Espen Kolstad Heen

• Heen, Espen Kolstad; Romøren, Maria; Yassin, Amal A & Madar, Ahmed Ali (2021). Household Water is the Main Source of Iodine Consumption Among Women in Hargeisa, Somaliland: A Cross-Sectional Study. Journal of Nutrition. ISSN 0022-3166. doi: 10.1093/jn/nxab377. Show summary

  Background: Iodine status surveys of women in Somaliland present widely conflicting results. Previous research indicates elevated concentrations of iodine (IQR 18-72 µg/L) in groundwater used for drinking and cooking, but the relationship with iodine intake is not characterized well. Objective: We aimed to investigate the contribution of household water iodine concentration (WIC), breastfeeding, total fluid intake, hydration levels, and urine volume on urinary iodine concentration and excretion (UIC, UIE) during 24 hours, and to define iodine status from iodine intake estimates and median UIC, normalized to a mean urine volume of 1.38L/day (hydration-adjusted). Methods: The study sample comprised 118 nonpregnant, healthy women aged 15-69. All resided in Hargeisa; 27 breastfeeding. Data collection consisted of a 24-hour (24-h) urine collection, a 24-h fluid intake diary, a beverage frequency questionnaire, and a structured recall interview. We measured UIC and WIC in all urine and in 49 household-water samples using the Sandell-Kolthoff reaction. Results: WIC ranged between 3 and 188 μg/L, with significant median differences across the water sources and city districts (P

• Heen, Espen Kolstad; Madar, Ahmed Ali; Yassin, Amal A & Romøren, Maria (2021). Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study. Journal of Nutritional Science (JNS). ISSN 2048-6790. doi: 10.1017/jns.2021.54. Show summary

  The study objective was to measure fluid intake and associations with background characteristics and hydration biomarkers in healthy, free-living, non-pregnant women aged 15–69 years from Hargeisa city. We also wanted to estimate the proportion of euhydrated participants and corresponding biomarker cut-off values. Data from 136 women, collected through diaries and questionnaires, 24h urine samples and anthropometric measurements, were obtained with a cross-sectional, purposeful sampling from fifty-two school and health clusters, representing approximately 2250 women. The mean (95 % CI) 24 h total fluid intake (TFI) for all women was 2⋅04 (1⋅88, 2⋅20) litres. In multivariate regression with weight, age, parity and a chronic health problem, only weight remained a predictor (P 0.034, B 0.0156 (l/kg)). Pure water, Somali tea and juice from powder and syrup represented 49⋅3, 24⋅6 and 11⋅7 % of TFI throughout the year, respectively. Mean (95 % CI) 24 h urine volume (Uvol) was 1⋅28 (1⋅17, 1⋅39) litres. TFI correlated strongly with 24 h urine units (r 0.67) and Uvol (r 0.59). Approximately 40 % of the women showed inadequate hydration, using a threshold of urine specific gravity (Usg) of 1⋅013 and urine colour (Ucol) of 4. Five percent had Usg > 1⋅020 and concomitant Ucol > 6, indicating dehydration. TFI lower cut-offs for euhydrated, non-breast-feeding women were 1⋅77 litres and for breast-feeding, 2⋅13 litres. Euhydration cut-off for Uvol was 0⋅95 litre, equalling 9⋅2 urine units. With the knowledge of adverse health effects of habitual hypohydration, Somaliland women should be encouraged to a higher fluid intake.

• Madar, Ahmed Ali; Heen, Espen Kolstad; Hopstock, Laila Arnesdatter; Carlsen, Monica Hauger & Meyer, Haakon E (2020). Iodine intake in Norwegian women and men: The population-based Tromsø Study 2015–2016. Nutrients. ISSN 2072-6643. 12(11), p. 1–13. doi: 10.3390/nu12113246. Full text in Research Archive
• Heen, Espen Kolstad & Madar, Ahmed Ali (2020). Bottled Water from National Manufacturers in Somaliland: Water Quality and Health Implications. ScienceOpen. ISSN 2199-1006. doi: 10.14293/S2199-1006.1.SOR-.PPRWQPU.v1.
• Lundeby, Karen Marie; Heen, Espen Kolstad; Mosa, Mohammed; Abdi, Abdirashid & Størdal, Ketil (2020). Neonatal morbidity and mortality in Hargeisa, Somaliland: An observational, hospital based study. Pan African Medical Journal. ISSN 1937-8688. 37(3). doi: 10.11604/pamj.2020.37.3.24741. Full text in Research Archive
• Madar, Ahmed Ali; Meltzer, Helle Margrete; Heen, Espen K & Meyer, Haakon E (2018). Iodine Status among Somali Immigrants in Norway. Nutrients. ISSN 2072-6643. 10(3). doi: 10.3390/nu10030305. Full text in Research Archive

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• Heen, Espen Kolstad & Engelsen, Thea Cecilie (2022). We need to rethink the methodology of assessing and supplementing iodine to large population groups. sciencenorway.no.

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