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Dr Nishant Kumar
Assistant Professor
Department of Community Medicine
Madhubani Medical College , Madhubani , Bihar
 Iodine is an essential micro nutrient
 It is required at 100-150 micrograms daily for normal
human growth and development
 Necessary for synthesis of Thyroid hormones
 The disorders caused due to nutritional deficiency of
iodine are called Iodine Deficiency Disorders
 Iodine Deficiency Disorders are a worldwide major
public health problem
 Affects people across ages and socio-economic strata
 Iodine deficiency is the world’s most prevalent, yet
easily preventable, cause of brain damage
 Iodine deficiency disorders (IDD), which can start
before birth, jeopardize children’s mental health and
often their very survival
 Iodine deficiency during pregnancy can result in
stillbirth, spontaneous abortion, and congenital
abnormalities such as cretinism, a grave, irreversible
form of mental retardation that affects people living
in iodine-deficient areas of Africa and Asia
 IDD leads to major learning disabilities in children.
Children born in iodine deficient areas were found to
have 13.5 intelligent quotient (IQ) points less than
those in iodine sufficient areas.
 54 countries are still iodine-deficient
 While it was believed to be endemic to the hilly
regions and few other areas in India, today we know
that not even a single state is free from IDD
FOETUS
 Abortions
 Still births
 Congenital Anomalies
 Increased Perinatal Mortality
 Increased Infant Mortality
 Cretinism
 Psychomotor Defects
NEUROLOGICAL CRETINISM
 Mental deficiency
 Deaf mutism
 Spastic diplegia
 Squint
MYXODEMATOUS CRETINISM
 Dwarfism
 Mental Deficiency
NEONATE
 Neonatal Goitre
 Neonatal Hypothyroidism
CHILD & ADOLESCENT
 Juvenile hypothyroidism
 Impaired mental function
 Retarded physical development
ADULT
 Goitre
 Hypothyroidism
 Impaired mental function
Goitre
Cretinism
Myxoedema
Neonatal goitre
 Iodised salt – A simple, universally effective, attractive
and cheap strategy to combat IDD
 Iodine has been added to salt since 1920’s in USA and
Switzerland
 However there are still many people at risk of IDD
especially children
Vehicle must be a part of the regular daily diet
Amount of nutrient added must provide an effective
supplement for low consumers of the vehicle
Not harmful to high consumers
Not cause noticeable change in the taste, smell,
appearance or consistency
Cost should be economical
The nutrient added should not adversely affect the
metabolism of any other nutrient
The nutrient's added should be sufficiently stable in the food
under customary conditions of packaging, storage,
distribution and use
The nutrient(s) added should be physiologically available
from the food
 Spray mixing
 Drip feed process
 Dry mixing (not used anymore)
 1950’s- Kangra, Himachal Pradesh Prof
Ramalingaswamy found the association between
iodine deficiency and goitre and that it could be
cured by addition of potassium iodate in salt used
for consumption
 It was a landmark study
 1962- National Goitre Control Programme
launched
 1983- NGCP reviewed as production did not meet
the demand of all goitre endemic areas. Moving
towards recognising IDD as a national health
problem, universal iodisation of edible salt.
 1992- programme modified and renamed as
“National Iodine Deficiency Disorders Control
Program (NIDDCP).
 GOI advised all states to ensure mandatory salt
iodization for direct human consumption under
the provisions of Prevention of Food Adulteration
(PFA) Act, 1954
 1997- ban on sale of non-iodised salt for direct
human consumption throughout the country
 2000- ban was lifted, again to be reinstated in 2005
after sustained advocacy
 2006- PFA replaced by Food Safety and Standards
Act, 2006
Today we have Universal Salt Iodisation
 Renamed in 1992
Goal :
 1. To bring the prevalence of IDD to below 5% in the
country
 2. To ensure 100% consumption of adequately iodated
salt (15ppm) at the household level.
Objectives:
 Surveys to assess the magnitude of Iodine Deficiency
Disorders in the districts.
 Supply of iodated salt in place of common salt.
 Resurveys to assess iodine deficiency disorders and the
impact of iodated salt after every 5 years in the districts.
 Laboratory monitoring of iodated salt and urinary iodine
excretion.
