Department of Health Sciences and Technology, Human Nutrition Laboratory, ETH Zürich, Zürich, Switzerland.
Iodine Global Network, Ottawa, Ontario, Canada.
Eur J Endocrinol. 2021 Jun 10;185(1):R13-R21. doi: 10.1530/EJE-21-0171.
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.
碘缺乏对生长发育有多种不良影响。如果不进行盐的碘强化，许多国家的饮食无法提供足够的碘。2020 年，有 124 个国家制定了强制食盐碘化的立法，21 个国家制定了允许自愿碘化的立法。因此，全球 88%的人口食用碘盐。进行人群调查时，应测量尿碘浓度（UIC），并以μg/L 为中位数表示。现有调查数据质量较高：在过去 15 年中，194 个国家中有 152 个国家进行了 UIC 调查；在 132 个国家中，这些研究具有全国代表性。碘摄入量充足的国家数量从 2003 年的 67 个增加到 2020 年的 118 个。然而，仍有 21 个国家碘缺乏，13 个国家碘摄入过量，要么是由于地下水中碘含量过高，要么是由于碘盐过度加碘。碘项目正在惠及最贫困的人群：在世界上最贫穷的 15 个国家中，有 10 个国家碘充足，只有 3 个（布隆迪、莫桑比克和马达加斯加）仍然处于轻度至中度缺乏状态。尼日利亚和印度的粮食供应系统不稳定，有上百万儿童营养不良，但这两个国家的碘含量都充足，碘盐的人群覆盖率分别高达 93%。一旦碘项目得以实施，即使在国家危机期间也往往具有很强的可持续性，例如饱受战争蹂躏的阿富汗和也门，碘含量都充足。然而，各国碘盐项目的公平性仍然是一个重要问题。总之，需要继续支持碘项目，以维持这些显著的全球成就，并帮助剩余的碘缺乏国家。
