scholarly journals Memories of the future

2020 ◽  
Vol 15 (3) ◽  
pp. 90-95
Author(s):  
Gregory A. Gerasimov
Keyword(s):  
Public Health ◽  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Iodine Intake ◽  
Successful Implementation ◽  
Bakery Products ◽  
Medium Term ◽  
Short Term ◽  
Salt Iodization ◽  
Supply Optimization

With bated breath we follow the fate of the long-suffering law On the prevention of diseases caused by iodine deficiency. What can be expected in terms of improving public health after the adoption and successful implementation of this bill, which provides for the enrichment with iodine of edible salt of extra, higher and first varieties, grinding No. 0 and No. 1? In addition, in the production of bakery products, the recipe of which contains edible salt, the use of iodized salt will become mandatory. According to the experience of many near and far countries, within 23 years from the start of the program of mandatory salt iodization, one can expect a significant (at times) reduction in the incidence of endemic goiter. This trend will not exhaust itself in subsequent years. In the medium term (after about 10 years), a decrease (by half or more) in the incidence of thyrotoxicosis can also be expected in Russia. However, in the short term (57 years), a transient increase in the incidence of thyrotoxicosis in people over 60 years of age is possible, which can be considered a kind of payment for the previous iodine deficiency. The trend towards an increase in the incidence of subclinical and, possibly, manifest hypothyroidism may continue, but this will not be a consequence of an increase in iodine supply. Optimization of iodine intake against the background of mandatory salt iodization should reduce the frequency of transient disorders of thyroid function in newborns and, possibly, congenital hypothyroidism.

scholarly journals Endemic Goiter and Iodine Prophylaxis in Calabria, a Region of Southern Italy: Past and Present

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2428 ◽  
Author(s):  
Giordano ◽  
Barone ◽  
Marsico ◽  
Bruno ◽  
Bonofiglio ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Public Health Problem ◽  
Iodine Intake ◽  
Important Public Health Problem ◽  
Hormone Synthesis ◽  
Iodine Prophylaxis ◽  
Salt Iodization ◽  
Italian Law ◽  
Epidemiological Surveys

Iodine, a micronutrient that plays a pivotal role in thyroid hormone synthesis, is essential for proper health at all life stages. Indeed, an insufficient iodine intake may determine a thyroid dysfunction also with goiter, or it may be associated to clinical features such as stunted growth and mental retardation, referred as iodine deficiency disorders (IDDs). Iodine deficiency still remains an important public health problem in many countries, including Italy. The effective strategy for the prevention and control of IDDs is universal salt iodization, which was implemented in Italy in 2005 as a nationwide program adopted after the approval of an Italian law. Despite an improvement in the iodine intake, many regions in Italy are still characterized by mild iodine deficiency. In this review, we provide an overview of the historical evolution of the iodine status in the Calabria region, located in the South of Italy, during the past three decades. In particular, we have retraced an itinerary from the first epidemiological surveys at the end of the 1980s to the establishment of the Regional Observatory of Endemic Goiter and Iodine Prophylaxis, which represents an efficient model for the surveillance of IDDs and monitoring the efficacy of iodine prophylaxis.

scholarly journals Iodine Content of Salt Use after Years of Universal Iodization Policy and Knowledge on Iodized Salt among Households in the Sissala East Municipality in Upper West Region of Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Prince Kubi Appiah ◽  
Clement Tiimim Yanbom ◽  
Martin Amogre Ayanore ◽  
Alex Bapula
Keyword(s):  
Public Health ◽  
Iodine Deficiency ◽  
Educational Level ◽  
Great Influence ◽  
Iodine Content ◽  
The Body ◽  
Iodized Salt ◽  
Health Concern ◽  
Good Knowledge ◽  
Salt Iodization

