Max Haldimann
Federal Department of Home Affairs
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The Journal of Clinical Endocrinology and Metabolism | 2010
Maria Andersson; Isabelle Aeberli; Nadja Wüst; Alberta M. Piacenza; Tamara Bucher; Isabelle Henschen; Max Haldimann; Michael B. Zimmermann
BACKGROUNDnIf children and pregnant women in the population are iodine sufficient, it is generally assumed infants are also sufficient. But weaning infants may be at risk of iodine deficiency because iodized salt contributes little dietary iodine during this period. To fill this gap, iodine fortification of infant formula milk (IFM) and complementary foods (CF) is likely important.nnnOBJECTIVESnThe objective of the study was to first confirm that Swiss school children and pregnant women remain iodine sufficient and then to assess iodine status in infancy and the relative contribution of breast milk and IFM/CF to their iodine intakes.nnnMETHODSnWe measured urinary iodine concentrations (UIC) in national cross-sectional samples of: 1) pregnant women (n=648); 2) school children (n=916); 3) infants at three time points: at 3-4 d after birth and at 6 and 12 months (n=875); and 4) breast-feeding mothers (n=507). We measured breast milk iodine concentrations in the mothers, assessed iodine sources in infant diets, and analyzed iodine content of commercial IFM/CFs (n=22) and salt samples from the school childrens households (n=266).nnnRESULTSnMedian (m) UICs in pregnant women (162 μg/liter) and school children (120 μg/liter) were sufficient, and 80% of the household salt was adequately iodized (≥15 ppm). However, mUICs in infants not receiving IFM/CF were not sufficient: 1) mUIC in breast-fed infants (82 μg/liter) was lower than in non-breast-fed infants (105 μg/liter) (P<0.001) and 2) mUIC in breast-fed weaning infants not receiving IFM/CF (70 μg/liter) was lower than infants receiving IFM (109 μg/liter) (P<0.01). mUIC was low in lactating mothers (67 μg/liter) and median breast milk iodine concentration was 49 μg/kg.nnnCONCLUSIONSnIn countries in which iodized salt programs supply sufficient iodine to older children and pregnant women, weaning infants, particularly those not receiving iodine-containing IFM, may be at risk of inadequate iodine intakes.
The Lancet Diabetes & Endocrinology | 2014
Raschida Bouhouch; Sabir Bouhouch; Mohamed Cherkaoui; Abdelmounaim Aboussad; Sara Stinca; Max Haldimann; Maria Andersson; Michael B. Zimmermann
BACKGROUNDnIodine deficiency in infants can damage the developing brain and increase mortality. Present recommendations state that oral iodised oil should be given to breastfeeding mothers to correct iodine deficiency in infancy when iodised salt is not available, and that direct supplementation should be given to infants who are not being breastfed or receiving iodine-fortified complimentary foods. However, there is little evidence for these recommendations. We aimed to assess the safety and efficacy of direct versus indirect supplementation of the infant.nnnMETHODSnWe did this double blind, randomised, placebo-controlled trial in Morocco. Healthy breastfeeding mothers and their term newborn babies (aged ≤8 weeks) were block randomised by clinic day to receive either: one dose of 400 mg iodine to the mother and placebo to the infant (indirect infant supplementation), or one dose of about 100 mg iodine to the infant and placebo to the mother (direct infant supplementation). Randomisation was masked to participants and investigators. Coprimary outcomes were: maternal and infant urinary iodine concentrations, breastmilk iodine concentration, maternal and infant thyroid-stimulating hormone (TSH) concentrations, maternal and infant thyroxine (T4) concentrations, and infant growth. These outcomes were measured at baseline, and when infants were aged about 3 months, 6 months, and 9 months, and the two groups were compared using mixed effects models. This study is registered with ClinicalTrials.gov, number NCT01126125.nnnFINDINGSnWe recruited 241 mother-infant pairs between Feb 25, and Aug 10, 2010, and completed data collection by Aug 6, 2011. At baseline, median urinary iodine concentration was 35 μg/L (IQR 29-40) in mothers and 73 μg/L (29-237) in infants, suggesting iodine deficiency. During the study, maternal urinary iodine concentration (p=0.011), breastmilk iodine concentration (p<0.0001), and infant urinary iodine concentration (p=0.042) were higher in the indirect infant supplementation group than in the direct supplementation group. Maternal TSH (p=0.276) and T4 (p=0.074) concentrations did not differ between the groups over the course of the study, nor did infant TSH (p=0.597) and T4 (p=0.184) concentrations, but the number of infants with thyroid hypofunction was lower (p=0.023) in the indirect supplementation group than the direct supplementation group. The infant groups did not differ in anthropomorphic measures, except that length-for-age Z score was slightly greater in the direct infant supplementation group (p=0.032). At 3 months and 6 months of age, median infant urinary iodine concentration in the indirect infant supplementation group was sufficient (>100 μg/L), whereas infant urinary iodine concentration was sufficient only at 6 months in the direct supplementation group. There were no serious adverse events in either group.nnnINTERPRETATIONnIn regions of moderate-to-severe iodine deficiency without effective salt iodisation, lactating women who receive one dose of 400 mg iodine as oral iodised oil soon after delivery can provide adequate iodine to their infants through breastmilk for at least 6 months, enabling the infants to achieve euthyroidism. Direct supplementation is less effective in improving infant iodine status.nnnFUNDINGnETH Zurich, Switzerland; the Medicor Foundation, Vaduz, Lichtenstein.
