scholarly journals Endemic Goiter and Iodine Prophylaxis in Calabria, a Region of Southern Italy: Past and Present

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2428 ◽  
Author(s):  
Giordano ◽  
Barone ◽  
Marsico ◽  
Bruno ◽  
Bonofiglio ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Public Health Problem ◽  
Iodine Intake ◽  
Important Public Health Problem ◽  
Hormone Synthesis ◽  
Iodine Prophylaxis ◽  
Salt Iodization ◽  
Italian Law ◽  
Epidemiological Surveys

Iodine, a micronutrient that plays a pivotal role in thyroid hormone synthesis, is essential for proper health at all life stages. Indeed, an insufficient iodine intake may determine a thyroid dysfunction also with goiter, or it may be associated to clinical features such as stunted growth and mental retardation, referred as iodine deficiency disorders (IDDs). Iodine deficiency still remains an important public health problem in many countries, including Italy. The effective strategy for the prevention and control of IDDs is universal salt iodization, which was implemented in Italy in 2005 as a nationwide program adopted after the approval of an Italian law. Despite an improvement in the iodine intake, many regions in Italy are still characterized by mild iodine deficiency. In this review, we provide an overview of the historical evolution of the iodine status in the Calabria region, located in the South of Italy, during the past three decades. In particular, we have retraced an itinerary from the first epidemiological surveys at the end of the 1980s to the establishment of the Regional Observatory of Endemic Goiter and Iodine Prophylaxis, which represents an efficient model for the surveillance of IDDs and monitoring the efficacy of iodine prophylaxis.

scholarly journals Iodine Status in Schoolchildren and Pregnant Women of Lazio, a Central Region of Italy

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1647 ◽  
Author(s):  
Baldini ◽  
Virili ◽  
D’Armiento ◽  
Centanni ◽  
Ulisse
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Iodine Deficiency ◽  
Iodine Intake ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Care Providers ◽  
Iodine Prophylaxis ◽  
Italian Regions ◽  
Epidemiological Surveys

The inhabitants of Lazio, similarly to those of other Italian regions, have been historically exposed to the detrimental effects of an inadequate intake of iodine. The latter is a micronutrient essential for the biosynthesis of thyroid hormones (TH). Iodine deficiency is responsible for a number of adverse effects on human health known as iodine deficiency disorders (IDD), the most common of which worldwide are goiter and hypothyroidism. In order to reduce IDD, a national salt iodination program was started in Italy in 2005. In this article we reviewed the available data regarding iodine intake in the Lazio population before and after the introduction of the national salt iodination program, in order to evaluate its efficacy and the eventual problem(s) limiting its success. On the whole, the information acquired indicates that, following the introduction of the program, the dietary iodine intake in the Lazio population is improved. There is, however, still much work ahead to ameliorate the iodine prophylaxis in this region. In fact, although a generally adequate iodine intake in school-age children has been observed, there are still areas where a mild iodine insufficiency is present. Moreover, two independent epidemiological surveys on pregnant women evidenced a low urinary iodine concentration with respect to the reference range conceived by the World Health Organization. These findings demonstrate the need for greater attention to the iodine prophylaxis by health care providers (i.e., obstetricians, gynecologists, pediatricians, etc.), and the implementation of effective advertising campaigns aimed at increasing the knowledge and awareness of the favorable effects of iodine supplementation on population health.

scholarly journals Increased prevalence of hyperthyroidism as an early and transient side-effect of implementing iodine prophylaxis

2007 ◽  
Vol 10 (8) ◽  
pp. 799-802 ◽  
Author(s):  
Filip Gołkowski ◽  
Monika Buziak-Bereza ◽  
Małgorzata Trofimiuk ◽  
Agata Bałdys-Waligórska ◽  
Zbigniew Szybiński ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Thyroid Dysfunction ◽  
Thyroid Autoimmunity ◽  
Final Analysis ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Iodine Prophylaxis ◽  
Sudden Rise ◽  
Epidemiological Surveys ◽  
Thyroid Microsomal Antibodies

