Low intake of iodized salt and iodine containing supplements among pregnant women with apparently insufficient iodine status - time to change policy?

Rosen, Shani; Ovadia, Yaniv S.; Anteby, Eyal Y.; Fytlovich, Shlomo; Aharoni, Dorit; Zamir, Doron; Gefel, Dov; Shenhav, Simon

doi:10.1186/s13584-020-00367-4

Cited by 13 publications

(11 citation statements)

References 30 publications

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“…Последствия ЙДЗ включают в себя как мертворождения, самопроизвольные аборты, возникновение врожденных аномалий у плода при тяжелом ЙД, репродуктивные нарушения, так и специфические заболевания щитовидной железы (ЩЖ), такие как гипотиреоз в районах с тяжелым ЙД и тиреотоксикоз, функциональная автономия (токсический узловой, многоузловой зоб) на территории с умеренным и легкой степени тяжести ЙД. Кроме того, хронический ЙД приводит к развитию умственной и физической отсталости детей, кретинизму, а также существенно увеличивает риск радиационно-индуцированного рака ЩЖ в случае ядерных катастроф [ 2 ][ 3 ].…”

Section: обоснованиеunclassified

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Dynamics of epidemiological indicators of thyroid pathology in the population of the Russian Federation: analytical report for the period 2009–2018

Troshina

Platonova

Panfilova

2021

Probl Endokrinol (Mosk)

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BACKGROUND: The level of iodine consumption by the population largery determines the spectrum of thyroid pathology. To date, in the Russian Federation, iodine-deficiency disorders (IDD) occupy a leading position in the structure of all thyroid diseases. Chronic ID leads to adverse health consequences and significant economic costs for their elimination on a national scale. However, the spectrum of thyroid pathology is not limited to the problem of ID, and the study of other thyroid diseases is also of interest.AIMS: to assess the dynamics of prevalence and incidence of IDD and other thyroid diseases in the entire population of the RF for the period 2009–2018, using official state statistics.MATERIALS AND METHODS: the main epidemiological indicators (incidence and prevalence) of thyroid diseases in the entire population of the RF were analyzed using official state statistics. The analyzed period is 2009–2018. There was no medical intervention. To assess the dynamics of prevalence and incidence, a linear regression models were constructed, the slope of the trend line was calculated.RESULTS: the data were analyzed in accordance with the structure of diseases presented in the statistical reporting: goiter, thyroiditis, hypothyroidism, thyrotoxicosis, congenital iodine deficiency syndrome. For the ten-year period 2009–2018 there is a statistically significant increase in the prevalence of various forms of goiter, thyrotoxicosis, congenital iodine deficiency syndrome in the entire population of the Russian Federation. During the observation period, an increase in the incidence of thyrotoxicosis was revealed. With regard to the incidence of congenital iodine deficiency syndrome, only an upward trend was revealed. Despite the fact that during the observation period the number of new cases of various forms of goiter decreased, the prevalence of goiter among the population of the Russian Federation remains high: 1.2% of the population by January 1, 2019. with the growth of autoimmune pathology, improvement of the level of diagnosis, and also, in some cases, with overdiagnosis (for example, when diagnosing autoimmune thyroiditis in individuals with asymptomatic carriage of antithyroid antibodies). The current approaches to iodine prophylaxis are not effective enough.CONCLUSIONS: the results of the analysis indicate mainly an increase in the high prevalence of thyroid pathology among the population of the RF against the background of regional events. The problem of ID remains unresolved, which dictates the need to introduce universal mandatory salt iodization in the territory of the RF.

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Section: обоснованиеunclassified

“…Другие страны, не имеющие законодательного регулирования проблемы ЙД, также сообщают о необходимости его введения [ 22 ].…”

Section: обсуждение основного результата исследованияunclassified

Dynamics of epidemiological indicators of thyroid pathology in the population of the Russian Federation: analytical report for the period 2009–2018

Troshina

Platonova

Panfilova

2021

Probl Endokrinol (Mosk)

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“…A recent IJHPR article by Rosen and colleagues [10] has evaluated iodine status in 134 pregnant women living in an area reliant on desalinated iodine-diluted water. While iodine concentration in water from Ashkelon was 35 μg/L the water iodine concentrations in several municipalities in the Ashkelon subdistrict ranged between 0 and 9 μg/L.…”

