Continuously sustained elimination of iodine deficiency: a quarter of a century success in the Islamic Republic of Iran

Abstract

BackgroundIodine deficiency and related disorders were very common in Iran prior to 1996, when universal salt iodization (USI) was implemented and in 2000 Iran was declared iodine deficiency disorders (IDD) free. The aim of this study was to evaluate the adequacy of iodine intake by Iranian households in all 30 provinces of Iran, a quarter of a century after the intervention.MethodsA total of 18,000 school-aged children (8–10 years with mean 8.7 ± 1 year) were included in this study. Urine samples were collected from all children for measurement of urinary iodine excretion and 1800, 210 and 3000 salt samples were randomly collected from the family kitchen, production site of 73 salt factories and distribution circles of 30 provinces, respectively.ResultsThe median urinary iodine concentration (UIC) of participants was 161 μg/L. The proportion of children with UIC of, 20–49, 50–99 and ≥ 100 μg/L were 10.3, 15.9 and 73.7%, respectively. The mean (± SD) and median salt iodine values were 28.2 (± 12.6) and 31.7 ppm, at the production site, and 31.5 (± 13.6) and 29.6 ppm at the distribution circles, respectively. About 80% of factory salts had more than 20 ppm iodine. 98% of households consumed iodized salt, 80% had appropriate salt storage, and 83% of the household salts contained ≥ 20 ppm.ConclusionsBased on the results of this study, Iranian populations are consuming adequate iodine. The well-maintained and monitored USI program has improved the dietary iodine intakes of the population, and the country has achieved all criteria of a well-controlled IDD program.

Maternal and neonatal outcomes and determinants of iodine deficiency in third trimester of pregnancy in an iodine sufficient area

“…However, studies have shown that even in countries with consistent iodinated salt use 50% of pregnant women have urinary iodine concentrations below 150 micrograms/litre [18]. A recent study in Iran showed that the Iranian community has enough iodine intakes and has all of the IDD criteria for optimum control of iodine deficiency [19]. However, the same study showed that nearly 5% of the pregnant women participating in that study suffered from iodine deficiency.…”

Assessment of the Impact of Salt Iodisation Programmes on Urinary Iodine Concentrations and Goitre Rates: A Systematic Review

“…Based on the salt iodisation programme classification for schoolchildren, five were sustainable, in China, Iran, Ethiopia, Tanzania, and Turkey [10][11][12][13][14][15][16][17][18][19][20][21]; five were effective, in Mexico, Tunisia, New Zealand, Portugal, and Sierra Leone [13,[22][23][24]; and two were inequitable in India and Cameroon [25,26]. For pregnant women, two were inequitable in Sierra Leone and China [18,24].…”

“…us, TGR reduction in a population is expected when the intervention is combined with an increased ICS, more of the population has access to iodised salt, and there is regular monitoring of ID in the population. e change in the TGR pattern from severe to mild and from mild to eliminated IDDs in the 18-year period of intervention with iodised salt indicates the adequacy of UIC levels [10,11,[14][15][16][17][18][19][20].…”

“…e studies that reported adequate UIC underscored the good impact that the salt iodisation programmes had had. Indeed, three programmes [13,21,25,26,31] were inequitable, six [22][23][24]30] were effective, and nine [10,11,[14][15][16][17][18][19][20] were sustainable, thus reducing or eliminating IDDs [1,6,34]. Most studies examined schoolchildren, who are particularly vulnerable to iodine insufficiency and sufficiency [3].…”

Urinary Iodine Concentration in a Cohort of Adult Outpatients with Thyroid Diseases in Liguria 14 Years after the Law on Salt Iodization

“…As a result of iodine fortification programs implemented over the last two decades, some countries, such as Iran [6] and the Netherlands [7], have achieved the target of iodine sufficiency and IDD control. In Italy, IDD have been documented since ancient times, and a nationwide salt iodization program was implemented in 2005 after the approval of Law no.…”