Iodine Deficiency in Israel Needs Immediate Action

High burden of iodine insufficiency in Israel increases risk of maternal and fetal hypothyroidism and impaired neurological development.

A high burden of iodine deficiency among Israelis poses a high risk of maternal and fetal hypothyroidism and impaired neurological development of the fetus in Israel.

Researchers from the Hebrew University of Jerusalem, and their colleagues at Maccabi Healthcare Services and Barzilai University Medical Center in Ashkelon in Israel, and ETH Zurich in Switzerland, with support of the Iodine Global Network, have obtained the first nationally representative data about iodine status in the Israeli population.

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‘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.’

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.

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. 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.

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.

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Adequate iodine intake is essential

for thyroid function and human health throughout life
full intellectual potential
cognitive performance

According to the researchers, the high burden of iodine insufficiency in Israel is a serious public health and clinical concern. By comparison to data from other countries with a similar extent of deficiency, these data suggest that there is a high risk of maternal and fetal hypothyroidism and impaired neurological development of the fetus in Israel.

Iodine deficiency in utero and in early childhood impairs brain development, and severe iodine deficiency causes cretinism (physical malformation, dwarfism and mental retardation) and goiter (the enlargement of the thyroid gland). "The immediate implication of our findings is that we need to improve the public’s intake of iodine," said Prof. Aron Troen, Principal Investigator at the Nutrition and Brain Health Laboratory, School of Nutrition Science, Hebrew University’s Robert H. Smith Faculty of Agriculture, Food and Environment.

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Symptoms of hypothyroidism are often general, unspecific changes in the body. Lethargy, weight gain, stiffness and cramping of muscles are some of the symptoms of hypothyroidism.

"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. The costs are small and the benefits substantial and have been proven in over 160 countries around the world where this is done."

The need for action

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According to the researchers, a universal salt iodization and monitoring program should be urgently initiated. Dr. Jonathan Arbelle, lead co-investigator from Maccabi Healthcare Services, who presented the findings at the meeting, called upon the Israel Endocrine Society to develop guidelines for clinical practitioners who care for pregnant and lactating women.

"Caregivers should recommend adequate iodine intake during pregnancy and lactation, and a randomized clinical trial of risk and benefit for correction of mild-moderate iodine deficiency during pregnancy must be considered," said Dr. Arbelle.

"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 Prof. Troen.

The World Health Organization and Iodine Global Network encourage mandatory, universal salt iodization, including the all discretionary household salt. However, some countries have effectively been able to increase their iodine intakes through the use of iodized salt in processed foods, including bread and condiments, and this may be considered in Israel. "Government action is needed to ensure that everyone has access to iodized salt, added Prof. Troen.

These 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.

"I’m pleased that the Ministry of Health has been supportive of this particular research effort, but to act on the findings and make a sustainable change will require government funding and legislation," said Prof. Troen.

Source-Eurekalert