Indian Thyroid society expert consensus on salt Iodisation

Author:

Pandav Chandrakant S.1,Bajaj Sarita2,Yadav Kapil3,Joshi Shashank R4,Seshadri Krishna G5,Kalra Pramila6,Rajput Rajesh7,Ghosh Sujoy8,Menon Arun S9,Pillai Mini G.10,Jabbar P K11,Puri Surabhi12,Gupta Sushil13,Ganie Mohd Ashraf14,Rao Himagirish K15,Shenoy Mohan T.16,Joshi Ameya17

Affiliation:

1. Former Professor and Head of the Department, Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India

2. Consultant Endocrinologist, Former Director-Professor and Head, Department of Medicine, MLN Medical College, Prayagraj, Uttar Pradesh, India

3. Professor, Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India

4. Senior Consultant Endocrinologist, Lilavati Hospital and Research Centre, Mumbai, India

5. Senior Consultant Endocrinologist, Apollo Hospitals, Chennai, India

6. Professor and Head, Department of Endocrinology, Ramaiah Medical College and Hospitals, Bengaluru, India

7. Director, Division of Endocrinology and Diabetes, Medanta-The Medicity, Rohtak, India

8. Professor of Endocrinology, IPGMER SSKM, Kolkata, India

9. Head and Consultant Endocrinologist, Lisie Hospital, Ernakulam, India

10. Consultant Endocrinologist, Lakshmi Hospital, Ernakulam, India

11. Professor and Head, Department of Endocrinology, Trivandrum Medical College, Trivandrum, India

12. Senior Resident, Department of Community Medicine, AIIMS, New Delhi, India

13. Professor and Head, Department of Endocrinology, SGPGIMS, Lucknow, India

14. Professor Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India

15. Associate Professor of Surgery, St. John’s Medical College Hospital, Bengaluru, India

16. Consultant Endocrinologist, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Trivandrum, India

17. Consultant Endocrinology, Bhaktivednata Hospital and Research Institute, Mumbai, India

Abstract

ABSTRACT Iodine, an essential micronutrient, is crucial for the production of thyroid hormones - triiodothyronine(T3) and thyroxine(T4). Thyroid hormones regulate the optimum mental development, physical growth and development, regulation of body metabolism, heat generation, and maintenance of body temperaturein an individual. Geological processes like flooding, soil erosion, deforestation, and rivers changing course, deplete the surface soil of iodine, as it is present in the top layers of soil and easily soluble in water. As a result, the population residing in the area with iodine-deficient soil, becomes susceptible to a spectrum of functional and developmental abnormalities due to dietary deficiency of iodine. Universal Salt Iodization (USI) for prevention of IDDs in India is a public health success story. The adoption of the salt iodization strategy serves as a textbook example of the journey of an intervention through the iterative loop of research to policy to programme. Salt iodization has proved to be a safe, accessible, available, affordable, and cost-effective strategy to address the burden of IDDs in India. India has been at the forefront of the efforts to control IDDs globally. India is on its way to achieving the target of > 90 percent household coverage of adequately iodized salt. Revised Food Safety and Standards (Fortification of Foods) Regulations released in 2019 introduced an upper limit for iodine concentration in salt, the adequate iodine level required at the production and consumer level, including the distribution channel at 15 – 30 ppm. Universal Salt Iodisation (USI) is India’s public health success story. There is a need to consolidate progress so far and focus on strategy to reach the “last mile”. Sustainable elimination of Iodine Deficiency Disorders (IDDs) with Universal Salt Iodisation (USI) being the primary strategy needs to also factor in harmonisation with salt reduction strategy for control of non-communicable diseases.

Publisher

Medknow

Reference15 articles.

1. Iodine;Zimmermann;Adv Nutr,2013

2. Thyroidology over the ages;Niazi;Indian J Endocrinol Metab,2011

3. Evolution of iodine deficiency disorders control program in India:A journey of 5000 years;Pandav;Indian J Public Health,2013

4. Observations on endemic goitre in the Chitral and Gilgit Valleys;McCarrison;Med Chir Trans,1906

5. Preliminary report of an experiment in the Kangra Valley for the prevention of Himalayan endemic goitre with iodized salt;Sooch;Bull World Health Organ,1965

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