Iodine Deficiency Disorder Among Filipino School Children, Pregnant and Lactating Women and the Elderly 20 Years After the Act for Salt Iodization Nationwide Law

Abstract

Background: Iodine deficiency disorder (IDD) is still a public health problem globally. In response to this, universal salt iodization (USI) has been implemented. This is the most cost-effective strategy to prevent and control it. In the Philippines, an Act for Salt Iodization Nationwide (ASIN Law) was passed in 1995, in response to the increasing goiter rates. This paper describes the prevalence and severity of IDD among Filipino school-aged children (SAC), pregnant and lactating women and the elderly, 20 years after the implementation of the ASIN Law. Methods: Casual urine samples were collected from SAC, pregnant and lactating women and elderly of 1998, 2003, 2008 and 2013, of selected households of the National Nutrition Survey (NNS). Urinary iodine (UI) levels were determined using the acid digestion method. UI levels and prevalence of IDD in the 2013 NNS were compared with those in previous NNSs. Results: Iodine nutrition among the SAC has improved from mild deficiency with a median of 71 ug/L in 1998 to 201 ug/L in 2003. It has remained “optimal” till the 2013 NNS, almost 20 years after ASIN Law. UI was 107 ug/L among the elderly in 2008, but decreased to 80 ug/L in 2013, also indicating “mild” iodine deficiency. Among the lactating women, UI was 111 ug/L in 2003, indicating iodine sufficiency, but decreased to 81 and 77 ug/L in 2008 and 2013 NNS, respectively, indicating “mild” iodine deficiency. Median UI among the pregnant women was 142, 105 and 105 ug/L, also indicating the presence of IDD for the 2003, 2008 and 2013 NNS, respectively. Conclusion: Twenty years after ASIN Law, Filipino SAC have achieved optimum iodine status while the pregnant and lactating women and the elderly remain to be iodine deficient. Strict monitoring of iodization of salt at the production site should be implemented, since iodine levels in salt have remained at levels below the standard. J Endocrinol Metab. 2017;7(3):86-93 doi: https://doi.org/10.14740/jem414w