Awareness towards vital Health issues: Iodine deficiency disorders

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TOPIC: General studies 2

• Health

What is Iodine deficiency disorders (IDD)?

Iodine deficiency disorders (IDD) constitute the single largest cause of preventable brain damage worldwide. Iodine is an essential micronutrient required for the synthesis of the hormones – thyroxine and triiodothyronine. 

What is Iodine?

Iodine is a mineral used by the body to regulate metabolism. It also helps regulate bone growth and brain development in children. It is found in seafood, iodized salt, dairy products, and some fruits and vegetables.

Iodine deficiency disorders & diseases

In the past, iodine deficiency was thought to cause only goitre and cretinism. However, over the last quarter of the century, it has become increasingly clear that iodine deficiency leads to a much wider spectrum of disorders commencing with the intrauterine life and extending through childhood into adult life with serious health and social problems. The spectrum of diseases includes goitre, cretinism, hypothyroidism, brain damage, abortion, still birth, mental retardation, psychomotor defects and hearing and speech impairment. Majority of consequences of IDD are invisible and irreversible but at the same time preventable.

What is the situation in India?

In India, the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. Due to glaciations, flooding, rivers changing course and deforestation the iodine present in top soil is constantly leached. This in turn leads to deficiency of iodine in crops grown on iodine deficient soil with consequently low iodine in the diet for livestock and humans. 

The study shows that 76.3% of Indian households consumed adequately iodised salt, which is salt with at least 15 parts per million of iodine. The five worst performers were 

• Tamil Nadu (61.9%), 
• Andhra Pradesh (63.9%), 
• Rajasthan (65.5%), 
• Odisha (65.8%) Jharkhand (68.8%) 

Rajasthan, which is the second largest producer of salt, also figured among the five worst covered States. Gujarat produces 71% of salt in the country, followed by Rajasthan at 17% and Tamil Nadu at 11%. The rest of the country accounts for a mere 1% of salt produced.

• The northeastern States are doing very well with respect to iodised salt consumption at the household level because of the distance they have from the three salt producing centres — Gujarat, Rajasthan and Tamil Nadu. By and large most States get their salt from Gujarat and Rajasthan and because of the distance, it is sent by rail. This salt is strictly monitored by the Salt Commissioner’s office and if it is inadequately iodised, they don’t allot rakes. 
• Secondly, salt-producing States have access to common (or non-iodised) salt and, therefore, they start consuming it since it is readily available

The survey was conducted by Nutrition International in collaboration with the All India Institute of Medical Sciences and the Indian Coalition for the Control of Iodine Deficiency Disorders (ICCIDD). The survey tested the iodine content in samples of cooking salt from households to estimate the coverage of iodised salt.

India made fortification of salt with iodine mandatory for direct human consumption in 1992. This was relaxed in 2000 and then reimposed in 2005. In 2011, the Supreme Court, too, mandated universal iodisation for the control of iodine deficiencies.

The Way Forward

• To combat the risk of IDD, salt is fortified with iodine
• Sustain the momentum so that iodine coverage does not fall below current levels
• Fix lack of political commitment: States and the Centre should work together to address the current gaps and look into issues that vary from one State to another, leading to adequately iodised salt not being produced.
• To ensure the supply of adequately iodized salt, sustained monitoring of the iodine level is required at different stages, namely, at the production stage, before dispatch by rail or road, the wholesale and retail level, and the consumer household level. Monitoring at the production level is a crucial component of the salt iodization program.
• Public awareness of IDD and its serious consequences remains low, and there is a lack of consumer demand for adequately iodized salt. Most importantly, consumers are not equipped with the tools and skills necessary to assess the quality of the salt they purchase, making them unable to demand only adequately iodized salt. There is a serious need to fix this.