Iodine supplementation/fortification

Figures 116.1 and 116.2 show the estimated 24-h iodine excretion among users and nonusers of dietary supplements before and after fortification. They show that even among nonusers of dietary iodine supplements Hving in an area with low iodine content in groundwater and thereby a relatively low iodine intake, the iodine intake from food seems to be adequate after fortification.

Before the introduction of iodine fortification (IF) of salt, and iodine supplementation of man and domestic animals, most European countries were more or less affected by iodine deficiency (ID) disorders (Kelly and Snedden, 1960). The countries with the most severe manifestations were, in general, early to introduce preventive programs. However, some countries with only mild-to-moderate ID, such as Denmark, have only introduced programs... 

The feasibility of micronutrient supplementation and the degree to which it should be pursued in combination with other strategies to prevent and control micronutrient deficiencies depend on the local needs, resources, capabilities, commitment, and evidence of benefit. The successful prevention and control of vitamin A, iron, and zinc deficiencies will probably result from a combination of repetitive distribution of high-dose nutrient supplements, fortification of staple foods, and behavioral change, whereas fortification of salt alone with iodine has already achieved much success in combating iodine deficiency disorders. The adoption of supplementation approaches should be guided by evidence of a need for targeting, impact potential, costs, and potential sustainability. 

The recommended daily intake (RDI) for iodine by the WHO (2004) and United States Institute of Medicine (US lOM), for preschool children (90meg), school-age children up to 12 years (120meg), older children and adults (150 meg) is in the same range. The fortification levels are determined as a percentage of the daily requirement in a single or daily serve. In a single serve, the nutritional supplement can provide anywhere between one-third to half the daily requirement of iodine for children. Fortified foods which are to be consumed as such or require minimum reconstitution, provide an opportunity to include known or measured amount of iodine in the diet. 

Notes-. Iodine intake expressed as iodine dietary intake and urinary iodine excretion in elderly males (M) and females (F). The early Danish surveys indicate mild-to-moderate iodine deficiency, even among users of dietary supplements. The 68-year-old Danes were also compared to elderly subjects in Iceland with a long-standing relatively high iodine intake. After the mandatory fortification of salt in 2000-2001, the Danish National Survey 2002 indicates a sufficient iodine intake among elderly subjects. N, numbers 7-D R, 7-days food record FFQ, food frequency questionnaire. 

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