Section: The Israel Situationmentioning

confidence: 99%

Iodine deficiency in Israeli pregnant women – a time for action

Lazarus

2020

Isr J Health Policy Res

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Iodine is an essential micronutrient for thyroid gland function. Iodine deficiency disorders are a spectrum of conditions affecting the fetus, child, adolescent and adult. Iodine requirements are increased in pregnancy in order that the fetus receives enough maternal thyroxine via transplacental passage. Previous studies in Israel have shown widespread iodine deficiency by measurement of urinary iodine concentrations in school age children and adults. The present study clearly shows iodine deficiency in a group of 2nd trimester women as judged by measurement of serum thyroglobulin (a recently evaluated marker of iodine deficiency). An additional factor in this work is that the subjects all resided in an area using desalinated water. Desalination has previously been shown to significantly reduce the iodine content of water compared to water in Israel not subject to this process. The data in this group of pregnant women should serve as a wakeup call to the public health community to correct this deficiency which is known to significantly affect child neurodevelopment. There are several issues to be addressed. The knowledge base relating to iodine nutrition especially during pregnancy is low. An educational plan is required. The strategy for achieving adequate iodine nutrition in the population and particularly before and during pregnancy requires urgent review. While iodine supplementation before and during gestation can correct iodine deficiency, the provision of iodised salt in the community is recommended, similar to more than 80% of countries in the world. It is indeed a time for action to ensure the adequate intellectual performance of Israel's children.

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“…Mean urine iodine levels of school-aged children and pregnant women indicated that these populations were iodine-deficient [ 11 ]. Additional studies in recent years in Israel showed low iodine intake and low prevalence of iodized salt intake in pregnant women [ 12 ]. Previous research has shown that while Israeli milk and dairy products are iodine rich, consumption patterns of milk, dairy, as well as dairy-based foods, among Israeli adults do not ensure adequate iodine intake [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Results of the national biomonitoring program show persistent iodine deficiency in Israel

Barnett-Itzhaki

Ehrlich

Troen

et al. 2022

Isr J Health Policy Res

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Background Adequate iodine intake is essential for human health, for normal thyroid function, and for attainment of full intellectual potential in children. In light of Israel's lack of a mandatory salt fortification policy, heavy reliance on desalination and low iodine intake from dairy products and seafood, there is concern in Israel that the population is iodine deficient. Indeed, the first Israeli National Iodine Survey in 2016 found a median urinary iodine concentration (UIC) of 83 µg/L among school age children, falling below the WHO’s adequacy range of 100–299 µg/L for children. Methods In the framework of the National Human Biomonitoring Program in Israel, spot urine samples and questionnaire data were collected from 166 healthy children aged 4–12 years in 2020–2021. Urinary iodine concentrations were measured at the Ministry of Health National Biomonitoring Laboratory, using mass spectrometry. An international comparison of median urinary iodine concentrations (UIC) was performed taking into consideration the levels of desalinated water per capita, and fortification policies. Results The overall median (interquartile range [IQR]) UIC was 80.1 µg/L (44.7–130.8 µg/L) indicating that the population’s iodine status has not improved in the five years that have passed since inadequacy was first identified. When comparing 13 countries with population size above 150,000, whose desalinated water per capita was at least 1 m3, Israel and Lebanon were the only countries with median UIC below the WHO adequacy range. Conclusions There is an urgent need for mandatory salt fortification in Israel. Based on our international comparison, we conclude that the potential impact of desalination on iodine intake can be compensated for using the implementation of salt fortification policy. This study highlights the critical need for public health surveillance of nutritional and environmental exposures using human biomonitoring, with emphasis on vulnerable populations such as pregnant women and children.

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Low intake of iodized salt and iodine containing supplements among pregnant women with apparently insufficient iodine status - time to change policy?

Cited by 13 publications

References 30 publications

Dynamics of epidemiological indicators of thyroid pathology in the population of the Russian Federation: analytical report for the period 2009–2018

Dynamics of epidemiological indicators of thyroid pathology in the population of the Russian Federation: analytical report for the period 2009–2018

Iodine deficiency in Israeli pregnant women – a time for action

Results of the national biomonitoring program show persistent iodine deficiency in Israel

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