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Iodine deficiency is the world’s leading cause of preventable brain damage, according to the World Health Organization (WHO). For example, iodine is a critical micronutrient for brain development in the foetus and in babies.
Up to half of all newborns in Europe may not reach their full intellectual potential or may suffer behavioural problems owing to iodine deficiency during pregnancy, says Professor Henry Völzke of the University Medicine Greifswald and coordinator of the EUTHYROID project. Later effects include thyroid disorders among adults, which put a significant burden on healthcare systems.
Yet, few EU countries regularly monitor iodine deficiency, and their different techniques and methodologies mean Europe does not have a harmonised database to fully assess the issue and its effect on health.
In response, EUTHYROID collated data on iodine deficiency across all EU countries and established a pan-European infrastructure to monitor, evaluate and prevent iodine deficiency and the significant health problems it causes.
“We have now produced a harmonised system for monitoring iodine status and linking this to medical costs and outcomes as well as a series of cultural and region specific factors, such as socio-economic factors and dietary choices,” says Prof. Völzke. “For policymakers, this means that the results of any decision to fortify foodstuffs through the mandatory iodisation of table salt can be monitored and evaluated.”
A harmonised programme
The database includes information on existing national efforts to monitor iodine deficiency and data from medical registries on the nature and incidence of related health issues, such as thyroid conditions. This important data helps evaluate what does and does not work to encourage people to get enough iodine, and thus improve their health.
Furthermore, the project team tested and improved a ‘dried blood test’ technique to evaluate the iodine status of populations. The test is considered easier and more reliable than the current urine analysis test, says Prof. Völzke.
Time for action
Considering the weight of medical evidence built up over many years, and the clear recommendations of international bodies such as the WHO and the Iodine Global Network, Prof. Völzke hopes that EUTHYROID will encourage national health authorities and policymakers to take the next step and legislate for iodine fortification.
Today, in Europe, only 27 % of households have access to iodised salt, leaving an estimated 350 million citizens exposed to possible iodine deficiency and its consequences, says Prof. Völzke.
“Voluntary iodine fortification policies are not working well as industry receives mixed messages,” he says. “We need controlled amounts of iodine in all salt – table salt, salt for the food industry, and salt for the animal feed industry – without restrictions across Europe. This needs legislation.”
He believes such legislation will ensure EU citizens, and in particular pregnant women and their babies, will get the iodine they need to improve overall health and well-being – while reducing the burden on healthcare systems.
The Krakow Declaration
In April 2018, EU scientists published the Krakow Declaration on Iodine and called on policymakers to take strong measures to eliminate the current widespread and dangerous iodine-deficiency levels among Europeans through the obligatory iodisation of table salt. At the forefront of the declaration were the 27 partners involved in EUTHYROID.
“This is a vital topic, not just for health in Europe, but also as an example to the rest of the world on how to implement harmonised monitoring and evaluation of health outcomes,”