Elimination Of Iodine Deficiency Research Articles

Iodine deficiency in Russia: Current state of the problem, global practice and new approaches to therapy

Iodine performs a number of important functions in the body, participating in the synthesis of thyroid hormones, which creates the need for constant replenishment of the element in adequate amounts. Continuous monitoring of micronutrient deficiency in the Russian Federation reveals low average daily iodine intake and an increase in the number of cases of thyroid diseases in the period from 2010 to 2020. This actualizes the need to develop new therapeutic and preventive approaches to replenish iodine deficiency. The aim of the review is to analyze the problem of iodine deficiency in Russia and existing practices of its leveling in order to develop a new approach to the prevention and treatment of iodine deficiency conditions. The sample includes publications in Russian and English in the period from 2002 to 2023, using the resources of scientific metric databases Elibrary, Google Scholar, CyberLeninka, PubMed and ScienceDirect. The research work showed that the common practice of eliminating iodine deficiency is to increase the level of consumption of the trace element in the diet, the consequence of which is the availability of a wide range of iodized food supplements and products on the market. However, the analysis of the current functional nutrition sector has revealed a number of drawbacks associated with low bioavailability of the element and its resistance to technological factors in the production of food products. The article presents the key factors influencing the effectiveness of nutritional supplements being developed for nutritional correction of iodine deficiency. They are based on the evaluation of existing means of prevention. The study proposes the development of the technology of whey hydrolysates enriched with iodine and zinc. Application in food production of a food additive based on protein components of milk whey opens new opportunities for processing of secondary dairy raw materials and for full utilization of all milk components. The rich amino acid composition of the additive helps to increase the concentration of essential trace elements in products, as amino acid residues are able to bind iodine and chelate zinc.

Behavior change intervention to sustain iodide salt utilization in households in Ethiopia and study of the effect of iodine status on the growth of young children: community trial.

Monitoring systems in a broad range of countries are a notable effort to eliminate iodine deficiency disorders (IDDs). This study aimed to gather data on the amount of iodide present in table salt and how household consumption patterns affect children's iodine status and its effect on their growth. A single treatment arm community trial study design was designed. Lower community units (LCUs) were chosen at random from districts assigned either intervention or control. From a list of LCUs, 834 mothers and their paired children were chosen randomly. Urine and table salt samples were collected and examined in the national food and nutrition laboratory. The deference between arms was determined using a t test, and the generalized estimating equation (GEE) was used to forecast parameters. The mean iodide content in the table salt samples of 164 (98.1%) was 45.3 ppm and a standard deviation (SD) of 14.87, which were above or equal to the recommended parts per million (ppm). Between the baseline survey and the end-line survey, the mean urine iodine concentration (UIC) was 107.7 µg/L (+/- 8.64 SD) and 260.9 µg/L (+/- 149 SD). Children's urine iodine excretion (UIE) had inadequate iodine in 127 (15.2%) children at the beginning of the study, but only 11 (2.6%) of the intervention group still had inadequate iodine at the end. The childrens' mean height (Ht) was 83.1 cm (+/-10 SD) at baseline and 136.4 cm (+/-14 SD) at the end of the survey. Mothers knew a lot (72%) about adding iodized salt to food at the end of cooking, and 183 (21.9%) of them did so regularly and purposefully. A total of 40.5% of children in the intervention group had stunted growth at baseline, which decreased to 15.1% at the end of the study but increased in the control group to 51.1%. The mean difference (MD) of urine iodine concentration (UIC) between intervention and control groups was 97.56 µg/L, with a standard error (SE) of 9.83 (p=0.001). The end-line Ht of children in the intervention group was increased by 7.93 cm (β=7.93, p=0.005) compared to the control group. Our research has shown that mothers who embraced healthy eating habits had perceived improvements in both the iodine status and height growth of their children. In addition to managing and using iodine salt, it has also introduced options for other healthy eating habits that will also play a significant role in their children's future development. This sort of knowledge transfer intervention is essential for the sustainability of society's health. Therefore, this trial's implications revealed that the intervention group's iodine status and growth could essentially be improved while the control group continued to experience negative effects. ClinicalTrials.gov Identifier: NCT048460 1.

