The challenges of implementing and monitoring of salt iodisation programmes

Sullivan, Kevin M.

doi:10.1016/j.beem.2009.09.001

Cited by 10 publications

(15 citation statements)

References 3 publications

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“…At high iodide concentrations, this reaction is displaced to the right due to mass action, trapping I2, considered to be an intermediary in iodine organification [41]. When moderate or high iodine doses are given repeatedly, organification and thyroid hormone formation inhibitionis partially corrected; this "escape" or "adaptation" mechanism occurs because iodine transport diminishes and thyroid iodine concentration is insufficient to maintain the complete "WolffChaikoff" effect.…”

Section: Toxic Effects Of Iodine Excessmentioning

confidence: 99%

“…When moderate or high iodine doses are given repeatedly, organification and thyroid hormone formation inhibitionis partially corrected; this "escape" or "adaptation" mechanism occurs because iodine transport diminishes and thyroid iodine concentration is insufficient to maintain the complete "WolffChaikoff" effect. This response is a manifestation of the thyroid selfregulated inhibition of iodine transport, preventing the development of hypothyroid goiter in the normal population [40,41]. On occasions, the "escape" or "adaptation" phenomenon does not occur, giving rise to the persistent inhibition of thyroid hormone formation, leading to hypothyroidism and goiter (myxedema).…”

Section: Toxic Effects Of Iodine Excessmentioning

confidence: 99%

“…However, in neonates, where iodine concentration is very low, iodine turnover is very high and this increased iodine turnover is exaggerated in iodine deficient areas. When it is present, an increase in TSH levels is required, explaining why in iodine deficient areas TSH rises far above normal in the first weeks of life, creating a state called "transient hyperthyrotropinemia" [14,[40][41][42][43]. Therefore, TSH elevation in this age group is of great value for determining the severity of iodine deficiency in a given population.…”

Section: Tshmentioning

confidence: 99%

“…Significant differences were found in mean thyroid volume adjusted by age and body surface, suggesting that reference values for a specific population in countries with longstanding iodine "sufficiency" may be more accurate than an international reference standard. These reference values are recommended for goiter screening during IDD monitoring, and they are more conservative than those previously used, although it is clear that inter-observer variability with this method is high -up to 26%- [32][33][34][40][41][42][43]. In order to improve thyroid volume data reliability and comparability on ultrasound when monitoring for IDD, a standardized approach has to be adopted worldwide [33,41].…”

Section: Thyroid Volumementioning

confidence: 99%

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Iodine Deficiency Disorders

Vargas‐Uricoechea¹,

Bonelo-Perdomo²,

Hernán³

2014

Thyroid Disorders Ther

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Iodine deficiency disorders are among the most significant public health problems in the world at the present time, especially among children and pregnant women, considered the highest risk population. These disorders hinder socio-economic development in the affected areas. IDD are a permanent natural occurrence that affects the entire planet, which means that the people living in iodine-deficient areas will always be exposed to the consequences of that deficiency, in particular increased perinatal mortality, mental retardation and brain developmental delay. Consequently, it is the major cause of preventable brain damage in childhood, and its elimination is one of the biggest challenges in public health. Iodine is present in small amounts in the body and its main role is to act as the substrate for thyroid hormone synthesis. When dietary requirements are not met, the frequency of IDD increases. In general, these disorders are underdiagnosed and, in many countries, there is no awareness of the associated problems or of the iodine status in the population.Methods: Accurate methodological review of the medical literature included in the MEDLINE database using the MeSH terms "iodine", "disorders", "iodide", "deficiency", combined with the logical operators "AND", "OR" and "NOT" and the "also try" characteristic of data published in "any date", limiting the search to results including the link with abstracts and full text, exclusively in humans and regardless of gender. For the preliminary evaluation, the following types of studies were selected: clinical trials, meta-analyses, randomized controlled trials, clinical practice guidelines, and review articles. The search was limited to papers published in English, and related to the population between 0 and 18, and adults 19 and over, from January 1974 to November 2014. The same criteria were also used in the TRIP DATABASE, as a meta-search engine of the terms specified above.

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Section: Toxic Effects Of Iodine Excessmentioning

confidence: 99%

Section: Toxic Effects Of Iodine Excessmentioning

confidence: 99%

Section: Tshmentioning

confidence: 99%

Section: Thyroid Volumementioning

confidence: 99%

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Iodine Deficiency Disorders

Vargas‐Uricoechea¹,

Bonelo-Perdomo²,

Hernán³

2014

Thyroid Disorders Ther

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“…The method recommended by the WHO to correct iodine deficiency in a population is Universal Salt Iodisation (2) , which is the iodisation of all salt for human and animal consumption; salt is usually iodised with potassium iodide or iodate (62) . Salt has been the vehicle of choice for iodine fortification programmes as it is relatively inexpensive, easy to monitor and regulate and consumed at constant levels by most people in a population (5) .…”

Section: Eradication Of Goitre In the Ukmentioning

confidence: 99%

Iodine deficiency in the UK: an overlooked cause of impaired neurodevelopment?

Bath

Rayman

2013

Proc. Nutr. Soc.

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This review describes historical iodine deficiency in the UK, gives current information on dietary sources of iodine and summarises recent evidence of iodine deficiency and its association with child neurodevelopment. Iodine is required for the production of thyroid hormones that are needed for brain development, particularly during pregnancy. Iodine deficiency is a leading cause of preventable brain damage worldwide and is associated with impaired cognitive function. Despite a global focus on the elimination of iodine deficiency, iodine is a largely overlooked nutrient in the UK, a situation we have endeavoured to address through a series of studies. Although the UK has been considered iodine-sufficient for many years, there is now concern that iodine deficiency may be prevalent, particularly in pregnant women and women of childbearing age; indeed we found mild-to-moderate iodine deficiency in pregnant women in Surrey. As the major dietary source of iodine in the UK is milk and dairy produce, it is relevant to note that we have found the iodine concentration of organic milk to be over 40 % lower than that of conventional milk. In contrast to many countries, iodised table salt is unlikely to contribute to UK iodine intake as we have shown that its availability is low in grocery stores. This situation is of concern as the level of UK iodine deficiency is such that it is associated with adverse effects on offspring neurological development; we demonstrated a higher risk of low IQ and poorer reading-accuracy scores in UK children born to mothers who were iodine-deficient during pregnancy. Given our findings and those of others, iodine status in the UK population should be monitored, particularly in vulnerable subgroups such as pregnant women and children.

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The size of the community rather than its geographical location better defines the risk of iodine deficiency: Results of an extensive survey in Southern Italy

Aghini-Lombardi

Vitti

Antonangeli

et al. 2013

J Endocrinol Invest

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The results of the present survey indicate that: 1) in Southern Italy mild to moderate iodine deficiency is still present; 2) median UIE in non urban areas is lower than in urban areas and is related to the size of the community rather than to its geographical location, being higher in a larger community. This may be due to better diversification of dietary habits and the easier availability of iodized salt and processed food through commercial facilities, more common in larger communities. Future monitoring surveys should take into account these observations.

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The challenges of implementing and monitoring of salt iodisation programmes

Cited by 10 publications

References 3 publications

Iodine Deficiency Disorders

Iodine Deficiency Disorders

Iodine deficiency in the UK: an overlooked cause of impaired neurodevelopment?

The size of the community rather than its geographical location better defines the risk of iodine deficiency: Results of an extensive survey in Southern Italy

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