AbstractObjectiveTo assess the prevalence of hyperthyroidism just after implementation of iodine prophylaxis among adults from an area with iodine deficiency.Study design and subjectsA total of 1648 adults (age 16 years and older) were sampled from an area of southern Poland during two nationwide epidemiological surveys. Of these, 1424 adults with negative medical history for thyroid disorders qualified for final analysis. The authors compared thyroid dysfunction in participants prior to (1989–1990) and after implementation of iodine prophylaxis (1997–1999).SettingThe southern part of Poland.ResultsWe found an increase in the serum concentration of anti-thyroid microsomal antibodies from 4.9% in the years 1989–1990 to 12.1% after introduction of iodised household salt (P < 0.0001). The prevalence of hyperthyroidism (defined as thyroid-stimulating hormone < 0.4 μU ml− 1) significantly increased in the equivalent period from 4.8 to 6.5% (P = 0.009).ConclusionsWe concluded that a sudden rise in iodine intake after implementation of iodine prophylaxis among adults from the area with iodine deficiency may lead to an increase in thyroid autoimmunity and prevalence of hyperthyroidism. Those possible early side-effects appear to be only temporary and are acceptable when compared with the evident benefits of adequate iodine intake.

scholarly journals Memories of the future

2020 ◽  
Vol 15 (3) ◽  
pp. 90-95
Author(s):  
Gregory A. Gerasimov
Keyword(s):  
Public Health ◽  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Iodine Intake ◽  
Successful Implementation ◽  
Bakery Products ◽  
Medium Term ◽  
Short Term ◽  
Salt Iodization ◽  
Supply Optimization

With bated breath we follow the fate of the long-suffering law On the prevention of diseases caused by iodine deficiency. What can be expected in terms of improving public health after the adoption and successful implementation of this bill, which provides for the enrichment with iodine of edible salt of extra, higher and first varieties, grinding No. 0 and No. 1? In addition, in the production of bakery products, the recipe of which contains edible salt, the use of iodized salt will become mandatory. According to the experience of many near and far countries, within 23 years from the start of the program of mandatory salt iodization, one can expect a significant (at times) reduction in the incidence of endemic goiter. This trend will not exhaust itself in subsequent years. In the medium term (after about 10 years), a decrease (by half or more) in the incidence of thyrotoxicosis can also be expected in Russia. However, in the short term (57 years), a transient increase in the incidence of thyrotoxicosis in people over 60 years of age is possible, which can be considered a kind of payment for the previous iodine deficiency. The trend towards an increase in the incidence of subclinical and, possibly, manifest hypothyroidism may continue, but this will not be a consequence of an increase in iodine supply. Optimization of iodine intake against the background of mandatory salt iodization should reduce the frequency of transient disorders of thyroid function in newborns and, possibly, congenital hypothyroidism.

scholarly journals The Role of Iodine for Thyroid Function in Lactating Women and Infants

2021 ◽  
Author(s):  
Maria Andersson ◽  
Christian P Braegger
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Current Knowledge ◽  
Iodine Intake ◽  
Infants And Toddlers ◽  
Iodine Nutrition ◽  
Lactating Women ◽  
Hormone Synthesis ◽  
The Impact

Abstract Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.

Comparative screening for thyroid disorders in old age in areas of iodine deficiency, long‐term iodine prophylaxis and abundant iodine intake

1997 ◽  
Vol 47 (1) ◽  
pp. 87-92 ◽  
Author(s):  
István Szabolcs ◽  
Jan Podoba ◽  
Joachim Feldkamp ◽  
Orsolya Dohán ◽  
Ildikó Farkas ◽  
...  
Keyword(s):  
Old Age ◽  
Iodine Deficiency ◽  
Iodine Intake ◽  
Thyroid Disorders ◽  
Iodine Prophylaxis