Background. Iodine deficiency is a global public health concern as it leads to inadequate production of thyroid hormone in the body, causing too many destructive consequences on the roles and functions of different human organs and muscles including brain growth and can manifest into many damaging effects such as intestinal cerebral impedance, cancer of intestine, breast disorders, and physical deformities like goitre and cretinism to one’s body. Despite all these negative effects, there are several important public health programs including universal salt iodization (USI) to improve on households’ iodine intake, notwithstanding this, countless families are still eating foods containing less iodine or no iodine at all. Hence, this study examined the intake of iodized salt after years of universal salt iodization and the knowledge on iodized salt among households in the Sissala East Municipality. Method. A descriptive cross-sectional study was adopted to collect data for the study. Data were collected from women in charge of household meal preparation using a semistructured questionnaire and rapid field iodine test kits. The Statistical Package for Social Sciences (SPSS) version 20 was used for the data analysis and presented in tables and graphs. p value <0.05 was considered as statistically significant. Findings. Only 41.4% of the households have good knowledge on benefits of iodized salt and dangers associated with iodine deficiency. It was realized that the health workers (46.6%) and television were the main sources of information on iodized salt. Household salt usage with adequate (>15 ppm) levels of iodine was 44.0%; however 85.9% of the salts were stored in covered containers. The study showed significant associations between knowledge on iodized salt and educational level (p≤0.001), occupation (p=0.043), religion (p=0.027), and ethnic lineage (p=0.046). Also, the use of iodized salt showed associations with the educational level (p≤0.001), occupation (p=0.003), religion (p=0.042), and knowledge on iodized salt (p≤0.001). Conclusions. Only about 4 in 10 households were consuming salt with adequate iodine, and this coverage is very low compared with the 90% or more coverage recommended by WHO/UNICEF/ICCIDD. Having secondary and tertiary education and having good knowledge of iodized salt has a great influence on the use of iodized salt; however, with this low level of knowledge of importance of iodized salt among women responsible for house food preparations, there is the need for health professionals to intensify education and promotion on iodized salt in the area and to monitor and verify iodine content of salts produced and sold in the market all times, as the source of the salt might have contributed to the low levels of iodine in the household salt.

Epidemiology of thyroid disease and swelling

2011 ◽  
pp. 358-370 ◽  
Author(s):  
Mark P. J. Vanderpump
Keyword(s):  
Iodine Deficiency ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Daily Intake ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Thyroid Disorders ◽  
Autoimmune Thyroid ◽  
Salt Iodization

Thyroid disorders are among the most prevalent of medical conditions. Their manifestations vary considerably from area to area and are determined principally by the availability of iodine in the diet. The limitations of epidemiological studies of thyroid disorders should therefore be borne in mind when considering the purported frequency of thyroid diseases in different communities (1). Almost one-third of the world’s population live in areas of iodine deficiency and risk the consequences despite major national and international efforts to increase iodine intake, primarily through the voluntary or mandatory iodization of salt (2). The ideal dietary allowance of iodine recommended by the WHO is 150 μ‎g iodine/day, which increases to 250 μ‎g in pregnancy and 290 μ‎g when lactating. The WHO estimates that two billion people, including 285 million school-age children still have iodine deficiency, defined as a urinary iodine excretion of less than 100 μ‎g/l. This has substantial effects on growth and development and is the most common cause of preventable mental impairment worldwide. In areas where the daily iodine intake is below 50 μ‎g, goitre is usually endemic, and when the daily intake falls below 25 μ‎g, congenital hypothyroidism is seen. The prevalence of goitre in areas of severe iodine deficiency can be as high as 80%. Iodization programmes are of proven value in reducing goitre size and in preventing goitre development and cretinism in children. Goitrogens in the diet, such as thiocyanate in incompletely cooked cassava or thioglucosides in Brassica vegetables, can explain some of the differences in prevalence of endemic goitre in areas with similar degrees of iodine deficiency. Autonomy can develop in nodular goitres leading occasionally to hyperthyroidism, and iodization programmes can also induce hyperthyroidism, especially in those aged over 40 years with nodular goitres. Autoimmune thyroiditis or hypothyroidism has not been reported to complicate salt iodization programmes. Relatively little prevalence data exist for autoimmune thyroid disease in areas of iodine deficiency (3). In iodine-replete areas, most people with thyroid disorders have autoimmune disease, ranging through primary atrophic hypothyroidism, Hashimoto’s thyroiditis, to hyperthyroidism caused by Graves’ disease. Cross-sectional studies in Europe, the USA, and Japan have determined the prevalence of hyperthyroidism, hypothyroidism, and the frequency and distribution of thyroid autoantibodies in different, mainly white, communities (1, 4–6). Recent US data have revealed differences in the frequency of thyroid dysfunction and serum antithyroid antibody concentrations in different ethnic groups (6), whereas studies from Europe have revealed the influence of dietary iodine intake on the epidemiology of thyroid dysfunction (7). Studies of incidence of autoimmune thyroid disease have only been conducted in a small number of developed countries (8–11). Following a review of the available epidemiological data, the value of screening adult populations for autoimmune thyroid disease will be considered.

