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Background: Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. Objective: The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Design: Use of adequately iodized salt ([greater than or equal to] 30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Results: Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged Conclusion: In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged KEY WORDS Children, iodized salt, mortality, Indonesia

Background: In programs to control iodine deficiency disorders (1DD), sustainability is a major concern. IDD has recently recurred in countries where salt iodization programs have lapsed. Objective: The objective of the study was to describe the evolution of thyroid dysfunction after the discontinuation of salt iodization in a cohort of children in an area of severe endemic goiter. Design: Moroccan children (aged 6-16 y, n = 159) with severe IDD received iodized salt (IS) for 1 y. Because of practical and financial constraints, including a lack of infrastructure and electricity at the production site, salt iodization abruptly ceased. The children were followed for another 14 mo, and concentrations of urinary iodine, thyrotropin, total thyroxine, and thyroglobulin and thyroid volume were measured. Results: Before iodization, median urinary iodine was 18 [micro]g/L, 88% of children had elevated serum thyroglobulin concentrations, and 72% were goitrous. One year after the introduction of IS, median urinary iodine and thyroglobulin concentrations had normalized, mean thyroid volume had decreased by 34%, and median thyrotropin and mean total thyroxine concentrations were improved. Five months after the discontinuation of salt iodization, median urinary iodine had fallen to 20 [micro]g/L. Fourteen months after the discontinuation of salt iodization, the rate of goiter was again similar to the rate before salt iodization; median thyrotropin and thyroglobulin concentrations were sharply higher than before the introduction of IS (P < 0.001); and the prevalence of hypothyroidism was 10%, compared with 3% before the introduction of IS (P < 0.001). Conclusions: In IDD-affected areas, cessation of salt iodization is associated with a rapid deterioration of thyroid function in school-age children. These findings underline the importance of sustainability in IDD control and the vulnerability of children to even short-term lapses in IS programs. KEY WORDS Iodine, deficiency, fortification, salt, goiter, thyroid, children

Background: In many developing countries, children are at high risk of both goiter and iron deficiency anemia. Iron deficiency adversely affects thyroid metabolism and may reduce the efficacy of iodine prophylaxis in areas of endemic goiter. Objective: The aim of this study was to determine whether iron supplementation in goitrous, iron-deficient children would improve their response to iodized salt. Design: We conducted a randomized, double-blind, placebo-controlled trial in 5-14-y-old children in Cote d'Ivoire. Goitrous, iron-deficient children (n = 166) consuming iodized salt (10-30 mg I/kg salt at the household level) were supplemented with either iron (60 mg Fe/d, 4 d/wk for 16 wk) or placebo. At 0, 1, 6, 12, and 20 wk, we measured hemoglobin, serum ferritin, serum transferrin receptor, whole-blood zinc protoporphyrin, thyrotropin, thyroxine, urinary iodine, and thyroid gland volume (by ultrasonography). Results: Hemoglobin and iron status at 20 wk were significantly better after iron treatment than after placebo (P < 0.05). At 20 wk, the mean reduction in thyroid size in the iron-treated group was nearly twice that in the placebo group ([bar]x [+ or -] SD percentage change in thyroid volume from baseline: -22.8 [+ or -] 10.7% compared with -12.7 [+ or -] 10.1%; P < 0.01). At 20 wk, goiter prevalence was 43% in the iron-treated group compared with 62% in the placebo group (P < 0.02). There were no significant differences between groups in whole-blood thyrotropin or serum thyroxine at baseline or during the intervention. Conclusions: Iron supplementation improves the efficacy of iodized salt in goitrous children with iron deficiency. A high prevalence of iron deficiency among children in areas of endemic goiter may reduce the effectiveness of iodine prophylaxis. Am J Clin Nutr 2002;75:743-8. KEY WORDS Iodine, iron, deficiency, anemia, goiter, iodized oil, iodized salt, children, Cote d'Ivoire

The use of discretionary salt, which is salt added during cooking and at the table, as a suitable vehicle for iodine intake was assessed by measuring salt consumption using the lithium-marker technique in rural areas of Guatemala and Benin. In both countries, we studied boys aged 6-12 y and their mothers. Subjects used lithium-labeled salt after all unlabeled salt was removed from their households. In Guatemala, 24-h urine samples for 9 mother-son pairs were collected at baseline and on days 7, 8, and 9 during the use of lithium-labeled salt. Total maternal salt intake averaged 5.2 [+ or -] 1.7 g/d ([bar x] [+ or -] SD), of which 77 [+ or -] 24% came from discretionary sources, whereas Guatemalan boys consumed 1.8 [+ or -] 0.6 g salt/d, of which 72 [+ or -] 12% came from discretionary sources. In Benin, urine collection from 13 mother-son pairs took place at baseline and on days 5 and 7. Beninese mothers had a total salt intake of 9.0 [+ or -] 2.9 g/d and their sons had an intake of 5.7 [+ or -] 2.8 g/d; discretionary salt contributed 52 [+ or -] 14% and 50 [+ or -] 13%, respectively, of total salt consumed. Therefore, fortification of household salt appears to be an appropriate method of controlling iodine deficiency in both countries, although fortification of other salt sources could be considered in Benin. Am J Clin Nutr 1998;68:636-41.