Epidemiology of thyroid disease and swelling

2011 ◽  
pp. 358-370 ◽  
Author(s):  
Mark P. J. Vanderpump
Keyword(s):  
Iodine Deficiency ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Daily Intake ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Thyroid Disorders ◽  
Autoimmune Thyroid ◽  
Salt Iodization

Thyroid disorders are among the most prevalent of medical conditions. Their manifestations vary considerably from area to area and are determined principally by the availability of iodine in the diet. The limitations of epidemiological studies of thyroid disorders should therefore be borne in mind when considering the purported frequency of thyroid diseases in different communities (1). Almost one-third of the world’s population live in areas of iodine deficiency and risk the consequences despite major national and international efforts to increase iodine intake, primarily through the voluntary or mandatory iodization of salt (2). The ideal dietary allowance of iodine recommended by the WHO is 150 μ‎g iodine/day, which increases to 250 μ‎g in pregnancy and 290 μ‎g when lactating. The WHO estimates that two billion people, including 285 million school-age children still have iodine deficiency, defined as a urinary iodine excretion of less than 100 μ‎g/l. This has substantial effects on growth and development and is the most common cause of preventable mental impairment worldwide. In areas where the daily iodine intake is below 50 μ‎g, goitre is usually endemic, and when the daily intake falls below 25 μ‎g, congenital hypothyroidism is seen. The prevalence of goitre in areas of severe iodine deficiency can be as high as 80%. Iodization programmes are of proven value in reducing goitre size and in preventing goitre development and cretinism in children. Goitrogens in the diet, such as thiocyanate in incompletely cooked cassava or thioglucosides in Brassica vegetables, can explain some of the differences in prevalence of endemic goitre in areas with similar degrees of iodine deficiency. Autonomy can develop in nodular goitres leading occasionally to hyperthyroidism, and iodization programmes can also induce hyperthyroidism, especially in those aged over 40 years with nodular goitres. Autoimmune thyroiditis or hypothyroidism has not been reported to complicate salt iodization programmes. Relatively little prevalence data exist for autoimmune thyroid disease in areas of iodine deficiency (3). In iodine-replete areas, most people with thyroid disorders have autoimmune disease, ranging through primary atrophic hypothyroidism, Hashimoto’s thyroiditis, to hyperthyroidism caused by Graves’ disease. Cross-sectional studies in Europe, the USA, and Japan have determined the prevalence of hyperthyroidism, hypothyroidism, and the frequency and distribution of thyroid autoantibodies in different, mainly white, communities (1, 4–6). Recent US data have revealed differences in the frequency of thyroid dysfunction and serum antithyroid antibody concentrations in different ethnic groups (6), whereas studies from Europe have revealed the influence of dietary iodine intake on the epidemiology of thyroid dysfunction (7). Studies of incidence of autoimmune thyroid disease have only been conducted in a small number of developed countries (8–11). Following a review of the available epidemiological data, the value of screening adult populations for autoimmune thyroid disease will be considered.

scholarly journals Relevance of iodine intake as a reputed predisposing factor for thyroid cancer

2007 ◽  
Vol 51 (5) ◽  
pp. 701-712 ◽  
Author(s):  
Meyer Knobel ◽  
Geraldo Medeiros-Neto
Keyword(s):  
Thyroid Cancer ◽  
Iodine Deficiency ◽  
Animal Experiments ◽  
Experimental Studies ◽  
Epidemiological Studies ◽  
Iodine Intake ◽  
Thyroid Cell ◽  
Predisposing Factor ◽  
Iodine Prophylaxis ◽  
Iodine Excess