scholarly journals IODINE STATUS IN SCHOOL CHILDREN AND DISTRIBUTION OF IODINE, MERCURY, LEAD IN SOIL AND WATER IN THE ENDEMIC GOITER HILL AREA, PONOROGO

2021 ◽  
Vol 13 (1) ◽  
pp. 1-10
Author(s):  
Muhamad Arif Musoddaq ◽  
Taufiq Hidayat ◽  
Khimayah Khimayah
Keyword(s):  
Public Health ◽  
Heavy Metals ◽  
Iodine Deficiency ◽  
School Children ◽  
Health Problem ◽  
Public Health Problem ◽  
Water Source ◽  
Iodine Intake ◽  
Hill Area ◽  
Soil And Water

Background.  Iodine deficiency disorders (IDD) remained a public health problem. Ponorogo was an IDD endemic area with prominent cases of mental retardation. Despite the lack of iodine intake, exposure to environmental heavy metals can exacerbate the effects of iodine deficiency. Objective. To describe iodine status of school children and distribution of environmental iodine and heavy metals including mercury (Hg), lead (Pb), and cadmium (Cd) in the endemic IDD hill area of Ponorogo. Method. This research is a cross-sectional study conducted in two villages in IDD endemic areas in Ponorogo, namely Dayakan and Watubonang villages, in 2011. A total of 127 urine samples of primary-school-age children were taken and analyzed for urinary iodine excretion (UIE). A total of 29 soil samples and 87 water samples were taken from the study site to measure the concentration of iodine and heavy metals Hg, Pb, and Cd. Types of water source, altitude, and land use, both soil and water source were recorded.  Results. The median (min-max) UIE was 130 (14 –1187 µg/L) within the range of adequate population iodine intake according to WHO (100-199 µg/L), while the percentage of UIE <100 µg/L was still around 33.07 percent. The concentration of iodine in the soil was 33.777 mg/kg (6.640 –108.809), and the concentration of iodine in the water was 8.0 µg/L (0-49). The concentration of Hg in the soil was 68.64 ppb (7.43–562.05), and the concentration of Hg in the water was 0.00 ppb (0.00-23.24).  The concentration of Pb in the soil was 3.273 ppm (0.000–25.227), while Pb was not identified in the water. The Cadmium was not detectable both in the soil and water. Conclusion. Iodine deficiency is still a public health problem in Dayakan and Watubonang villages. The environment of the endemic IDD area in Ponorogo was not completely poor in iodine, but iodine was not evenly spread and mobilized. There was a risk of environmental heavy metal exposure from Hg in the soil or water and Pb in the soil. Mercury in the environment can cause health problems due to the inhibition of the use of iodine in the thyroid gland.