Iodine status of school-aged children in the changing context of universal salt iodization program during 1997–2018 in Chongqing, China

ObjectiveTo illustrate the changes of iodized salt usage, goiter rate of school-aged children and median urinary iodine concentration (MUIC) of school-aged children in Chongqing for the last 21 years. This study aims to estimate the variational provincial status of iodine nutrition and provide scientific evidence for fine-tuning and adaptation of the current program. MethodsDifferent number of families and school children aged 8–10 years from Chongqing during 1997–2018 participated in the study. UIC and iodine content in table salt were measured. Thyroid volumes of students were examined and goiter prevalence was calculated across years. ResultsThe median iodine content of table salt was negatively associated with years(r = −0.727, P < 0.01). The MUIC were decreased annually (ranged between 200 and 300 μg/L) and was negatively associated with year(r = −0.831, P < 0.01). Goiter of school-aged children in Chongqing was decreased from the highest rate of 23.58% in 1999 to 1.62% in 2018(Cochran-Armitage Trend Test: χ2=-30.695, P < 0.01). Thyroid volume were negatively associated with years(r = −0.962, P < 0.01) and had a positive relationship with MUIC 1997–2018 (r = 0.862, P < 0.01). ConclusionsThe consumption of adequately iodized salt can eliminate Iodine deficiency disorders (IDD) in children, but possible excessive iodine intake from salt could result in high urinary iodine excretion and even goiter. A systematic, well-designed and continual program monitoring is essential to ensure the adequacy of iodine fortification levels and to regularly change the iodine concentration in household table salt.

FRI491 The Impact Of Insulin Resistance On Thyroid Function In Pregnancy

Abstract Disclosure: M. Trofimiuk-Muldner: None. A.J. Nowak: None. J. Podlewski: None. A. Hubalewska-Dydejczyk: None. The influence of hyperinsulinemia on thyroid function is debatable. Insulin as an anabolic hormone may be responsible for thyroid hypertrophy and nodular development. The interplay between insulin and the function of the pituitary-thyroid axis may influence thyroid tests’ results and their interpretation. This study evaluated the association between thyroid hormones and insulin resistance in pregnant women. The study group was recruited from the Polish National Program for Elimination of Iodine Deficiency, conducted between 2007-2017. We assessed the fasting glucose, insulin levels, thyroid hormones (TSH, FT4, FT3), and ATPO antibodies in 1069 pregnant women (median age 29 years, IQR 6 years). Based on calculated HOMA-IR, participants were stratified into three subgroups HOMA1 (324 women with HOMA-IR &amp;lt; 1), HOMA 2 (570 women with HOMA-IR ≥1&amp; &amp;lt;2.5) and HOMA3 (175 women with HOMA-IR ≥ 2.5). Results: Median (IQR) TSH concentrations were 1.42 (1.33) mIU/L, 1.65 (1.31) mIU/L, and 1.77 (1.29) mIU/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) FT4 concentrations were 12.9 (3.0) pmol/L, 12.48 (2.85) pmol/L, and 11.38 (2.8) pmol/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) FT3 concentrations were 4.79 (1.75) pmol/L, 4.6 (1.02) pmol/L, and 4.47 (0.88) pmol/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. Median (IQR) aTPO concentrations were 10 (11.34) IU/L, 11.59 (8.54) IU/L, and 10.15 (7.5) mIU/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. HOMA1 and HOMA2 subgroups differed significantly in TSH (p=0.026) and FT3concentrations (p=0.001). HOMA2 and HOMA3 subgroups differed significantly in FT4 (p&amp;lt;0.001) and aTPO concentrations (p=0.045). HOMA1 and HOMA3 patients differed in TSH (p=0.001), FT4 (p&amp;lt;0.001), and FT3 (p=0.001) concentrations. aTPO-positivity was not related to HOMA-IR values (mean HOMA-IR in aTPO-positive andaTPO-negative women were 1.63 and 1.80 respectively, p=0.32). Conclusions: Insulin resistance may impact thyroid function in pregnancy independently of thyroid autoimmunity, with higher TSH and lower thyroid hormones concentrations in pregnant women with higher HOMA-IR indices. Presentation: Friday, June 16, 2023