Iodine is a trace element that is essential for the synthesis of thyroid hormone. Both chronic iodine deficiency and iodine excess have been associated with hypertrophy and hyperplasia of follicular cells, attributed to excessive secretion of TSH. This may be associated to thyroid cancer risk, particularly in women. Experimental studies have documented thyroid cancer induction by elevation of endogenous TSH, although in a small number of animals. Iodine deficiency associated with carcinogenic agents and chemical mutagens will result in a higher incidence of thyroid malignancy. Inadequate low iodine intake will result in increased TSH stimulation, increased thyroid cell responsiveness to TSH, increased thyroid cell EGF-induced proliferation, decreased TGFbeta 1 production and increased angiogenesis, all phenomena related to promotion of tumor growth. Epidemiological studies associating iodine intake and thyroid cancer led to controversial and conflicting results. There is no doubt that introduction of universal iodine prophylaxis in population previously in chronic iodine-deficiency leads to a changing pattern of more prevalent papillary thyroid cancer and declining of follicular thyroid cancer. Also anaplastic thyroid cancer is practically not seen after years of iodine supplementation. Iodine excess has also been indicated as a possible nutritional factor in the prevalence of differentiated thyroid cancer in Iceland, Hawaii and, more recently, in China. In conclusion: available evidence from animal experiments, epidemiological studies and iodine prophylaxis has demonstrated a shift towards a rise in papillary carcinoma, but no clear relationship between overall thyroid cancer incidence and iodine intake.

scholarly journals Iodine in Table Salt in the Aseer Region, Southwestern Saudi Arabia

2021 ◽  
Vol 19 (2) ◽  
Author(s):  
Ayyub Ali Patel
Keyword(s):  
Saudi Arabia ◽  
Rural Areas ◽  
Urban Areas ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Table Salt ◽  
Cross Sectional ◽  
Hormone Synthesis ◽  
Salt Iodization

Background: Iodine, a micronutrient that plays a significant role in thyroid hormone synthesis, is essential for normal neurological development. Universal Salt Iodization is a plan advocated by the WHO to ensure sufficient iodine intake by all individuals. No accurate data was available about household coverage with iodized salt and salt iodization adequacy in the Aseer region, southwestern Saudi Arabia. Objectives: To estimate the proportion of households consuming iodized salt in the Aseer region, southwestern Saudi Arabia, and assess salt iodization’s adequacy. Methods: The study was a cross-sectional study on a stratified proportional allocation sample. The household of each child was requested to bring a teaspoonful of table salt consumed in their kitchen. The salt samples were taken in standard, small, self-sealed plastic bags. The Iodine concentration of salt was determined spectrophotometrically. Results: The study included 3038 samples of table salt. Insufficient iodized table salt samples (less than 15 ppm based on the WHO/UNICEF ICCIDD classification) were observed in 22.3% (95% CI: 20.8% – 23.8%) of the samples. Similarly, insufficient iodized table salt samples (less than 70 ppm based on Saudi Standards, Metrology and Quality Organization “SASO” classification) were observed in 75.7% (95% CI: 74.1% – 77.2%) of the study samples. The present study showed that rural areas significantly had higher insufficient table salt samples than urban areas. Conclusions: The study showed that the use of insufficient iodized salt in the region is still common. The accessibility of iodized salt can be achieved through iodized salt’s marketing and sales. Authorities in the Aseer region should play an influential role in forbidding non-iodized salt in the local markets in the Aseer region. Key words: Iodine; Table salt; Saudi Arabia

scholarly journals IODINE STATUS IN SCHOOL CHILDREN AND DISTRIBUTION OF IODINE, MERCURY, LEAD IN SOIL AND WATER IN THE ENDEMIC GOITER HILL AREA, PONOROGO

2021 ◽  
Vol 13 (1) ◽  
pp. 1-10
Author(s):  
Muhamad Arif Musoddaq ◽  
Taufiq Hidayat ◽  
Khimayah Khimayah
Keyword(s):  
Public Health ◽  
Heavy Metals ◽  
Iodine Deficiency ◽  
School Children ◽  
Health Problem ◽  
Public Health Problem ◽  
Water Source ◽  
Iodine Intake ◽  
Hill Area ◽  
Soil And Water