Assessment of iodine intake and deficiency in school-age children in Morocco

2018 ◽  
Vol 48 (6) ◽  
pp. 873-885
Author(s):  
Naima Saeid ◽  
Anass Rami ◽  
Samir Mounach ◽  
Abdeslam Hamrani ◽  
Asmaa El Hamdouchi ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
School Age Children ◽  
School Age ◽  
Content Type ◽  
Iodine Status ◽  
School Aged Children ◽  
Salt Iodization ◽  
Significant Difference

Purpose Iodine deficiency has several adverse effects on human growth and development and it is categorized collectively as iodine deficiency disorders (IDDs). Recent estimations showed that 29.8 per cent of school-age children have insufficient iodine intake. Salt iodization is widely accepted as the best method for increasing iodine intake. In 1995, Morocco adopted the universal salt iodization strategy to reduce iodine deficiency and consequently prevent and control IDDs. This study aims to determine the benefit of this strategy on schoolchildren and adolescent by assessing iodine intake and evaluating iodine deficiency. Design/methodology/approach This transversal study was conducted on 131 children and adolescents. Iodine intake was assessed using a food frequency questionnaire. Iodine status was evaluated on 24-h urine samples and the creatinine excretion was used to validate completeness of urine collection. Findings The medians of urinary iodine excretion and concentration were 77 µg/day and 96 µg/L, respectively. Overall, 72.5 per cent are deficient, so mild and moderate iodine deficiencies were reported in 58 per cent and 14.5 per cent, respectively, and no child exhibited severe deficiency. A significant difference was reported between iodine deficiency and, sex and age; iodine deficiency was more pronounced in boys and children under eight years. In this study, iodine status in deficient children does not change with the consumption pattern of dairy products and eggs, and results showed no significant association (p > 0.05). However, fish consumption was significantly associated to urinary iodine concentration = 100 µg/L (p = 0.044). Average UIC in school-aged children is still inadequate and consumption of foods high in iodine remains very insufficient. Therefore, additional efforts must focus on nutritional education of Moroccan school-aged children. Originality/value In the author’s knowledge, this is the first study evaluating schoolchildren iodine status by 24-h iodine collection; the study reported association of iodine deficiency with dietary habit concerning sources of food rich on iodine.

scholarly journals Gangguan Akibat Kekurangan Iodium di Indonesia: Tinjauan Epidemiologis dan Kebijakan Kesehatan

2009 ◽  
Vol 4 (2) ◽  
pp. 71 ◽  
Author(s):  
Laurentius Aswin Pramono
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Iodine Deficiency ◽  
Control Program ◽  
National Health Survey ◽  
Iodine Deficiency Disorders ◽  
Important Public Health ◽  
Salt Iodization ◽  
The World ◽  
Health Experts

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Padamasa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi ter-hadap permasalahan GAKI di Indonesia masih rendah. Demikian pula, publikasi ilmiah yang mengkaji GAKI dari sudut pandang epidemiologi dan aplikasinya bagi kebijakan kesehatan. Artikel ini diharapkan dapat memberi gambaran dan perspektif epidemiologi yang luas bagi para klinisi dan ahli kesehatan masyarakat.Kata kunci: GAKI (Gangguan Akibat Kekurangan Iodium), penanggulangan, epidemiologi, kebijakan kesehatan.AbstractIDD (Iodine Deficiency Disorders) is the most common cause of preventable mental retardation in the world. Nowadays, IDD still one of the most important public health problems in Indonesia. Up to now, Indonesia has not yet reached the target of IDD elimination as expected. National IDD Survey at 2003 and National Health Survey at 2007 show the achievement of IDD control program in Indonesia is still below the target of Universal Salt Idozation and Indonesia Health 2010 (RAN KPP GAKI strategy). Cross-sectoral commitment is very important for the elimination of IDD in the future. Clinicians and epidemiologist concern for IDD elimination in Indonesia is still low, so does the publications in the field of IDD from epidemiology and health policy perspective. It is expec-ted that this literature review can give broad description and epidemiological perspective for clinicians and public health experts. Key words: IDD (Iodine Deficiency Disorders), control program, epidemiology, health policy.