 Health education and publicity
NFHS-4 2015-16
Households using iodised salt:
 Urban- 96.5%
 Rural- 91.4%
 Total- 93.1%
(NFHS 3 2005-06- 76.1%)
 There are state IDD cells and state IDD monitoring
labs
 Adequately iodated salt- 15ppm at household level
 Has to be 30ppm at the point of production
 Laboratory monitoring of salt for iodine content at
household level (> 15ppm) and urinary iodine
excretion (optimal >100 µg/l)
 Salt Testing Kits (for household level estimation)
 Total Goitre Rate should be <5%
Iodised salt and idd

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Iodised salt and idd

  • 1. Dr Nishant Kumar Assistant Professor Department of Community Medicine Madhubani Medical College , Madhubani , Bihar
  • 2.  Iodine is an essential micro nutrient  It is required at 100-150 micrograms daily for normal human growth and development  Necessary for synthesis of Thyroid hormones  The disorders caused due to nutritional deficiency of iodine are called Iodine Deficiency Disorders
  • 3.  Iodine Deficiency Disorders are a worldwide major public health problem  Affects people across ages and socio-economic strata  Iodine deficiency is the world’s most prevalent, yet easily preventable, cause of brain damage  Iodine deficiency disorders (IDD), which can start before birth, jeopardize children’s mental health and often their very survival
  • 4.  Iodine deficiency during pregnancy can result in stillbirth, spontaneous abortion, and congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation that affects people living in iodine-deficient areas of Africa and Asia
  • 5.  IDD leads to major learning disabilities in children. Children born in iodine deficient areas were found to have 13.5 intelligent quotient (IQ) points less than those in iodine sufficient areas.  54 countries are still iodine-deficient  While it was believed to be endemic to the hilly regions and few other areas in India, today we know that not even a single state is free from IDD
  • 6. FOETUS  Abortions  Still births  Congenital Anomalies  Increased Perinatal Mortality  Increased Infant Mortality  Cretinism  Psychomotor Defects
  • 7. NEUROLOGICAL CRETINISM  Mental deficiency  Deaf mutism  Spastic diplegia  Squint MYXODEMATOUS CRETINISM  Dwarfism  Mental Deficiency
  • 8. NEONATE  Neonatal Goitre  Neonatal Hypothyroidism CHILD & ADOLESCENT  Juvenile hypothyroidism  Impaired mental function  Retarded physical development
  • 9. ADULT  Goitre  Hypothyroidism  Impaired mental function
  • 11.  Iodised salt – A simple, universally effective, attractive and cheap strategy to combat IDD  Iodine has been added to salt since 1920’s in USA and Switzerland  However there are still many people at risk of IDD especially children
  • 12. Vehicle must be a part of the regular daily diet Amount of nutrient added must provide an effective supplement for low consumers of the vehicle Not harmful to high consumers Not cause noticeable change in the taste, smell, appearance or consistency Cost should be economical
  • 13. The nutrient added should not adversely affect the metabolism of any other nutrient The nutrient's added should be sufficiently stable in the food under customary conditions of packaging, storage, distribution and use The nutrient(s) added should be physiologically available from the food
  • 14.  Spray mixing  Drip feed process  Dry mixing (not used anymore)
  • 15.  1950’s- Kangra, Himachal Pradesh Prof Ramalingaswamy found the association between iodine deficiency and goitre and that it could be cured by addition of potassium iodate in salt used for consumption  It was a landmark study  1962- National Goitre Control Programme launched
  • 16.  1983- NGCP reviewed as production did not meet the demand of all goitre endemic areas. Moving towards recognising IDD as a national health problem, universal iodisation of edible salt.  1992- programme modified and renamed as “National Iodine Deficiency Disorders Control Program (NIDDCP).  GOI advised all states to ensure mandatory salt iodization for direct human consumption under the provisions of Prevention of Food Adulteration (PFA) Act, 1954
  • 17.  1997- ban on sale of non-iodised salt for direct human consumption throughout the country  2000- ban was lifted, again to be reinstated in 2005 after sustained advocacy  2006- PFA replaced by Food Safety and Standards Act, 2006 Today we have Universal Salt Iodisation
  • 18.
  • 19.  Renamed in 1992 Goal :  1. To bring the prevalence of IDD to below 5% in the country  2. To ensure 100% consumption of adequately iodated salt (15ppm) at the household level.
  • 20. Objectives:  Surveys to assess the magnitude of Iodine Deficiency Disorders in the districts.  Supply of iodated salt in place of common salt.  Resurveys to assess iodine deficiency disorders and the impact of iodated salt after every 5 years in the districts.  Laboratory monitoring of iodated salt and urinary iodine excretion.  Health education and publicity
  • 21. NFHS-4 2015-16 Households using iodised salt:  Urban- 96.5%  Rural- 91.4%  Total- 93.1% (NFHS 3 2005-06- 76.1%)
  • 22.  There are state IDD cells and state IDD monitoring labs  Adequately iodated salt- 15ppm at household level  Has to be 30ppm at the point of production  Laboratory monitoring of salt for iodine content at household level (> 15ppm) and urinary iodine excretion (optimal >100 µg/l)  Salt Testing Kits (for household level estimation)  Total Goitre Rate should be <5%