Background.  Iodine deficiency disorders (IDD) remained a public health problem. Ponorogo was an IDD endemic area with prominent cases of mental retardation. Despite the lack of iodine intake, exposure to environmental heavy metals can exacerbate the effects of iodine deficiency. Objective. To describe iodine status of school children and distribution of environmental iodine and heavy metals including mercury (Hg), lead (Pb), and cadmium (Cd) in the endemic IDD hill area of Ponorogo. Method. This research is a cross-sectional study conducted in two villages in IDD endemic areas in Ponorogo, namely Dayakan and Watubonang villages, in 2011. A total of 127 urine samples of primary-school-age children were taken and analyzed for urinary iodine excretion (UIE). A total of 29 soil samples and 87 water samples were taken from the study site to measure the concentration of iodine and heavy metals Hg, Pb, and Cd. Types of water source, altitude, and land use, both soil and water source were recorded.  Results. The median (min-max) UIE was 130 (14 –1187 µg/L) within the range of adequate population iodine intake according to WHO (100-199 µg/L), while the percentage of UIE <100 µg/L was still around 33.07 percent. The concentration of iodine in the soil was 33.777 mg/kg (6.640 –108.809), and the concentration of iodine in the water was 8.0 µg/L (0-49). The concentration of Hg in the soil was 68.64 ppb (7.43–562.05), and the concentration of Hg in the water was 0.00 ppb (0.00-23.24).  The concentration of Pb in the soil was 3.273 ppm (0.000–25.227), while Pb was not identified in the water. The Cadmium was not detectable both in the soil and water. Conclusion. Iodine deficiency is still a public health problem in Dayakan and Watubonang villages. The environment of the endemic IDD area in Ponorogo was not completely poor in iodine, but iodine was not evenly spread and mobilized. There was a risk of environmental heavy metal exposure from Hg in the soil or water and Pb in the soil. Mercury in the environment can cause health problems due to the inhibition of the use of iodine in the thyroid gland.

Assessment of iodine intake and deficiency in school-age children in Morocco

2018 ◽  
Vol 48 (6) ◽  
pp. 873-885
Author(s):  
Naima Saeid ◽  
Anass Rami ◽  
Samir Mounach ◽  
Abdeslam Hamrani ◽  
Asmaa El Hamdouchi ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
School Age Children ◽  
School Age ◽  
Content Type ◽  
Iodine Status ◽  
School Aged Children ◽  
Salt Iodization ◽  
Significant Difference

Purpose Iodine deficiency has several adverse effects on human growth and development and it is categorized collectively as iodine deficiency disorders (IDDs). Recent estimations showed that 29.8 per cent of school-age children have insufficient iodine intake. Salt iodization is widely accepted as the best method for increasing iodine intake. In 1995, Morocco adopted the universal salt iodization strategy to reduce iodine deficiency and consequently prevent and control IDDs. This study aims to determine the benefit of this strategy on schoolchildren and adolescent by assessing iodine intake and evaluating iodine deficiency. Design/methodology/approach This transversal study was conducted on 131 children and adolescents. Iodine intake was assessed using a food frequency questionnaire. Iodine status was evaluated on 24-h urine samples and the creatinine excretion was used to validate completeness of urine collection. Findings The medians of urinary iodine excretion and concentration were 77 µg/day and 96 µg/L, respectively. Overall, 72.5 per cent are deficient, so mild and moderate iodine deficiencies were reported in 58 per cent and 14.5 per cent, respectively, and no child exhibited severe deficiency. A significant difference was reported between iodine deficiency and, sex and age; iodine deficiency was more pronounced in boys and children under eight years. In this study, iodine status in deficient children does not change with the consumption pattern of dairy products and eggs, and results showed no significant association (p > 0.05). However, fish consumption was significantly associated to urinary iodine concentration = 100 µg/L (p = 0.044). Average UIC in school-aged children is still inadequate and consumption of foods high in iodine remains very insufficient. Therefore, additional efforts must focus on nutritional education of Moroccan school-aged children. Originality/value In the author’s knowledge, this is the first study evaluating schoolchildren iodine status by 24-h iodine collection; the study reported association of iodine deficiency with dietary habit concerning sources of food rich on iodine.

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