Iodine deficiency in China

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Iodine deficiency is a widespread problem in western, southern and eastern parts of China, as their iodized salt intake level is much lower than the average national level. Iodine deficiency is a range of disorders that affect many different populations. It is estimated that IDDs affect between 800 million and 2 billion people worldwide; countries have spent millions of dollars in implementing iodized salt as a means to counteract the iodine deficiencies prevalent today. [1] With China accounting for "40% of the total population", [2] it bears a large portion of those who are iodine deficient.

Contents

Iodine is a micronutrient the body needs to properly produce thyroid hormones. The human body is not able to produce it, and iodine is an essential nutrient. Iodine is not readily available in many foods, thus making it difficult for many people to obtain it. One particular source, found in great supply, is ocean water although it is not an effective dietary source. Iodine deficiency diseases (IDDs) are able to develop before birth, so it is crucial for all populations to have sufficient levels of the micronutrient and prevent such diseases from developing early on.

The Chinese government and iodine regulations

The Chinese government implemented a program of regulating salt to contain iodine starting in 1995. A more recent study has confirmed that the availability of iodized salt in the provinces has increased since this date. Today, about one third of the Chinese population is living in areas with low concentrations of iodine in their water supply. [2] Salt is available in China for less than the retail price in some other countries, at about 5 cents, and is consumed regularly in most diets. This is very cost effective for producers who now must abide by the iodized salt regulations and those for those who need to consume it. The black market, however, is laden with the non-iodized counterpart and partially accounts for the population still be fairly saturated with IDDs.

Implementations of solutions

The levels of iodized salt were measured in a urinalysis of households in China. It was confirmed that about 15–25   mg/kg of iodized salt content in the diet was sufficient in preventing IDDs and preventing side effects of over consumption. In provinces where people are consuming less than this amount, there is an increased amount of improper brain development in children. Furthermore, one can see the relation between the importance of iodine in thyroid hormones and the IDD goitre. This disease causes a swelling in the neck, where the thyroid glands are, leading to impaired cognitive abilities. The child population was about 20% saturated with the disease but continues to decrease with the new initiatives. [3]

Another common IDD prevalent in China is Kashin-Beck disease [ citation needed ]. A particular outbreak in Tibet was recorded as occurring from lack of iodine. Kashin-Beck is a bone deformity endemic. Iodine deficiency, hypothyroidism, and low serum concentrations of thyroxine-binding globulin were significantly related to Kashin–Beck disease. [4] Iodine supplemented irrigation water in combination to iodized salt helps in reducing the neonatal and infant mortality rates. The province of Xinjiang suffers severely from IDDs and in 1993, started the use of potassium iodate in combination with irrigation water. [5] Irrigation water is widely used and accessible to all households making it the predominant solution in reducing micronutrient deficiencies for Xinjiang.

See also

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<span class="mw-page-title-main">Congenital iodine deficiency syndrome</span> Impaired physical and mental development due to insufficient iodine intake

Congenital iodine deficiency syndrome (CIDS) is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone (hypothyroidism) often caused by insufficient dietary iodine during pregnancy. It is one cause of underactive thyroid function at birth, called congenital hypothyroidism, historically referred to as cretinism (obsolete). If untreated, it results in impairment of both physical and mental development. Symptoms may include goiter, poor length growth in infants, reduced adult stature, thickened skin, hair loss, enlarged tongue, a protruding abdomen; delayed bone maturation and puberty in children; and mental deterioration, neurological impairment, impeded ovulation, and infertility in adults.

<span class="mw-page-title-main">Goitre</span> Neck swelling due to enlarged thyroid gland

A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland. A goitre can be associated with a thyroid that is not functioning properly.

<span class="mw-page-title-main">Hyperthyroidism</span> Clinical syndrome caused by excessive thyroid hormone

Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism. Some, however, use the terms interchangeably. Signs and symptoms vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremor, and weight loss. Symptoms are typically less severe in the elderly and during pregnancy. An uncommon but life-threatening complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature; this often results in death. The opposite is hypothyroidism, when the thyroid gland does not make enough thyroid hormone.

<span class="mw-page-title-main">Hypothyroidism</span> Insufficient production of thyroid hormones by the thyroid gland

Hypothyroidism is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormones. It can cause a number of symptoms, such as poor ability to tolerate cold, extreme fatigue, muscle aches, constipation, slow heart rate, depression, and weight gain. Occasionally there may be swelling of the front part of the neck due to goitre. Untreated cases of hypothyroidism during pregnancy can lead to delays in growth and intellectual development in the baby or congenital iodine deficiency syndrome.

<span class="mw-page-title-main">Human nutrition</span> Nutrients supporting human health

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<span class="mw-page-title-main">Hashimoto's thyroiditis</span> Autoimmune disease

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis and Hashimoto's disease, is an autoimmune disease in which the thyroid gland is gradually destroyed. A slightly broader term is autoimmune thyroiditis, identical other than that it is also used to describe a similar condition without a goiter.

<span class="mw-page-title-main">Potassium iodide</span> Ionic compound (KI)

Potassium iodide is a chemical compound, medication, and dietary supplement. It is a medication used for treating hyperthyroidism, in radiation emergencies, and for protecting the thyroid gland when certain types of radiopharmaceuticals are used. In the third world it is also used for treating skin sporotrichosis and phycomycosis. It is a supplement used by people with low dietary intake of iodine. It is administered orally.