scholarly journals Flaws of universal salt iodization programmes in nutrition transition contexts: is there a risk of a double burden of inadequate iodine intake and excess adiposity? A case study in Tunisia

2020 ◽  
Author(s):  
Radhouene DOGGUI ◽  
Myriam El Ati-Hellal ◽  
Jalila El Ati ◽  
Pierre Traissac
Keyword(s):  
Iodine Deficiency ◽  
Nutrition Transition ◽  
Iodine Intake ◽  
School Age Children ◽  
School Age ◽  
Mena Region ◽  
Double Burden ◽  
Salt Iodization ◽  
Excess Iodine ◽  
Excess Adiposity

Abstract Background In the Middle East and North Africa (MENA) region, universal salt iodization (USI) programs defaults were sometimes shown to increase the risk of iodine excess. Also, the nutrition transition which underlies the obesity epidemic in the MENA region is characterized by salt-rich diets, so that there could be a cumulative effect with respect to iodine status. We assess the within-subject co-existence of overweight and inadequate iodine intake, and associated factors.Methods A national cross-sectional study used a stratified, clustered random sample and conducted among Tunisian school-age children aged from 6 to 12 y. (n = 1560). Overweight (Ow) was body mass index (BMI)-for-age ≥ + 1z. Iodine deficiency was UIC (Urinary Iodine Content) < 100 µg/L and iodine intake above requirements (IAR) UIC ≥ 200 µg/L. Association of covariables with the within-subject double burden Ow–IAR was assessed by multinomial regression.Results The prevalences of Ow-ID or Obe-ID were marginal, but not so for excess adiposity and IAR as for example prevalence of Ow-IAR was 9.8% (95% CI:[7.7–12.3]). OW and IAR were found to co-occur independently (P = 0.29). Socio-economic patterning of Ow-IAR was mild. Nevertheless, prevalence were the lowest among children of mother with no formal schooling and in the South-East region. Beyond school-age children, we estimated that this double burden of overweight and excess iodine could concern a third of Tunisian adults (all the more for women).Conclusions Among Tunisian children, iodine deficiency coupled with excess adiposity was quite marginal. Coexistence of overweight and excess iodine may affect a tenth of these children. More data would be needed to document a possibly even higher rate among adults. Cumulative effects of unhealthy lifestyle due to the nutrition transition interacting with metabolic pathways may be involved in this potential overweight-high iodine intake double burden. In the MENA region, obesity and salt reduction policies should continue to be monitored.

scholarly journals Guidance on the monitoring of salt iodization programmes and determination of population iodine status: Russian language version

2018 ◽  
Vol 14 (2) ◽  
pp. 100-112
Keyword(s):  
Iodine Deficiency ◽  
Iodine Intake ◽  
Lessons Learned ◽  
Russian Language ◽  
Iodized Salt ◽  
School Age Children ◽  
Iodine Status ◽  
Language Version ◽  
Salt Iodization

Over the last two decades, there has been remarkable progress towards eliminating iodine deficiency (ID). While there has been remarkable success, there have been several notable changes in the way that salt iodization programs have been designed and monitored, as well as the general landscape in which salt iodization is being implemented. This article is based on the “Guidance on the monitoring of salt iodization programmes and determination of population iodine status”. It summarizes important lessons learned on how to better track the performance of and refine salt iodization programs. The adequacy of iodine intakes should be examined among different subsets of the population (not only school-aged children), especially among groups vulnerable to deficiency (such as pregnant women). The acceptable range of ‘adequate’ iodine intake among school-age children can be widened from 100–199 µg/L to 100–299 µg/L eliminating the range of 200–299 µg/L that previously indicates ‘more than adequate’ iodine intake. The interpretation of mUIC of ≥ 300 µg/L as ‘excessive iodine intake’ remains unchanged. With currently available methods, the mUIC can only be used to define population iodine status and not to quantify the proportion of the population with iodine deficiency or iodine excess. National salt iodization programmes should monitor the use of iodized salt in processed foods. If the salt contained in such foods is well iodized, it can be an important source of iodine and may help explain iodine sufficiency in settings where household iodized salt coverage is low.

