Low iodine putting Israel’s population at ‘high risk’

By Nathan Gray contact

- Last updated on GMT

Low iodine putting Israel’s population at ‘high risk’

Related tags: Iodine deficiency, Epidemiology

High levels of iodine deficiency in school-age children and expectant mothers is posing a risk to health in Israel, warns the first national survey conducted in the country.

The first nationally representative survey of iodine status in the Israeli population has found a high burden of iodine deficiency in the general population.

Additionally, the research led by Professor Aron Troen from the Hebrew University of Jerusalem found that 62% of school-age children and 85% of pregnant women fall below the WHO's adequacy range – leaving them at risk of maternal and fetal hypothyroidism and impaired neurological development of the fetus.

"The immediate implication of our findings is that we need to improve the public's intake of iodine," ​said Troen. "It seems that as in most other countries, Israel's food supply and our collective dietary habits do not ensure iodine sufficiency.”

“Thus eliminating iodine deficiency and achieving optimal iodine status in Israel's population will require a sustainable, government-regulated program of salt or food iodization,”​ he noted – adding that the costs of such fortification programs are small “and the benefits substantial and have been proven in over 160 countries around the world where this is done."

Global risk

The International Child Development Steering Group has identified iodine deficiency as a key global risk factor for impaired child development, and the World Health Organization's recommends routine monitoring of population-based data on urinary iodine every five years as a means of sustainable elimination of iodine deficiency, noted the team.

Iodine adequacy is defined by the WHO as a population median of 150-249 micrograms/liter for pregnant women and 100-199 micrograms/liter for school-age children.

Until now, Israel was among the few countries that had never performed a national iodine survey.

Furthermore the country does not provide iodine prophylaxis.

Backed by the Iodine Global Network, Troen and his team from the Hebrew University of Jerusalem – in cooperation with colleagues at at Maccabi Healthcare Services and Barzilai University Medical Center in Ashkelon in Israel, and ETH Zurich in Switzerland – have now obtained the first nationally representative data about iodine status in the Israeli population.

Israel data

The team collected spot-urine samples from 1,023 school-age children and 1,074 pregnant women, representing all regions and major sectors in Israel during 2016.

They found a high burden of iodine deficiency in the general population: 62% of school-age children and 85% of pregnant women fall below the WHO's adequacy range.

Virtually no differences were seen between different ethnicities and regions of the country suggesting that low iodine status is widespread and universal throughout the country, said Troen and colleageus.

The median urinary iodine concentration (UIC) among Israel's pregnant women, only 61 micrograms iodine/liter and for school-age children, the median of 83 micrograms/liter suggest that the iodine status in Israel is amongst the lowest in the world.

The team, warned that the high burden of iodine insufficiency in Israel is a serious public health and clinical concern. Indeed, comparisons to other countries with a similar extent of deficiency suggest there is a high risk of maternal and fetal hypothyroidism and impaired neurological development of the fetus in Israel, they said.

"A healthful diet is a foundation of a prosperous nation. The public has a right, and government has both a moral obligation and clear-cut social and economic incentive to ensure that the nation's food supply supports the public's health, well-being and productivity,"​ said Troen.

They added that until now, isolated but persistent calls to address this issue have not translated into action – perhaps due to lack of awareness.

"Government action is needed to ensure that everyone has access to iodized salt,”​ added Troen.

The findings also highlight the critical need for routine public health surveillance, not only of iodine, but also of other nutritional and environmental exposures that determine the Israeli population's collective health, said the team.

The study was presented at The 46th Annual Meeting of the Israel Endocrine Society. Abstracts from the meeting can be found here.

Related topics: Regulation & Policy

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