FRI489 The Interplay Between Thyroid Nodular Disease And Insulin Resistance Indices In Pregnant Women

Abstract Disclosure: A.J. Nowak: None. M. Trofimiuk-Muldner: None. J. Podlewski: None. A. Hubalewska-Dydejczyk: None. Thyroid cells proliferation and function is regulated by TSH. Other factor, such as insulin/insulin-like growth factors (IGF), through their mitogenic effects, may affect thyroid growth and nodules formation [1].This study evaluated the interplay between insulin resistance indices and thyroid structure in pregnant women. The study group was recruited from the Polish National Program for Elimination of Iodine Deficiency, conducted between 2007-2017. We assessed the fasting glucose, insulin levels, TSH in 1069 pregnant women (median age 29 years, IQR 6 years). Thyroid ultrasound was performed in each study participant. Based on calculated HOMA-IR, pregnant women were stratified into three subgroups HOMA1 (324 women with HOMA-IR &amp;lt; 1), HOMA 2 (570 women with HOMA-IR ≥1&amp; &amp;lt;2.5) and HOMA3 (175 women with HOMA-IR ≥ 2.5). Results: Median (IQR) TSH concentrations were 1.42 (1.33) mIU/L, 1.65 (1.31) mIU/L, and 1.77 (1.29) mIU/L in HOMA1, HOMA2, and HOMA3 subgroups, respectively. The mean (±SD) thyroid volume was 12.36 (4.27) mL, 12.71 (5.37) mL, and 13.70 (4.92) mL in HOMA1, HOMA2, HOMA3 subgroups respectively.33 (10.2%) of women in HOMA1, 53 (9.3%) in HOMA2 and 11 (6.3%) in HOMA3 subgroup had at least one thyroid nodule - there was no significant difference between the subgroups (P = 0.4724)Fasting insulin &amp;gt;10 mIU/mL was found in 27.53% of pregnant women (286 out of 1039) with thyroid volume &amp;lt;25 mL, and in 36.67% women (11 out of 30) with thyroid volume ≥25mL (P=0.27). Conclusions: We have not found any significant relationship between the thyroid volume or structure and insulin or insulin resistance indices in pregnant women. 1. Kimura T., Van Keymeulen A., Golstein J., Fusco A., Dumont J.E., Roger P.P. Regulation of thyroid cell proliferation by TSH and other factors: A critical evaluation of in vitro models. Endocr. Rev. 2001;22:631–656. doi: 10.1210/edrv.22.5.0444. Presentation: Friday, June 16, 2023

The content of microelements in fruits of the oriental persimmon (Diospyros kaki) and its dietary role in remedying micronutrient deficiency in the region

The relevance of the problem under study lies in the need to develop innovative approaches to the introduction of fruit crops into the diet to avoid the loss of nutrients and thus help prevent micronutrient deficiency in the human body. In this regard, the purpose of this article is to study the content of biologically active substances in the products of promising persimmon varieties and their effect on the normal functioning of the thyroid gland. The following results were obtained during the study: soil and climatic conditions affecting the nutritional value of the agricultural product were presented. It was established that Shaki-Zagatala economic region is an iodine deficiency endemic area and belongs to the zone of moderate iodine (I) deficiency. The quantity of macro- and microelements in fruits of 20 varieties of Oriental persimmon (Diospyros kaki) bred by folk selection growing in Shaki-Zagatala economic region was studied and compared by regions; the use of persimmon plants in the food industry as a way of increasing the amount of iodine in the human body was substantiated. It has been proved that in order to eliminate iodine deficiency, it is advantageous to eat more food enriched with iodine from fruits of the Oriental persimmon (D. kaki), which is rich in microelements. The role of awareness – raising activities among the population regarding health disorders associated with iodine deficiency was revealed. The practical value of the article materials consists in obtaining detailed information about biochemical composition of Oriental persimmon fruit (D. kaki) for the purpose of iodine deficiency prevention. The technologies of processing and storage of the product in fresh and processed form to preserve the useful properties of persimmon have been proposed in order to increase the profitability of production and increase the level of sales of products in the Shaki-Zagatala economic region of Azerbaijan.

