Iodine Global Network (IGN)

28.02.2015   IDD Newsletter 1/2015

In this issue:
  • Laos: renewed commitment to salt iodization
  • Global Iodine Scorecard 2014
  • WHO workshop in South East Asia
  • Italy
  • Palestine
  • ATA statement on risks of excess iodine
  • China
  • Ghana: reactivation of iodine lab
  • Niger
  • Ethiopia: a thriving salt co-operative
  • Meetings and Announcements
  • Abstracts

Articles

Renewed commitment to iodized salt in Laos

(Frits van der Haar and Gregory Gerasimov)
IDD has long been recognized as a significant public health problem in Lao PDR. Surveys conducted in 1989–1990 in five northern and four southern provinces reported significantly elevated goiter rates in school-age children, and a nationwide survey in 1993 found that an astounding 95% of children were iodine deficient. In response, Lao PDR introduced Universal Salt Iodization (USI) in 1995, and by 2000 the goiter rate had dropped from 40% to only 9%. In 2006, the National Nutrition Survey confirmed that this achievement had been sustained: 90% of households in Lao PDR were consuming salt with some iodine (above 5 ppm by quantitative analysis) while 73.9% were using salt that was iodized adequately (with at least 15 ppm of iodine).

Global Iodine Scorecard 2014: Number of iodine-deficient countries more than halved in the past decade

Before 1990, only a handful of countries were iodine sufficient. As a result of remarkable efforts in the past two and a half decades, the latest global estimate of iodine nutrition looks more optimistic than ever. Here is a summary of the most important changes since 2012.

Introducing salt reduction strategies without jeopardizing salt iodization: a WHO workshop in South-East Asia

(Based on a WHO report)
To harmonize national strategies to control iodine deficiency and reduce the burden of cardiovascular disease, the WHO Regional Office for South-East Asia and the All India Institute of Medical Sciences conducted a Regional Workshop on sodium intake and iodized salt on 29–30 September 2014 in New Delhi, India. In South-East Asia, many countries have effective salt iodization programs while others are in the process of developing or strengthening salt iodization. But nearly all still lack legislative measures or strategies to reduce salt consumption. The workshop’s objective was to help identify a path to successful integration of both strategies across the region.

If all Italian food salt is iodized, lowering salt intake is unlikely to affect iodine nutrition

(Excerpted from: Pastorelli AA, et al. EJCN. 2015; 69: 211–215.)
The native iodine content of most foods and beverages is low and highly variable. As a result, iodine intakes vary across regions and countries according to local eating habits and national strategies for IDD control. Universal salt iodization has been remarkably successful in eliminating IDD in many countries. But to prevent the rise of noncommunicable diseases, WHO recommends limiting salt intake to 5 g/day in adults and even less in children. In Italy, universal salt iodization was implemented in 2005. Iodine is added to coarse and table salt at 30 mg/kg as potassium iodate, and the use of iodized salt is permitted in the food industry and in communal eating areas.

Palestinian children are solidly iodine sufficient but iodized salt coverage needs to be improved

Situated at the eastern end of the Mediterranean, Palestine is a small state with a population of around 4.5 million. Palestine’s scarce natural resources combined with political unrest have adversely affected the socio-economic and nutritional status of vulnerable populations. In common with other transitional economies, Palestine is experiencing a rise in the prevalence of overweight and obesity, as it continues its efforts to tackle micronutrient deficiencies.

ATA proposes safe upper limits for iodine intake

(Excerpted from: Leung AM, et al.Thyroid. February 2015, 25(2): 145-146)
Iodine is a micronutrient required for normal thyroid function. In the United States, recommended daily allowances (RDA) for iodine intake are 150 mcg in adults, 220–250 mcg in pregnant women, and 250–290 mcg in breastfeeding women. The U.S. diet generally contains enough iodine to meet these needs, with common sources being iodized salt, dairy products, some breads, and seafood. During pregnancy and lactation, women require higher amounts of iodine for the developing fetus and infant. The American Thyroid Association (ATA) recommends that women take a multivitamin containing 150 mcg of iodine daily in the form of potassium iodide (KI) during preconception, pregnancy, and lactation.

China: Improving USI to ensure optimal iodine nutrition for all

(Prof. Qian Ming, Karen Codling, Prof. Yan Yuqin, and Prof. Chen Zupei)
Historically, many regions of China were iodine deficient and affected by endemic goiter and cretinism. This blocked economic development, because it limited intellectual capacity and learning potential, lowering IQ in children in affected areas by more than 10 points. The Chinese government’s introduction of mandatory Universal Salt Iodization (USI) in 1994 has led to enormous progress, and the program is now a model for many countries. The government target of sustained elimination of IDD has already been met at the national level: national coverage of households with adequately iodized salt has been sustained above 90% since 2005, the median urinary iodine concentration (MUIC) of school-age children (SAC) has consistently been >100 mcg/L, and the prevalence of goiter has remained well below 5%. This success is a result of ongoing, strong government commitment to maintain iodine sufficiency in the country through support to the salt industry, which has operated as a monopoly, as well as rigorous monitoring of the program to assure effective coverage and penetration throughout the country.

Rebirth of Ghana's national iodine laboratory

(Ebenezer Asibey-Berko)
Ghana’s first iodine laboratory was founded in 1994 at the Department of Nutrition and Food Science, University of Ghana in Legon. It was funded by the Canadian International Development Research Center (IDRC) as part of a contract to conduct a nationwide baseline IDD survey in 1991–1994. Equipped to carry out analyses of urine iodine and serum TSH, among others, the lab quickly established itself as the regional service and research center for IDD and the University’s training center in iodine analytical methods. Over the years, its services have supported the IDD programs of Ghana, Benin, and Togo.

Niger: ensuring the quality of iodized imported salt

(Boubacar Issa)
The first IDD survey in Niger was conducted in 1994. Led by Professor Hamani Daouda from the Faculty of Health Sciences, Abdou Moumouni University in Niamey, its objective was to determine the extent of iodine deficiency and its negative impact on the country’s social and economic development. Conducted in a representative sample of 9000 students, the survey reported an alarming total goiter rate of 35.8%. Luckily, these findings resonated with policymakers, who issued a recommendation in February 1995 that all salt for human consumption should be fortified to deliver iodine to the deficient population.

A thriving Ethiopian iodized salt co-operative

(Ato Mengistu, Ato Beyene Birru, Lorenzo Locatelli-Rossi)
The success story of the Shewit Salt Producers Co-operative is unique. Situated in Mekelle, the capital city of the Tigray region in Eastern Ethiopia, Shewit has been successfully pursuing universal salt iodization for over 12 years, and it is committed to innovation and staying abreast of the latest technology. Most members of the co-operative are former servicemen who played an important role in the downfall of the Derg regime.