scholarly journals Public health policy to redress iodine insufficiency in pregnant women may widen sociodemographic disparities

2013 ◽  
Vol 17 (6) ◽  
pp. 1421-1429 ◽  
Author(s):  
Simonette R Mallard ◽  
Lisa A Houghton
Keyword(s):  
Public Health ◽  
Health Policy ◽  
New Zealand ◽  
Public Health Policy ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Younger Women ◽  
Supplement Use ◽  
Salt Iodization ◽  
The Impact

AbstractObjectiveTo evaluate the impact of a mandatory bread fortification programme on estimated iodine intakes of childbearing women and to describe the extent to which uptake of a maternal iodine supplement recommendation is associated with sociodemographic characteristics.DesignA postpartum survey was conducted using a self-administered questionnaire. Details on pre- and post-conceptional supplement use, bread intake, iodized salt use and maternal sociodemographic and obstetric characteristics were obtained.SettingEleven maternity wards and hospitals located across New Zealand.SubjectsSeven hundred and twenty-three postpartum New Zealand women.ResultsMean iodine intake from fortified bread was 37 μg/d prior to conception. Younger women, women with higher parity, single women and those with unplanned pregnancies were less likely to meet the pregnancy Estimated Average Requirement (EAR) for iodine (all P ≤ 0·022). Although not statistically significant for all months of pregnancy, women with less education and income were less likely to meet the EAR (P ≤ 0·11 and P ≤ 0·2 for all months, respectively) and indigenous Māori women and Pacific women were less likely than New Zealand Europeans to meet the EAR (P ≤ 0·17 and P ≤ 0·051 for all months, respectively). During pregnancy, iodine-containing supplement uptake at the recommended level (150 μg/d) was non-uniform across sociodemographic subgroups, with the most disadvantaged women benefiting the least from this public health policy.ConclusionsThe disparities in supplement uptake noted here highlight the need for prioritizing further efforts towards universal salt iodization, such as the mandatory fortification of additional processed foods with iodized salt.

scholarly journals Not that simple goiter

2021 ◽  
Vol 16 (3) ◽  
pp. 4-11
Author(s):  
Gregory A. Gerasimov
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Single Case ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Urinary Iodine Concentration ◽  
The Past ◽  
Limited Scale ◽  
Main Thing

The year 2020 marks the centenary of the publication of a classic study by American physicians D. Marine and O. Kimball on the effectiveness of endemic goiter prevention in children in Akron, Ohio. Although goiter has been known from immemorial times, there is still a problem with determining the normal size of the thyroid gland, without which the diagnosis of goiter remains extremely subjective. For example, in Sweden over the past 20 years, not a single case of endemic goiter has been registered, which is not surprising: the country eliminated this pathology decades ago, and the median urinary iodine concentration indicates the optimal iodine intake. Cases of sporadic goiter in children in Sweden are also rare — no more than 6–8 per year. But in Belarus, with the same population (about 10 million), about 2900 cases of goiter in children, both endemic and sporadic, are recorded annually despite the fact that, due to the extensive use of iodized salt since the beginning of the 2000s, there is no iodine deficiency. The incidence of goiter in children, however, having decreased many times over the past 20 years, remains 3 times higher than in Russia, where iodine prophylaxis, if carried out on a limited scale. From the experience of Belarus, Sweden and Russia, we see that the main thing when assessing data on the incidence of goiter and other thyroid diseases associated with iodine deficiency should be not absolute numbers, but the trend of these indicators over the past years. This information should be more actively used by endocrinologists in Russia to assess the effectiveness of preventive measures both at the regional and federal levels.

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