Less than one-tenth teaspoon per year of this essential substance makes the difference between growing up healthy or being goitrous and retarded. Editor's Note: Last issue in Woods Hutchinson's classic [...]

Although the cure is known, iodine deficiency disorders continue to threaten people around the globe, many of them children. Present generations of Americans have been spared the misery of the [...]

Eating less salt can cut cardiovascular disease risk by a quarter and fatal heart disease by a fifth, a study of more than 3,000 people has shown. In the US [...]

Q. Does it make a difference whether I use iodized or uniodized salt? A. It could. Iodine is an essential mineral required by the body for the production of thyroid [...]

The human body needs tiny amounts of the mineral iodine throughout life to prevent the development of goiter and other thyroid conditions and to prevent low IQs and more severe [...]

Salt has come in for some bad press recently, and it may suffer from new scientific findings aired this week. The addition of iodine to salt is apparently to blame [...]

Background: Goiter rates and iodine deficiency usually show marked improvement in efficacy studies of mandatory iodization of salt, but little is known about the short-term effectiveness of mandatory iodization. Objective: The aim of the study was to evaluate, after 1 y, the effectiveness of mandatory iodization of salt at an iodine concentration higher than that occurring under optional iodization on the goiter rates and iodine status of schoolchildren living in an endemically goitrous area. Design: Goiters, measured by palpation, and urinary iodine concentrations of children in grades 4-7 in 4 schools in a known goitrous area in South Africa were assessed before and 1 y after the introduction of mandatory iodization at a higher iodine concentration than occurred with optional iodization. Estimates of the iodine concentration of iodized salt and the proportion of households using iodized salt were also made. Results: Iodine concentration in table salt and household use of iodized salt improved within 1 y. Goiter rates, which varied at baseline from 14.3% to 30.2% in the 4 schools, remained unchanged, with an overall mean ([+ or -] SE) prevalence of 25.6 [+ or -] 2.5% at baseline and of 27.5 [+ or -] 2.7% 1 y later. The distribution of urinary iodine concentrations in the 4 schools improved substantially from the baseline deficient range. The overall median urinary iodine concentration increased from 0.17 to 1.47 [micro]mol/L. Conclusions: Mandatory iodization of salt virtually eradicated iodine deficiency within 1 y in South African schoolchildren, but the goiter rate in these children did not decline. Measurement of goiters by palpation may not be appropriate in short-term evaluations of mandatory iodization programs. Am J Clin Nutr 2000;71:75-80. KEY WORDS Iodine deficiency, goiters, mandatory iodization, urinary iodine excretion, iodized salt, short-term effectiveness, South Africa, primary school children

Background: In 1993 the compulsory iodization of salt was introduced in Zimbabwe, a country that was previously an area of severe iodine deficiency. Objective: The objective of this study was to document urinary iodine excretion and biochemical thyroid function in seemingly healthy, community-dwelling adults after the introduction of iodization. Design: A multistage, random sampling method was used in rural and urban settings to identify households from which the senior household member (aged [is greater than] 35 y) was recruited (alternating male and female recruits). Demographic data were collected for each subject and urinary and venous blood samples were taken. Urinary iodine excretion and serum thyroid hormone status (thyrotropin and total thyroxin) were evaluated according to age, sex, and area of residence. Results: A total of 736 adults were recruited (253 men; mean age: 64 y). Urinary iodine concentrations were high [median (first and third quartiles): 4.41 (2.84, 6.78) [micro]mol/L, or 560 (360, 860) [micro]g/L] and were significantly higher in rural areas than in urban areas [4.73 (3.07, 7.14) [micro]mol/L, or 600 (390, 906) [micro]g/L, compared with 3.47 (2.05, 4.73) [micro]mol/L, or 440 (260, 600) [micro]g/L; P [is less than] 0.001 ]. Urinary iodine excretion declined significantly with increasing age (r = -0.29, P [is less than] 0.001). Serum thyroid status suggested that the prevalence of biochemical hyperthyroidism in the study was 3%, with 13 of 415 cases in rural and 3 of 149 cases in urban subjects. Conclusion: This study reaffirms the need to continuously monitor iodine replacement programs to ensure efficacy. Am J Clin Nutr 1999;70:888-91. KEY WORDS Thyroid hormones, iodine deficiency, iodization, hyperthyroidism, urinary iodine, Zimbabwe, humans

Iodine is necessary for the thyroid gland to function normally. Studies have reported that the iodine intakes of vegans in several countries are lower than those of non-vegetarians. Staples of [...]

Sometimes the smallest things make the biggest difference. For instance, kids all around the world could avoid sickness, mental retardation, and thyroid gland disorders if they just had access to […]

Sometimes it s the smallest things that make the biggest difference. For instance, kids all around the world could avoid sickness, mental retardation, and thyroid disorders if they just had […]

Iodine deficiency remains a problem in China as economic reforms in the mid-1980s decentralized production, resulting in a black market for cheap, noniodized salt.--Katie Lewis, Beijing, [...]

VIENTIANE, Laos -- Soudsadi Keothaune was suffering from an iodine deficiency when she gave birth to her first daughter, Naly, 14 years ago. Iodine is an essential mineral in the [...]