Journal of Trace Elements in Medicine and Biology | 2008
Judith Burri; Max Haldimann; Vincent Dudler
A monitoring study of serum selenium concentration was carried out on healthy blood donors from different regions of Switzerland. With an overall mean serum concentration of 98 microg/L (n=1847), the selenium status of the healthy adults can be assessed as adequate. The lowest measured concentration of 62 microg/L denotes that the risk of a marginal selenium deficiency in the Swiss population is small. Compared to a similar study carried out in 1993, the status improved for both genders, although the increase is higher among women. It is noteworthy that the supplementation practice has increased during this period with ca. 2% of the population taking Se-micronutrients. No correlation between the age and the serum concentration is detected, even though the age-range was enlarged in this study to 18-68 years for the women and to 19-72 years for the men. The place of residence only marginally influences the selenium concentration, which implies a certain uniformity of the dietary habits between the various regions of the country.
Food Additives and Contaminants Part A-chemistry Analysis Control Exposure & Risk Assessment | 2007
Max Haldimann; A. Blanc; Vincent Dudler
Antimony residues, a result of the use of a polycondensation catalyst in the production of polyethylene terephthalate (PET) oven-proof trays, were analysed in ready-to-eat meals. The toxicity of antimony has raised concerns about consumer safety; therefore, the migration of small fractions of these residues into ready meals and foods as a result of cooking directly in the PET trays was studied. A straightforward approach of measuring real samples was selected to obtain accurate exposure data. Background antimony concentration was determined separately from a series of lunch meals, which ranged from not detectable to 3.4u2009µgu2009kg−1. Microwave and conventional oven-cooking caused a distinct increase in the concentration of antimony in food and ready meals of 0–17 and 8–38u2009µgu2009kg−1, respectively, depending, to a certain extent, on the industrial preparations. The migrated quantities of antimony corresponded to 3–13u2009µg. For comparison, PET roasting bags and ready-made dough products in PET baking dishes were also evaluated. About half of the products prepared at a temperature of 180°C exceeded the specific migration limit set for food contact material by the European Commission. However, the migrated amounts of antimony relative to the accepted tolerable daily intake (TDI) show that exposure from this type of food is currently not of toxicological concern.
