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Nutritional epidemiology and thyroid hormone metabolism.
1Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles 1020, Belgium. jean.vanderpas@chu-brugmann.be
Annual Review of Nutrition
|May 18, 2006
Summary
Severe iodine deficiency, a cause of goiter and cretinism, still affects 200 million globally. Public health efforts must prioritize reaching remote populations and monitoring iodine supplementation programs to prevent adverse effects.
Area of Science:
- Endocrinology
- Public Health
- Environmental Health
Background:
- Severe iodine deficiency historically caused endemic goiter and cretinism.
- Iodized salt supplementation has reduced many endemic areas, but 200 million remain at risk in remote regions.
Purpose of the Study:
- To highlight the ongoing global risk of iodine deficiency.
- To emphasize the need for targeted public health interventions and robust monitoring of supplementation programs.
- To discuss complementary diagnostic tools and environmental risk factors for endemic diseases.
Main Methods:
- Review of historical data on iodine deficiency and supplementation programs.
- Discussion of advanced diagnostic techniques like echography and inductively coupled plasma-mass spectrometry.
- Analysis of environmental goitrogens (thiocyanate) and nutrient deficiencies (selenium) as contributing factors.
Main Results:
- Geographical distribution of severe iodine deficiency has decreased, but significant populations remain vulnerable.
- Iodine-induced hyperthyroidism and supplementation interruptions pose risks.
- Environmental factors like thiocyanate overload and selenium deficiency are linked to endemic cretinism subtypes.
Conclusions:
- International public health programs must focus on reaching underserved populations and rigorously monitoring iodine supplementation.
- Advanced diagnostics improve goiter assessment and iodine/thyroid hormone measurement.
- Understanding environmental risk factors is crucial for addressing variable presentations of endemic cretinism and related disorders like Kashin-Beck osteoarthropathy.