Methods for determining iodine in urine

Iodine deficiency remains a serious threat to public health worldwide, especially in children and pregnant women. Despite the apparent ease of iodine deficiency elimination with the help of a simple and highly effective strategy of compulsory salt iodization, the problem of iodine deficiency and iodine deficiency disorders remains urgent for public health in the Russian Federation. The most effective and informative way to study iodine status at population level is determination of iodine concentration in urine in epidemiological studies. This article presents a review of urinary iodine determination methods, as well as methodological recommendations for iodine determination, developed and adopted in National Medical Research Center for Endocrinology.

Sustained Elimination of Iodine Deficiency Within the Third Decade After Compulsory Iodine Supplementation Policy in the South of Iran: A Population-Based Cross-Sectional Study

ObjectivesRecently, some studies in Iran have shown mild to moderate iodine concentrations in adult and pregnant women populations despite iodine sufficiency in children. This study aimed to evaluate the urine iodine status and salt intake among adult households in the city of Sadra, Fars province in southern Iran, and to assess its possible influencing factors. MethodParticipant households for this cross-sectional study were selected using randomized cluster sampling in the city of Sadra, Fars province, southern Iran from 1 February, 2021 to 30 November, 2021. Two subjects >18 y of age from each household were invited. Ninety-two subjects (24 men, 68 women) were enrolled. The participants were asked to collect their 24 h urine. They were then examined for thyroid disorders and subjected to thyroid ultrasonography and thyroid function tests. Urine samples were tested for iodine, sodium, and creatinine concentrations. Household salt intake was also estimated. ResultsMedian urine iodine content (UIC) in the participants was 175 (IQR: 117, 250) μg/L, whereas the median salt consumption per person per day was 9.6 (IQR, 7.3-14.5) g. Sex, methods of salt storage, presence of goiter or thyroid nodules, the addition of salt in the cooking stage, and subclinical hypothyroidism had no effect on UIC, whereas individuals with hypertension and lower education had significantly lower iodine concentrations. UIC had a significant positive correlation with urine sodium and thyroid stimulating hormones (TSH) concentrations (P < 0.001, 0.046) and a negative correlation with thyroid volume and T4 (P = 0.029, 0.018). ConclusionIodine status in the adult population of Sadra city was categorized as sufficient, although the iodine concentrations reported in Tehran were insufficient. The contributing factor can be higher salt consumption or possible higher environmental iodine concentrations in Sadra city than Tehran.

The remarkable impact of iodisation programmes on global public health.

The objective of this paper is to review the global effort to eliminate iodine deficiency and its impact on public health. Iodine is an essential component of hormones produced by the thyroid gland. Iodine deficiency has multiple adverse effects in humans due to inadequate thyroid hormone production that are termed the iodine deficiency disorders. The major adverse effect is impaired cognition in children. The WHO's first estimate of the global prevalence of goitre in 1960 suggested that 20-60 % of the world's population was affected, with most of the burden in low- and middle-income countries. Iodine deficiency was identified as a key global risk factor for impaired child development where the need for intervention was urgent. This spurred a worldwide effort to eliminate iodine deficiency led by a coalition of international organisations working closely with national governments and the salt industry. In most countries, the best strategy to control iodine deficiency is carefully monitored iodisation of salt. The reach of current iodised salt programmes is remarkable: in 2018, 88 % of the global population used iodised salt. The number of countries with adequate iodine intake has nearly doubled over the past 20 years from 67 in 2003 to 118 in 2020. The resulting improvement in cognitive development and future earnings suggests a potential global economic benefit of nearly $33 billion. Iodine programmes are appealing for national governments because the health and economic consequences are high and can be easily averted by salt iodisation, a low-cost and sustainable intervention.

Mandatory Versus Voluntary Implementation of Salt Iodization Program for the Last Two Decades in Ethiopia: A Comparative Review of Existing Literatures.

