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Cited by 231Thyroid Disorders and TreatmentsChild Nutrition and Water AccessNutrition, Health, and Society Studies

Global endocrinology: global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020

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Zimmermann, Michael B, Andersson, Maria·2021·European Journal of Endocrinology
DOI 10.1530/eje-21-0171PMC PMC8240726
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Abstract

Iodine deficiency has multiple adverse effects on growth and development. Diets in many countries cannot provide adequate iodine without iodine fortification of salt. In 2020, 124 countries have legislation for mandatory salt iodization and 21 have legislation allowing voluntary iodization. As a result, 88% of the global population uses iodized salt. For population surveys, the urinary iodine concentration (UIC) should be measured and expressed as the median, in μg/L. The quality of available survey data is high: UIC surveys have been done in 152 out of 194 countries in the past 15 years; in 132 countries, the studies were nationally representative. The number of countries with adequate iodine intake has nearly doubled from 67 in 2003 to 118 in 2020. However, 21 countries remain deficient, while 13 countries have excessive intakes, either due to excess groundwater iodine, or over-iodized salt. Iodine programs are reaching the poorest of the poor: of the 15 poorest countries in the world, 10 are iodine sufficient and only 3 (Burundi, Mozambique and Madagascar) remain mild-to-moderately deficient. Nigeria and India have unstable food systems and millions of malnourished children, but both are iodine-sufficient and population coverage with iodized salt is a remarkable 93% in both. Once entrenched, iodine programs are often surprisingly durable even during national crises, for example, war-torn Afghanistan and Yemen are iodine-sufficient. However, the equity of iodized salt programs within countries remains an important issue. In summary, continued support of iodine programs is needed to sustain these remarkable global achievements, and to reach the remaining iodine-deficient countries.

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  • Since the early 1990s, the prevalence of iodine deficiency has declined dramatically worldwide; 88% of the global population now has access to iodised salt and only 21 countries are currently considered iodine deficient.

    “Since the early 1990s, the prevalence of iodine deficiency has declined dramatically worldwide; 88% of the global population now has access to iodised salt and only 21 countries are currently considered iodine deficient.33”

    From Hypothyroidism (2024) · cites this paper as [33]

  • In iodine-sufficient countries, the prevalence of overt hypothyroidism is approximately 1-2%.

    “In iodine-sufficient countries, the prevalence of overt hypothyroidism is approximately 1-2%.3,31- 33”

    From Hypothyroidism (2024) · cites this paper as [33]

    The Introduction section on countries with adequate iodine nutrition reports how many countries have adequate iodine intake, but not the prevalence of overt hypothyroidism. Searches for “overt hypothyroidism” and “1–2%” found no passage giving that prevalence for iodine-sufficient countries. Page numbers were unavailable in our copy. (LLM, conf=0.73)

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Authors
Zimmermann, M. B., & Andersson, M.
Affiliations
  • ETH Zurich (CH)
  • University Children's Hospital Zurich (CH)
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2021-07-01
Volume
185
Issue
1
Pages
R13-R21
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-21-0171
PMC
PMC8240726
OpenAlex
W3161367626
Cited by
231
References
31
Citations by year
2026: 46 · 2025: 44 · 2024: 35 · 2023: 52 · 2022: 44 · 2021: 10
FWCI
5.41
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Endocrinology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • ETH Zürich Research Collection (cc-by)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
Keywords
iodine deficiency, iodized salt, salt iodization, urinary iodine, iodine status, iodine intake, iodine deficiency disorders, iodine sufficiency
MeSH terms
Adult, Child, Deficiency Diseases, Endocrinology, Female, Humans, Infant, Newborn, Iodine, National Health Programs, Pregnancy, Primary Prevention, Global Health, Sodium Chloride, Dietary, Malnutrition, History, 21st Century

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