Iodinedeficiency 2015 pirzado

IODINE DEFICIENCY

Abdul Rehman Pirzado

Iodine Deficiency

Iodine function: component of thyroid hormones (T3 and T4) which

regulate a variety of processes, including:

• Metabolic rate

• Heart rate

• Temperature

• Mental function

Food sources: depends on the iodine content of the soil on which food

was raised; good natural sources are seafood and seaweed, and iodized

salt, processed foods and dairy products are iodine-rich


Iodine Deficiency

Signs and symptoms of iodine deficiency:

• In adults/children: hypothyroidism and goiter (thyroid gland

hyperplasia due to elevated TSH levels)

• Congenital hypothyroidism (in fetuses of affected mothers):

intellectual impairment, short stature, speech and hearing loss

Risk factors for deficiency:

iodine-poor soil


In 2014 Iodine Deficiency remains a Major Public Health Problem Worldwide

A. Strongly Agree

B. Agree

C. Somewhat Agree

D. Neutral

E. Somewhat Disagree

F. Disagree

G. Strongly Disagree


Iodine Deficiency is an Important Health Issue for my Clients

A. Strongly Agree

B. Agree

C. Somewhat Agree

D. Neutral


F. Disagree



Iodine Deficiency may impact my Health

A. Strongly Agree

B. Agree

C. Somewhat Agree

D. Neutral


F. Disagree



Goiter


Himalayas

Goiter


Congenital Hypothyroidism


Congenital Hypothyroidism

Bolivia Tanzania Pakistan


A brief history of goiter

• 1813 Iodine isolated from seaweed

• Theodor Kocher (1841-1917), who performed over 5000

thyroidectomies for goiter, recognized post-op myxedema in his

patients

• 1873 children in Albi, France treated with 7.5 mg of iodine daily for 75

days with clinical improvement in goiter

• 1893 Thyroid extracts found to be useful in treating myxedema

• 1890s Baumann and Roos isolated “thyroiodine” from the thyroid

finding it contained 10% iodine

• Osler writes in the 1900s that the cause of goiter and the function of

the thyroid are still unknown

J. Nutr. 135: 675–680, 2005 Abdul Rehman Pirzado

The Problems:

There is widespread dietary iodine deficiency

• One-half to two-thirds of the world population at risk

In affected populations, goiter and cretinism in

a few coexist with cognitive deficits in all

• In populations where >5% of school children have

goiter, the cognitive performance among apparently

healthy individuals is shifted downward by 10 - 15 IQ

points


The Solution:

Universal Salt Iodization


Iodine Needs

Age Daily Requirements (ug/day)

0-6 months 35

6-12 months 45

1-10 years 60-100

≥ 11 years 100-115

Pregnancy / Lactation 125-150


The Solution:


Key Components of IDD Elimination

Universal Salt Iodization

Strategy

Oversight

Advocacy Evaluation

and and

Social Mobilization Surveillance


Advocacy & Social Mobilization

• Accepting the magnitude of the problem

• Overcoming some resistance to universal salt iodization

• Establishing the safety of potassium iodate

• Setting adequate and safe salt iodine levels

• Salt is not an unhealthy product

• Iodization is enrichment of a commonly eaten food

• Support large companies also, not only the cottage industry

• Focus first on areas where success is attainable, not the poorest and most remote


Evaluation & Surveillance

• WHO 2007 Resolution: Efforts to eliminate IDD require continuous

monitoring and oversight and require Member States to establish

mechanisms for monitoring iodine nutrition and reporting on their

progress.

• UIE trends in school-aged children to be complemented with iodine

status of pregnant and lactating women.

• Monitoring of iodine status should not only check for deficiency but

also highlight excess.


Source:de Benoist B et al. Iodine deficiency in 2007: Global progress since 1993.Food and Nutrition Bulletin, vol 29, no. 3, 195-202, September 2008.

Category of public health significance (based on median urinary iodine)

Moderate iodine deficiency (20-49 µg/l)

Mild iodine deficiency (50-99 µg/L)

Optimal (100-199 µg/l)

Risk of iodine induced hyperthyroidism (200-299 µg/l)

Risk of adverse health consequences (>300 µg/l)

No data

Degree of public health significance of iodine nutrition based on median urinary iodine: 1993-2006

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever

on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2009. All rights reserved




Situation in Pakistan

Iodine Deficiency Disorder (IDD) is a public health problem in

Pakistan

More than half of the population estimated to be at risk

1989 Government of Pakistan initiated National Iodine

Deficiency Disorders (IDD) Control Program in the hilly areas

2000 USI program with Provincial governments started

2006 The USI Program was revitalized- piloted in 20 districts -

Nutrition Wing MoH ,MI, UNICEF and WFP - scaled up in

phases to 102 districts.


Situation in Pakistan

2011- The National Nutrition Survey -household consumption of

iodized salt as 69 % compared to 17 % in 2001.

Percentage of children 6-12 years with iodine deficiency by 28

(i.e. NNS 2011- 36 %: NNS 2001- 64 %).

Percentage of women with iodine deficiency has increased by 30

(i.e. NNS 2011- 52 %: NNS 2001- 24 %)

Prevalence of goiter among CBA women decreased to one third

as per NNS of 2011 and now stands at only 3 %.



Conclusions




Conclusions

• Iodine Deficiency Disorders are widespread in the world

affecting millions of people with a range of physical and

mental abnormalities.

• Universal Salt Iodization (USI) of all human and animal salt is

the global strategy for elimination of severe iodine deficiency.

• While tremendous progress has been made to make salt

iodization universal, 2 billion people are still at risk in the world


Conclusions

• Government Commitment is key for USI

• IDD knowledge needs to be embedded into health sector

infrastructure

• Continued advocacy efforts are needed particularly in Europe

• Expand iodization to include salt used in processed foods

• RDA is 150 µg/day for adults; 250 µg/day for pregnant and

nursing mothers


Date post:	16-Aug-2015
Category:	Healthcare
Upload:	abdul-rehman-pirzado
View:	76 times
Download:	4 times

Iodinedeficiency 2015 pirzado

Healthcare