Ethiopian government was implementing mandatory salt iodization program for the last decade to eliminate iodine deficiency disorders, but several recent studies reported mixed findings. This review aimed to assess the difference in implementation of iodized salt program 10 years before and after mandatory salt iodization being implemented in Ethiopia since 2011. In Ethiopia, legislation that enforces salt producers to iodize all salts used for human consumption started in February 2011. All studies about iodine deficiency and iodized salt conducted in Ethiopia in the last 2 decades were searched. Searches were performed in PubMed database. Google Scholar, Iodine Global Network, and Ethiopian Public Health Institute websites were also searched. A total of 235 titles and abstracts were identified. After scanning the abstracts and full papers, 43 articles were remained for final data synthesis. In this review, all studies conducted before 2011 reported a urinary iodine concentration (UIC) value of < 100 μg/L and 66.7% of them reported a goiter prevalence of > 30%. On the other hand, among studies conducted after 2011, 88.9% reported UIC value < 100 μg/L and 73.7% reported goiter prevalence of > 30%. Household availability of adequately iodized salt increased from nearly 20% in pre 2011 to more than 50% in post 2011 period. Despite the efforts made by the Ethiopian government on mandatory salt iodization for the last decade, iodine deficiency is sustained in the country. Moreover, the goal of universal salt iodization program is offtrack and needs urgent revision. Registered on PROSPERO register with reg. no CRD42021251124.

Elimination of iodine deficiency is a concern for the health of the nation. An excursion into the history, scientific aspects and the current state of the legal regulation of the problem in Russia

The article presents current data on the prevalence of thyroid diseases associated with iodine deficiency in Russia, focuses on the features of the comorbidity of iodine deficiency and autoimmune thyroid pathologies, methods for assessing the iodine supply of the population. Information about the study and prevention of iodine deficiency diseases (IDD) in the USSR and the Russian Federation is given. The history of legislative initiatives aimed at eliminating dietary iodine deficiency and preventing IDD is illustrated in detail. The ways of solving the problem of iodine deficiency at the present stage, both at the federal and regional levels, are proposed.

Iodine determination in mineral water using ICP-MS: Method development and analysis of brands available in Israeli stores

Reliable iodine determination in drinking water samples has gained importance in the last few decades, mostly due to intensive use of both desalinized water that lacks several important nutritional elements, and bottled mineral water. ICP-MS is a sensitive method for iodine determination that must be performed under alkaline conditions because of the volatile nature of some iodine species. However, in water samples with high pH (>10), slow precipitation of calcium (Ca) and/or magnesium (Mg) carbonates leads to clogging of the ICP-MS nebulizer. We propose preventing this precipitation by adding the chelating agent ethylenediaminetetraacetic acid (EDTA) at 0.1% to a 2% ammonium hydroxide matrix. This concentration of EDTA sufficed for most drinking water samples studied, as long as a 1:1 molar ratio of EDTA to Ca+Mg concentration in the water was maintained. The limit of quantitation of the developed method for iodine was < 0.1 µg L−1. The average iodine concentration in various brands of bottled mineral water sold in Israel was relatively low (average value of seven brands ± standard deviation was 7.67 ± 6.38 µg I L−1). . Regular consumption of either desalinated water or bottled mineral water probably does not supply enough iodine to eliminate iodine deficiency in Israeli consumers. Therefore, continuous follow-up of the iodine status in both tap and bottled water is strongly recommended.

2013 Iodine Nutrition in Africa: An Update for 2014

The elimination of iodine deficiency and its serious consequences, called the iodine deficiency disorders (IDD), are among the health priorities of most countries in the world. These IDDs include impaired mental development, adverse effects on growth, infant mortality, hypothyroidism, reproductive failure, and endemic goitre, which may lead to decreased educability, apathy, and reduced work capacity and may ultimately result in impaired social and economic development. Salt iodization programs in approximately 150 countries have markedly improved the global iodine nutritional status over the past decade. This is reflected in the decrease in the number of iodine-deficient countries worldwide fr om 54 in 2003 to 47 in 2007 and then to 32 in 2011.3 Despite remarkable progress, the successes have been regionally variable, with some regions showing little progress. Against the background of a general global improvement in iodine status and a marked improvement in four of the six WHO regions since 2003, the trend in Africa indicated a small decrease in the proportion of school-age children (SAC) with insufficient iodine intake as judged by urinary iodine concentration (UIC) below 100 μg/L, while the number of African SAC with insufficient iodine intake remained the same between 2007 and 2011.