Thyroid | 2016
Susanne Dold; Jeannine Baumgartner; Christophe Zeder; Adam Krzystek; Jennifer Osei; Max Haldimann; Michael B. Zimmermann; Maria Andersson
BACKGROUNDnBreast milk iodine concentration (BMIC) may be an indicator of iodine status during lactation, but there are few data comparing different analytical methods or timing of sampling. The aims of this study were: (i) to optimize a new inductively coupled plasma mass spectrometry (ICP-MS) method; and (ii) to evaluate the effect of analytical method and timing of within-feed sample collection on BMIC.nnnMETHODSnThe colorimetric Sandell-Kolthoff method was evaluated with (a) or without (b) alkaline ashing, and ICP-MS was evaluated using a new (129)I isotope ratio approach including Tellurium (Te) for mass bias correction (c) or external standard curve (d). From iodine-sufficient lactating women (nu2009=u200997), three samples were collected within one breast-feeding session (fore-, mid-, and hind-feed samples) and BMIC was analyzed using (c) and (d).nnnRESULTSnIodine recovery from NIST SRM1549a whole milk powder for methods (a)-(d) was 67%, 24%, 105%, and 102%, respectively. Intra- and inter-assay coefficients of variation for ICP-MS comparing (c) and (d) were 1.3% versus 5.6% (pu2009=u20090.04) and 1.1% versus 2.4% (pu2009=u20090.33). The limit of detection (LOD) was lower for (c) (0.26u2009μg/kg) than it was for (d) (2.54u2009μg/kg; pu2009=u20090.02). Using (c), the median [95% confidence interval (CI) obtained by bootstrap] BMIC (μg/kg) in foremilk (179 [CI 161-206]) and in mid-feed milk (184 [CI 160-220]) were not significantly different (pu2009=u20090.017), but were higher than in hindmilk (175 [CI 153-216]; pu2009<u20090.001). In foremilk using (d), BMIC was 199 ([CI 182-257]; pu2009<u20090.001 vs. (c)). The variation in BMIC comparing (c) and (d) (13%) was greater than variation within feeding (5%; pu2009<u20090.001).nnnCONCLUSIONSnBecause of poor recoveries, (a) and (b) should not be used to measure BMIC. Compared with (d), (c) has the advantages of higher precision and a lower LOD. In iodine-sufficient women, BMIC shows low variation within a breast-feeding session, so timing of sampling is not a major determinant of BMIC.
Public Health Nutrition | 2015
Max Haldimann; Murielle Bochud; Michel Burnier; Fred Paccaud; Vincent Dudler
OBJECTIVEnTo assess the iodine status of Swiss population groups and to evaluate the influence of iodized salt as a vector for iodine fortification.nnnDESIGNnThe relationship between 24 h urinary iodine and Na excretions was assessed in the general population after correcting for confounders. Single-day intakes were estimated assuming that 92 % of dietary iodine was excreted in 24 h urine. Usual intake distributions were derived for male and female population groups after adjustment for within-subject variability. The estimated average requirement (EAR) cut-point method was applied as guidance to assess the inadequacy of the iodine supply.nnnSETTINGnPublic health strategies to reduce the dietary salt intake in the general population may affect its iodine supply.nnnSUBJECTSnThe study population (1481 volunteers, aged ≥15 years) was randomly selected from three different linguistic regions of Switzerland.nnnRESULTSnThe 24 h urine samples from 1420 participants were determined to be properly collected. Mean iodine intakes obtained for men (n 705) and women (n 715) were 179 (sd 68.1) µg/d and 138 (sd 57.8) µg/d, respectively. Urinary Na and Ca, and BMI were significantly and positively associated with higher iodine intake, as were men and non-smokers. Fifty-four per cent of the total iodine intake originated from iodized salt. The prevalence of inadequate iodine intake as estimated by the EAR cut-point method was 2 % for men and 14 % for women.nnnCONCLUSIONSnThe estimated prevalence of inadequate iodine intake was within the optimal target range of 2-3 % for men, but not for women.
Food Additives and Contaminants Part A-chemistry Analysis Control Exposure & Risk Assessment | 2010
Judith Jenny-Burri; Max Haldimann; Vincent Dudler
The selenium concentration in foods was analysed in order to identify principal sources of this trace element in Switzerland. Selenium intake estimations based on three different approaches were carried out. From the relationship between intake and serum/plasma concentration, the selenium intake was estimated to 66 µg day−1. The second approach based on measured food groups combined with consumption statistics; and the third approach consisted of duplicate meal samples. With the last two methods, over 75% of the serum/plasma based intake was confirmed. Swiss pasta made of North American durum wheat was the food with the highest contribution to the dietary intake, followed by meat. The strong decrease in imports of selenium-rich North American wheat of the last years was not reflected in the present intake estimations. It appears that this intake loss was compensated by a consumption increase of other foods. Compared with former intake estimations, selenium intake seems to be in Switzerland nearly constant for the last 25 years.