Micronutrients are essential dietary elements required by organisms in varying quantities to regulate physiological functions of cells and organs. Micronutrients support the health of organisms throughout life.

<span class="mw-page-title-main">Iodised salt</span> Table salt preparation with iodide salts added

Iodised salt is table salt mixed with a minute amount of various salts of the element iodine. The ingestion of iodine prevents iodine deficiency. Worldwide, iodine deficiency affects about two billion people and is the leading preventable cause of intellectual and developmental disabilities. Deficiency also causes thyroid gland problems, including endemic goitre. In many countries, iodine deficiency is a major public health problem that can be cheaply addressed by purposely adding small amounts of iodine to the sodium chloride salt.

<span class="mw-page-title-main">Salt</span> Mineral used as food ingredient, composed primarily of sodium chloride

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Iodine deficiency is a lack of the trace element iodine, an essential nutrient in the diet. It may result in metabolic problems such as goiter, sometimes as an endemic goiter as well as congenital iodine deficiency syndrome due to untreated congenital hypothyroidism, which results in developmental delays and other health problems. Iodine deficiency is an important global health issue, especially for fertile and pregnant women. It is also a preventable cause of intellectual disability.

Food fortification or enrichment is the process of adding micronutrients to food. It can be carried out by food manufacturers, or by governments as a public health policy which aims to reduce the number of people with dietary deficiencies within a population. The predominant diet within a region can lack particular nutrients due to the local soil or from inherent deficiencies within the staple foods; the addition of micronutrients to staples and condiments can prevent large-scale deficiency diseases in these cases.

Kashin–Beck disease (KBD) is a chronic, endemic type of osteochondropathy that is mainly distributed from northeastern to southwestern China, including 15 provinces. As of 2011, Tibet has the highest incidence rate of KBD in China. Southeast Siberia and North Korea are other affected areas. KBD usually involves children ages 5–15. To date, more than a million individuals have had KBD. The symptoms of KBD include joint pain, morning stiffness in the joints, disturbances of flexion and extension in the elbows, enlarged inter-phalangeal joints, and limited motion in many joints of the body. Death of cartilage cells in the growth plate and articular surface is the basic pathologic feature; this can result in growth retardation and secondary osteoarthrosis. Histological diagnosis of KBD is particularly difficult; clinical and radiological examinations have proved to be the best means for identifying KBD. Little is known about the early stages of KBD before the visible appearance of the disease becomes evident in the destruction of the joints.

Selenium deficiency occurs when an organism lacks the required levels of selenium, a critical nutrient in many species. Deficiency, although relatively rare in healthy well-nourished individuals, can have significant negative results, affecting the health of the heart and the nervous system; contributing to depression, anxiety, and dementia; and interfering with reproduction and gestation.

<span class="mw-page-title-main">Iodine in biology</span> Use of Iodine by organisms

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<span class="mw-page-title-main">Selenium in biology</span> Use of Selenium by organisms

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The Iodine Global Network describes itself as a "non-profit, non-government organization for the sustainable elimination of iodine deficiency worldwide."

<span class="mw-page-title-main">Undernutrition in children</span> Medical condition affecting children

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<span class="mw-page-title-main">Creswell Eastman</span>

Creswell John Eastman is the Clinical Professor of Medicine at Sydney University Medical School, Principal of the Sydney Thyroid Clinic and Consultant Emeritus to the Westmead Hospital. Eastman is an endocrinologist and has directed or conducted research and public health projects into elimination of iodine deficiency disorders (IDD) in Malaysia, Indonesia, Laos, Cambodia, Thailand, several Pacific Islands, Hong Kong, China and Tibet and Australia. For his work in remote areas of China, he has been dubbed the "man who saved a million brains".

<span class="mw-page-title-main">Child health and nutrition in Africa</span>

Child health and nutrition in Africa is concerned with the health care of children through adolescents in the various countries of Africa. The right to health and a nutritious and sufficient diet are internationally recognized human rights that are protected by international treaties. Millennium Development Goals (MDGs) 1, 4, 5 and 6 highlight, respectively, how poverty, hunger, child mortality, maternal health, the eradication of HIV/AIDS, malaria, tuberculosis and other diseases are of particular significance in the context of child health.

References

  1. Piccone, N (2011). "The Silent Epidemic of Iodine Deficiency". Life Extension. 17 (10): 42–51.
  2. 1 2 World Health Organization. "Nutrition—Micronutrient Deficiencies: Iodine Deficiency Disorders". Archived from the original on April 16, 2008. Retrieved 23 March 2012.
  3. Li, S; et al. (2010). "Is the current iodine content in edible salt appropriate for eliminating iodine deficiency in China". Asia Pacific Journal of Clinical Nutrition. 19 (2): 231–5. PMID   20460237 . Retrieved 23 March 2012.
  4. Moreno-Reyes, R; et al. (1998). "Kashin–Beck Osteoarthropathy in Rural Tibet in Relation to Selenium and Iodine Status". The New England Journal of Medicine . 339 (16): 1112–1120. doi: 10.1056/NEJM199810153391604 . PMID   9770558. S2CID   2485235.
  5. DeLong, R; et al. (1997). "Effect on infant mortality of iodination of irrigation water in a". The Lancet. 350 (9080): 771–773. doi:10.1016/S0140-6736(96)12365-5. PMID   9297997. S2CID   8169226.