BIOCHEMICAL AND CLINICAL CHARACTERIZATION OF IODINE DEFICIENCY DISORDERS IN CENTRAL INDIA

Background: Iodine (I) is a trace element that is required by both humans and animals. It can be found in a variety of chemical forms, including iodine, iodide (I), and iodate (IO3). It is widely distributed across the earth's ecology, with a concentration in the oceans. Iodine entered the natural cycle from the ocean, the atmosphere, and rainfall, as well as from rainfall into streams and rivers. Iodine is absorbed as iodide in human nutrition. Iodine is a necessary micronutrient and a component of thyroid hormones. Fish and seafood have a high iodine level. The amount of iodine in soil and drinking water varies depending on where it comes from. Iodine shortage produces a variety of negative health consequences, which are referred to as iodine deficiency illnesses (IDD). These conditions are caused by a lack of iodine, which causes insufficient thyroid hormone production.&#x0D; Aim: The aim of this study is to characterize the iodine deficiency disorder by biochemical and clinical assessment and to correlate the iodine status with thyroid disorder(s) in adults.&#x0D; Material and Method: The samples for this investigation were taken from patients at the Department of Endocrine Surgery. This study comprised a total of 100 hundred goiter patients, who had their urinary iodine excretion and thyroid hormone levels examined. For all goiter patients, the grading of goitre was established using the WHO/UNICEF/ICCIDD approved criteria. TSH, Free T4, Free T3 by using ELISA Method using commercial kits. Anti-microsomal antibody (AMA) or Thyroperoxidase antibody (TPO-Ab) by using ELISA Method using commercial kits. Anti-thyroglobulin antibody (ATG) estimated by using ELISA Method using commercial kits.&#x0D; Results: The data for each group were presented as Median and inter quarter range (IQR) The median and IQR of Urinary iodine excretion of the hypothyroid, hyperthyroid and Euthyroid goiter subjects were respectively and there was significant difference in the median urinary iodine excretion. The median and IQR of Urinary iodine excretion of the thyroiditis, thyrotoxicosis, cancer of thyroid and benign goiter respectively and there was significant difference in the median urinary iodine excretion.&#x0D; Conclusion: For ages, endemic goitre and cretinism have been recognised as public health issues, and iodine deficiency is thought to be the leading cause of preventable mental retardation. Most countries now include iodine deficiency control as part of their national nutrition policies. To eliminate iodine deficiency, several therapies with high efficacy have been employed, including iodized oil capsules (IOC) and universal salt iodisation (USI). Although some progress has been made, efforts to eliminate this devastating health problem must be hastened. Not only should iodine deficiency be monitored, but so should excessive iodine intake, as this is a problem in various areas, including the camps.&#x0D; Keywords: IDD, Goitre, TSH, IOC, USI, ATG, AMA, T4, T3.

