Universal salt iodization

Universal salt iodization (USI) is the main intervention strategy for iodine deficiency control, and was adopted by the International Conference on Nutrition in 1992, reaffirmed by the World Heath Assembly in 1993, and established as a World Summit for Children mid-decade goal in 1995- Salt has been chosen as a vehicle, because of its widespread consumption and the extremely low cost of iodization. In high-risk areas, where populations cannot... 

Promote actively and worldwide all policies leading to universal salt iodization. 

Utilization of iodized table salt, together with its use in processed food should theoretically provide for dietary requirements. Except in countries who have adopted a policy of universal salt iodization (USI) the availability and... 

This program has refied on the use of iodized salt through a policy known as universal salt iodization (USI). This requires all salt for human and animal consumption to be iodized at a level of 20—40 mg iodine/kg potassium iodate. 

As a result, by 1999, in the absence of an efficient national universal salt iodization (USI) program, we introduced a program of iodine implementation designed to encourage voluntary consumption of iodized salt in both fertile-age and pregnant women fiving in the moderately iodine-deficient area previously studied. 

In countries with well-established universal salt iodization (USI) programs and iodine sufficiency, pregnancies probably are not at risk of iodine deficiency. In countries without USI programs and mild ID (most European countries), supplementation can be achieved with 100—200p,g of iodine per day given during pregnancy. 

The preferred public health technology on the grounds of effectiveness and cost is universal salt iodization (USl). This means that all food industry salt for human (and animal) consumption should be iodized, which requires legislative action. The recommended level is 20 0 mg iodine/kg salt (WHO/UNICEF/ICCIDD, 1996). Such a measure has been adopted by many countries, including the highly populated countries, such as Bangladesh, China, India, Indonesia and Nigeria. 

However, our study, carried out in Delhi after salt iodization, seems to suggest that iodine intake may lead to an alteration in the response of Graves disease to treatment with antithyroid medication. In 1988, 50% of the patients with Graves disease in Delhi became euthyroid after 3 weeks of carbimazole treatment (Jones et al., 1988). This smdy was carried out one year before the ban on the sale of edible noniodized salt in Delhi was introduced. In 1999, 10 years after there was universal salt iodization in Delhi, only 15% of patients with Graves disease studied in the same hospital were euthyroid after 3 weeks of treatment with the same dose of carbimazole (Ahluwalia et al., 2001). When treated with 30 mg/day of carbimazole, 15.4% had normalized serum T3 levels and 26.9% had normalized serum T4 levels after 3 weeks of treatment. After 6 weeks of treatment, 38.5 and 53.8% of the patients with Graves disease had normalized serum T3 and T4 levels, respectively. This seems to suggest that the response of Graves disease to carbimazole has become poorer with the increase in iodine consumption. 

In view of changing eating patterns (vegetarians and reduced salt intake) and lack of universal salt iodization, screening of pregnant women would help to identify those who are at maximum risk. 

TPOAb Anti-thyroid peroxidase antibody USI Universal salt iodization... 

In July 2000, as conclusive evidence of a return to iodine deficiency emerged, the Tasmanian Department of Health and Human Services (DHHS) referred the matter to the food regulatory body for Australia and New Zealand (then called the Australian and New Zealand Food Authority), with a recommendation that binational iodine fortification be investigated with serious consideration of universal salt iodization. Anticipating that it would take time to develop a binational approach, the TAG called for interim action in Tasmania to correct iodine deficiency. The DHHS established an interim strategy to increase iodine uptake in the Tasmanian population... 

Mandatory fortification, preferably universal salt iodization (including all salt used in processed foods), is required to eliminate iodine deficiency in all groups in the population. 

Mali is a landlocked country in West Africa, and is one of the poorest countries in the world. Iodine deficiency disorders (IDD) have been prevalent in several areas of the country, especially in the southern part. This chapter provides a historic overview of the changes in IDD over time, and of the various strategies that have been implemented to combat IDD. While the national total goiter rate was estimated to be 30% in 1974, a nationwide survey in 2005 found a total goiter rate of 8%, with 88% of the households using iodized salt. The latest figures indicate that Mali still suffers from iodine deficiency, and that efforts must continue in order to reach the goal of universal salt iodization. 

The difficulties in the production and quality maintenance of iodized salt for the millions who are iodine deficient, especially in Asia, were vividly demonstrated in India, where there was a breakdown in supply. These difficulties led to the adoption of universal salt iodization (USI) for India and subsequently for many other countries. This policy includes legislation to provide for compulsory iodization of all salt for human and animal consumption, and this legislation makes it illegal for noniodized salt to be available for human or animal consumption. 

---