Food Additives and Contaminants Part A-chemistry Analysis Control Exposure & Risk Assessment | 2015
Judith Jenny-Burri; Max Haldimann; Beat Brüschweiler; Murielle Bochud; Michel Burnier; Fred Paccaud; Vincent Dudler
Urinary cadmium (Cd) excretion was measured within a representative Swiss collective. With a median of 0.23 µg/24 h (n = 1409) and the 95th percentile at 0.81 µg/24 h, no increased health risk for the general non-exposed population was identified. The independent variables Age, BMI and Smoking habit had a significant effect on urinary Cd excretion. No association was found with the region of residence and sex. A subsample comparison between 24-h and spot urines of the same subjects (n = 90) did not reveal an evident concentration difference for both creatinine-adjusted sample types. Dependencies on age and gender were observed for creatinine, which consequently impacts on the creatinine normalisation of urine samples.
Journal of Trace Elements in Medicine and Biology | 2018
Barbara Walther; Daniel Wechsler; Patrick Schlegel; Max Haldimann
The iodine content in milk depends on various factors, including the season, production system, and location of milk production. The aim of this study was 1) to obtain data on the iodine concentration of conventional and organically produced milk and according to seasons; 2) to compare these actual data with previous measurement data; 3) to study the influence of UHT treatment on the iodine content and 4) to estimate the contribution of organic and conventional milk to the consumers iodine intake. A total of 110 samples of conventional and organic ultra-heat treated (UHT) whole milk were collected in the period between 1 May 2013 and 30 April 2014 from two large-scale companies, processing milk from two regions in Switzerland. The iodine concentration in organic milk (average 71u202f±u202f25u202fμg/l) was significantly lower than in conventional milk (average 111u202f±u202f26u202fμg/l) and varied between suppliers. Milk iodine concentration varied according to the month of collection in organic and conventionally produced milk, with lowest values between August and October (organic milk 42u202fμg/l; conventional milk 75u202fμg/l) and highest values in January (organic milk 99u202fμg/l; conventional milk 145u202fμg/l). Heat treatment did not influence iodine concentration. Since milk and dairy products are significant source of food-related iodine intake in Switzerland, consumers who prefer organic milk and dairy products are likely to have an inferior iodine status.
The Journal of Clinical Endocrinology and Metabolism | 2018
Murielle Bochud; Judith Jenny-Burri; Menno Pruijm; Belen Ponte; Idris Guessous; Georg B. Ehret; Dusan Petrovic; Vincent Dudler; Max Haldimann; Geneviève Escher; Bernhard Dick; Markus G. Mohaupt; Fred Paccaud; Michel Burnier; Antoinette Pechère-Bertschi; Pierre Yves Martin; Bruno Vogt; Daniel Ackermann
ContextnUrinary cadmium (Cd) excretion is associated with cancer and cardiovascular morbidity. A potential mechanism could be disturbance of steroidogenesis in gonads and adrenal glands.nnnObjectivenWe tested whether urinary excretion of Cd is correlated with that of cortico- and sex steroid metabolites in the general adult population.nnnSettingnThe Swiss Kidney Project on Genes in Hypertension is a multicentric, family-based population study.nnnMeasuresnUrinary excretions of steroid hormone metabolites and Cd were measured with separate day and night collections. Associations were analyzed by mixed linear models.nnnResultsnUrinary Cd and testosterone excretions in men were significantly correlated (respective day and night β values [standard error (SE)], 1.378 [0.242], P < 0.0005; and 1.440 [0.333], P < 0.0005), but not in women [0.333(0.257), P = 0.2; and 0.674 (0.361), P = 0.06]. Urinary Cd and cortisol excretions were positively associated in both sexes [day: β = 0.475 (SE, 0.157), P = 0.0025, and 0.877 (SE, 0.194), P < 0.0005, respectively; night: β = 0.875 (SE, 0.253), P < 0.0005 and 1.183 (SE, 0.277), P = 0.00002, respectively]. Cd excretion was correlated with mineralocorticoid metabolites excretion, except tetrahydroaldosterone, in both sexes (P < 0.01). There was an independent effect of Cd on sex hormone and corticosteroid synthesis and an interdependent effect on gluco- and mineralcorticoid production.nnnConclusionnOur findings provide evidence for a global stimulating effect on steroid synthesis already at low-dose Cd exposure. These findings might explain the association of Cd with diseases such as steroid-sensitive cancers or metabolic disorders.