Iodine intakes in the United States have declined over the past 30 years [33], partly because of changes in the production of bread and milk. In addition, reliance on processed food has increased and food processors frequently use non-iodized salt [34]. The iodine content of most fruits, nuts, and vegetables is low, but can vary depending on soil iodine content, irrigation, and fertilization practices [35].

Vegetarians who do not use iodized salt may be at increased risk of developing iodine deficiency because, in general, plant-based diets are relatively low in iodine [36-39]. This is of special concern in pregnancy because of the effects of iodine deficiency on the developing brain [27].

Use of iodized salt (0.75 teaspoon) in cooking and at the table will provide enough iodine to meet the iodine RDA for pregnancy of 220 mcg/day. Other alternatives include iodine supplements and sea vegetables. Some, but not all prenatal supplements contain iodine. Sea vegetables like nori and hiziki can provide iodine but their iodine content is quite variable [40]. Excessive maternal iodine (2,300-3,200 mcg/day) from sea vegetables has been linked to hypothyroidism in newborn infants in Japan [41] and to postpartum thyroiditis in China [42].

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