On integration of the iodine deficiency elimination and salt reduction programs

Excessive salt intake is a risk factor for noncommunicable diseases, but salt iodization is the most effective method of population-based prevention of iodine deficiency. Therefore, an assessment of dietary iodine intake from the use of iodized salt in the food industry and potential reductions in salt intake is needed. Objective. To assess the feasibility of integrating iodine deficiency prevention and salt reduction programmes among the adult population in the Republic of Belarus. Material and methods. Using the thiocyanate-nitrite method, the determination of iodine in various types of foods was carried out. Taking into account the actual dietary intake, estimated using the frequency method among 583 respondents over 18 years old, living in Minsk, from various socioeconomic groups, alimentary iodine intake was assessed at different levels of salt use in households. The level of iodine sufficiency was additionally estimated on the base of urinary excretion data obtained by the cerium-arsenite spectrophotometric method in 100 healthy adults over the age of 18 living in Minsk (65 women and 35 men). Results. As part of the legal framework for the use of iodized salt in food production, there has been a steady increase in iodine levels in the target products (bakery and meat products to 42.0 and 133.3 μg/100 g respectively). The content of the discussed micronutrient in the diet of the adult population has raised at least 1.9-fold in recent decades, to 237.3 μg/day in the most realistic consumption model. The main source of iodine among this subpopulation is commercially produced foods with iodized salt, which forms 30-58% of the alimentary iodine exposure. Consumption of salt in Belarus averages 10.6 g per day, which poses a risk of developing noncommunicable diseases and necessitates programmes to reduce the level of salt in the diet. Modeling of scenarios with reduction of salt use in households in accordance with the recommendations of the World Health Organization (WHO) shows that the main contribution to dietary iodine exposure will be made by bread products (38%), about 1/3 will be formed by table salt, the value of non-target fortified products (milk and eggs) will increase (up to 21%). The contribution of table iodized salt to the dietary iodine exposure reaches 43% at actual consumption levels and will decrease to 18% if it is reduced to the WHO recommended values. The median of ioduria among those surveyed is 136.8 μg/l, indicating adequate iodine supply. Conclusion. In implementing joint programs on prevention of iodine deficiency and cardiovascular diseases associated with excessive salt intake, it is necessary to consider national conditions - mandatory use of iodized salt in food industry, its level of fortification, content of this micronutrient in foodstuffs and structure of their consumption among certain population groups.

Knowledge, Practice, and Availability of Iodized Salt and Associated Factors in Jibat Woreda, West Shoa Zone, Ethiopia.

Appropriate knowledge, practice, and availability of iodized salt are used to eliminate iodine deficiency disorders. However, little is known about the availability of adequately iodized salt in the western part of Ethiopia. Thus, the aim of this study was to assess knowledge, practice, and availability of iodized salt and associated factors at household level in Jibat woreda, Ethiopia. Community-based cross-sectional study was conducted using structured and pretested questionnaire interview. Sampling salt was tested by the iodometric titration method. The result showed that iodine content more than 90% was considered as adequately iodized salt. The result of this study shown that among the 357 salt samples, 191(53.5%) households had good knowledge on iodized salt while 166 (46.5%) had poor knowledge on iodized salt. In addition, the result of the study revealed that 162 (45.4%) had good practice of iodized salt, whereas 195 (54.6%) had poor practice of iodized salt. The result of this study also shown that 149 (41.7%) households were using adequately iodized salt while 208 (58.3%) were using inadequate iodized salt in study area. Residence area, education level, household job, and average monthly income were significantly associated with knowledge of iodized salt at household level. Residence area, educational level, average monthly income, and expose to sunlight were significantly associated with availability of adequately iodized salt. In this finding, the knowledge and practices of iodized salt at household level in Jibat woreda, Ethiopia, were poor, and the availability of iodine in iodized salt was inadequate. This is associated to residence area, education level of household, and average monthly income. Therefore, any concerned body/institution should have to work in the above gabs of the knowledge, practice, and availability of iodized salt.

Йодный дефицит: где мы теперь? (Эффективность белорусской стратегии ликвидации йодного дефицита: 15-летний опыт)

Между республиками бывшего СССР, ставшими независимыми государствами, существуют большие различия в состоянии йодной обеспеченности и технологии устранения йодного дефицита в питании населения. В публикации изложена стратегия ликвидации йодной недостаточности, разработанная и внедренная в Республике Беларусь с целью достижения уровня адекватной йодной обеспеченности в государстве. В Республике Беларусь 94 % потребляемой соли составляет йодированная соль, что и обеспечивает адекватное потребление йода, подтверждаемое экскрецией йода с мочой (медиана 169 мкг/л). Продемонстрированная эффективность применяемой в Беларуси модели йодной профилактики, основанной на повсеместном использовании йодированной соли в пищевой промышленности, дает основания рекомендовать эту модель к внедрению в других странах.

Low Iodine Intake May Decrease Women's Fecundity: A Population-Based Cross-Sectional Study.

