October 21st marks the event of "World Iodine Deficiency Day or Global Iodine Deficiency Disorders Prevention Day". It is observed annually as a reminder of iodine's role in fetal growth and development along with the maintenance of thyroid hormone levels. Despite the critical importance of iodine physiologically, iodine deficiency remains the leading cause of preventable intellectual disability globally.
The daily dietary requirement of iodine in adults is 150 μg/dl. It increases to about 250-280 μg/dl during pregnancy and lactation. Iodine deficiency during pregnancy can lead to severe neurological and developmental deficits in an infant, along with cases of miscarriages and stillbirths. In severe cases, it can also cause cretinism, which is characterized by delayed sexual maturation and motor disabilities.
Further, iodine is required for the adequate production of thyroid hormones, which are needed for various calorigenic, developmental, and metabolic processes like an increase in basal metabolic rate, lipolysis, protein breakdown, and brain development.
In India, the government has been combating iodine deficiency since 1962 with the National Goiter Control Programme, later expanded into the National Iodine Deficiency Disorders Control Programme (NIDDCP) in 1992.
The primary objectives include reducing goiter cases to below 5%, achieving 100% consumption of adequately iodized salt, and monitoring iodine intake through laboratory testing and health surveys.
A major policy decision was made in 1984 to iodize all edible salt in India, which became a phased initiative starting in 1986. By 1992, the country aimed to fully transition to iodized salt. Today, India produces 65 lakh metric tonnes of iodized salt annually, which is sufficient to meet the needs of its population.
The Salt Commissioner of India, under the Ministry of Commerce and Industry (headquartered in Jaipur, Rajasthan), ensures iodization of salt at various production and distribution levels, ensuring the country's iodine needs are met.
Key indicators of iodine deficiency include:
Urine iodine excretion (UIE) rate is the principal indicator. If UIE is <20%, it is considered a public health concern.
Neonatal hypothyroidism cases are used as an environmental impact indicator, reflecting the iodine levels during prenatal development.
Goiter rate is a long-term impact indicator of iodine deficiency.
A National Reference Laboratory for monitoring iodine deficiency disorders has been established at the National Centre for Disease Control (NCDC), Delhi, along with four regional laboratories at NIN, Hyderabad, AIIH&PH, Kolkata, AIIMS, and NCDC, Delhi. These laboratories conduct training, monitoring, and quality control of salt and urine testing for iodine levels.
Through consistent efforts like the NIDDCP and the promotion of iodized salt, India continues to make strides in eradicating iodine deficiency and its associated health risks, working towards improved health outcomes and preventing intellectual disabilities across the population.
Global Efforts to Combat Iodine Deficiency
Global efforts to combat iodine deficiency have been significant, with initiatives like Iodine Deficiency Day focusing on raising awareness about the critical role iodine plays in thyroid function, growth, and development. Globally, an estimated 1.88 billion people are at risk of inadequate iodine intake, impacting nearly 30% of school-aged children. The World Health Organization (WHO) and UNICEF have championed universal salt iodization since 1993, resulting in over 120 countries adopting iodization programs.
(Input from various sources)
(Rehash/Dr. Chhavi Garg/MSM)
