Optimization of iodine intake in Belgium.

Mild iodine deficiency (MID) is a long-standing problem in Belgium and was recognized only recently as public health issue by the Ministry of Health (MOH). The main MID-related health problems in Belgium are a high prevalence of thyroid nodules and multinodular goiter. The economic cost of thyroid nodular disease only in Belgium was estimated at about €40 millions per year. The Belgian health authorities adopted a selective strategy to optimize iodine intake through the fortification of bread with iodized salt. A progressive, step-by-step increase of the iodine content of salt was chosen in order to minimize the incidence of hyperthyroidism. MOH monitors this strategy by assessing periodically the urinary iodine concentration in school-aged children and pregnant women, as well as by a yearly follow-up of TSH concentrations in all Belgian newborns. Although the implementation of this strategy was an important step, the main drawback of the current situation is the absence of a legal framework to support the strategy. The utilization of iodized salt in bread on a voluntary basis was endorsed by the bakery industry and MOH. However a legal framework is required to assure the effectiveness and continuity of the program and to avoid a higher than optimal iodine intake in the population.

Situación nutricional de yodo en la población escolar de Alicante / Iodine nutritional status in the school-aged population in Alicante (Spain)

Antecedentes Según la Organización Mundial de la salud (OMS), España se consideró un país afectado de endemia bociosa. El déficit de yodo es el responsable de dicha endemia además de ser la principal causa de retraso mental y parálisis cerebral evitable en el mundo. Material y métodos Estudio observacional para determinar la prevalencia de bocio endémico y el estado nutricional de yodo en la provincia de Alicante. Para ello se midió la yoduria en una muestra aislada y el volumen tiroideo mediante ecografía. Se consideró bocio todo volumen tiroideo superior al percentil 97 por edad publicado por la OMS. Resultados No se ha encontrado ningún caso de bocio. Así mismo las cifras de yoduria obtenidas también pueden ser consideradas dentro de la normalidad bajo los criterios de la OMS. Conclusiones Se puede decir que la provincia de Alicante no padece endemia bociosa y que además las cifras de yoduria demuestran una adecuada ingesta de yodo. Se evidencia la necesidad de realizar más estudios ecográficos de tiroides en otras zonas para establecer volúmenes tiroideos de referencia para nuestra población

Background According to the World Health Organization (WHO), goiter is endemic in Spain. The main cause of endemic goiter is iodine deficiency, which is also the principal cause of mental retardation and avoidable cerebral palsy throughout the world. Material and methods We conducted an observational study to determine the prevalence of endemic goiter and nutritional iodine status in the province of Alicante. Urinary iodine excretion was measured in a morning urine sample, and thyroid volume was measured by means of a thyroid ultrasound scan. A case of goiter was diagnosed if thyroid volume was above the 97th percentile adjusted by age, as published by the WHO. Results No cases of goiter were found. In addition, the median urinary iodine excretion levels adjusted by age were within the normal range, as defined by the WHO's criteria. Conclusions Endemic goiter was not found in the province of Alicante and urinary iodine excretion values demonstrated adequate iodine intake. Further ultrasound studies are needed to establish reference thyroid volumes for our population