Salt iodization is one of the most cost-effective strategies to eliminate iodine deficiency disorders (IDD). However, China’s dismantling of salt monopoly has reduced the availability of iodized salt in the susceptible population in pregnancy, which might cause IDD and have adverse health effects on both themselves and their offspring. The aim of our study was therefore to explore the association between IDD and women’s reproductive health. This is a population-based cross-sectional study conducted in 2018 in Zhejiang Province, China. A total of 1653 pregnant women participated in this study. Median urinary iodine concentration (UIC) in the population was used to assess iodine intake. Cox regression analyses were used to estimate the association between iodine intake and time to pregnancy, which was indicated with fecundability ratio (FR) and 95% confidence interval (CI). The percentage of participants with iodine deficiency who had been waiting longer than 13 months to get pregnant (20%; median UIC 119.6 μg/L) was significantly higher than those with iodine sufficiency (14%; median UIC 147.1 μg/L). A significant decrease in fecundity was observed in participants with iodine deficiency (FR, 0.820; 95% CI, 0.725−0.929) than those with iodine sufficiency. These findings indicate the importance of ongoing monitoring of iodine nutrition in women of reproductive age. Keeping a safe and optimal level of iodine nutrition during pregnancy should be emphasized.

Mild to moderate iodine deficiency in pregnancy: A matter of debate

During the last few decades painstaking efforts have been made to eliminate iodine deficiency through the world. Nowadays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Severe iodine deficiency during pregnancy increases the risk of irreversible brain damage, intellectual disability, neurologic abnormalities, stunted growth, increased pregnancy loss, infant mortality, impairments in child development and cretinism. The potential effects of mild-to-moderate iodine deficiency are debated. Results from animal studies and observational human studies indicate that maternal mild-to-moderate iodine deficiency disturbs thyroid function in pregnancy and it also may affects fetal neurodevelopment. The effect of supplementation of iodine on thyroid function of pregnant women and their newborn, neurodevelopment of infants and cognitive performance of children have been investigated using iodine nutrition in pregnancy, based on median urinary iodine concentration. However they have found conflicting results regarding the benefits or harms of iodine supplementation in pregnancy. Although many epidemiological, interventional and clinical studies have supported the association between thyroid function in pregnant women and later psychomotor and mental development of their children, the effect of iodine supplementation in pregnant women on neurodevelopment of children is inconclusive. Even in areas with well-established universal salt iodization program, pregnancy could be at risk of having iodine deficiency and despite WHO/ICCIDD/UNICEF recommendation which believe that dietary iodine fortification during pregnancy depends primarily on the extent of pre-existing iodine deprivation, systematic dietary fortification needs to be implemented in this vulnerable group. However, iodine supplementation of mildly iodine deficient pregnant women may not have beneficial effects in their thyroid function or neurodevelopment of their children.

Assessment of iodine nutritional status in school children concerning autoimmune thyroiditis in Tamil Nadu, India

Objective: To eliminate iodine deficiency disorders (IDD) in children, the Indian government implemented a universal salt iodization program more than 3 decades ago. Recently, it was identified that excess iodine intake could lead to autoimmune thyroiditis in children. We aimed to measure the level of iodine excretion as well as thyroid profiles as an option to identify autoimmune thyroiditis in school-going children. Materials and Methods: A total of 111 children between the ages of 6 and 12 years were subjected to a blood test to measure free thyroxine, thyroid-stimulating hormone, anti-thyroglobulin, and anti-thyroperoxidase levels. The children were categorized into control and case groups based on the clinical outcome. Biochemical analysis, thyroid gland assessment, fine-needle aspiration cytology (FNAC), and ultrasound sonography were performed. Urinary iodine excretion (UIE) level was measured by the Sandell-Kolthoff reaction method. Results: Approximately 90% of the study population was identified with a higher level of iodine in urine. A positive correlation was observed between the UIE, anti-TPO, and anti-TGO titers among the cases. Out of 61 cases, 21 children showed overt hypothyroidism (34.43%) and the remaining were identified with subclinical thyroid symptoms (65.57%). FNAC confirmed autoimmune thyroiditis in 43 children within the case group. Conclusion: Excess iodine intake may trigger thyroid autoimmunity in children. Children who are having higher levels of anti-thyroid antibodies are at risk of developing thyroid dysfunction if they consume more than the required iodine for metabolism. High levels of iodine in the urine of control children indicate that the IDD program in our nation is running successfully.