and reprint requests to Rut Anne Thomassen, RD, Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Pb 4950 Nydalen, 0424 Oslo, Norway (e-mail:

Received 15 July, 2016

Accepted 5 October, 2016

The present study was supported by the UNIFOR foundation for research in asthma and related diseases at the University of Oslo.

The authors report no conflicts of interests.

© 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,