BİR HALK SAĞLIĞI SORUNU: İYOT YETERSİZLİĞİ

Gökçe Uğurlu; Dilek Aslan

doi:10.35232/estudamhsd.1370984

Review

BİR HALK SAĞLIĞI SORUNU: İYOT YETERSİZLİĞİ

Year 2023, Volume: 8 Issue: 3, 541 - 551, 29.10.2023

Gökçe Uğurlu Dilek Aslan

https://doi.org/10.35232/estudamhsd.1370984

Abstract

Bir halk sağlığı sorunu olan iyot yetersizliğinin halk sağlığı bakış açısıyla güncel bilimsel veriden yararlanarak incelenmesi, verinin farklı değişkenler kullanılarak değerlendirilmesi ve önleme konusunda önerilerin geliştirilmesi amaçlanmıştır. İnceleme kapsamında literatür taraması yapılmıştır. Görsel sunumlarda kullanılan ülkelerin durumlarını gösteren İyot Küresel İş Birliği Ağından alınan veriler, farklı ülkelerden ulusal, bölgesel kapsamda 2005 ve 2020 yılları arasında yapılan durum tespit çalışmalarından yararlanılarak oluşturulmuştur. İnsani Gelişme İndeksi için Birleşmiş Milletler tarafından yayınlanan rapor kullanılmıştır. Verinin görsel sunumu için Microsoft Excel programı kullanılarak haritalandırma yapılmıştır. Dünyada, bazı bölgelerde ve gereksinimi fazla olan, ulaşımı az olan gruplarda iyot yetersizliğinin sorun olduğu görülmüştür. İyot Küresel İş Birliği Ağı’ndan alınan veriye göre 26 ülkede iyot alımı yetersizdir. Alımı yetersiz olarak değerlendirilen 26 ülkenin sekizinin İnsani Gelişme İndeksi düşük, beşinin orta, dördünün yüksek ve sekizinin çok yüksektir. Bir ülkenin İnsani Gelişme İndeksi belirtilmemiştir. İyot alımı yetersiz olarak sınıflandırılan 26 ülke verisinin dokuzu doğurganlık çağında kadınlarda, 15’i okul çağı yaş grubu ve/veya ergenlerde, ikisi yetişkinlerde ve biri tüm yaş gruplarını kapsayacak çalışmalarla yetersizlik saptanmıştır. İyot yetersizliğinden kaynaklanan sorunlar uygun halk sağlığı müdahaleleri ile önlenebilir. Çalışmaların bu yönde yapılması önerilmektedir.

Keywords

İyot yetersizliği, halk sağlığı, önleme ve kontrol

References

1. Kapil U. Health consequences of iodine deficiency. Sultan Qaboos Univ Med J. 2007;7(3):267-72.
2. T. C. Sağlık Bakanlığı Bingöl İl Sağlık Müdürlüğü. İyot Yetersizliği Hastalıklarının Önlenmesi Haftası 2020 [03.10.2023]. Available from: https://bingolism.saglik.gov.tr/TR,81167/iyot-yetersizligi-hastaliklarinin-onlenmesihaftasi.html#:~:text=%C4%B0yot%20ve%20%C4%B0yotlu%20tuz%20kullan%C4%B1m%C4%B1n%C4%B1n,Hastal%C4%B1klar%C4%B1n%C4%B1n%20%C3%96nlenmesi%20Haftas%C4%B1'%20olarak%20belirlenmi%C5%9Ftir.
3. Yevglevsky A, Gostev A, editors. Iodine deficiency: socio-economic problems and new approaches to its solution in veterinary medicine. BIO Web of Conferences; 2021: EDP Sciences Pages: 04002.
4. World Health Organization. Nutrition: Effects of iodine deficiency [03.10.2023]. Available from: https://www.who.int/news-room/questions-and-answers/item/nutrition-effects-of-iodine-deficiency.
5. Magri F, Zerbini F, Gaiti M, Capelli V, Croce L, Bini S, et al. Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation. Journal of Endocrinological Investigation. 2019;42(4):435-42.
6. Fereja M, Gebremedhin S, Gebreegziabher T, Girma M, Stoecker BJ. Prevalence of iodine deficiency and associated factors among pregnant women in Ada district, Oromia region, Ethiopia: a cross- sectional study. BMC Pregnancy and Childbirth. 2018;18(1):257.
7. Wei R, Wang Z, Zhang X, Wang X, Xu Y, Li Q. Burden and trends of iodine deficiency in Asia from 1990 to 2019. Public Health. 2023;222:75-84.
8. World Health Organization. Iodine status worldwide WHO Global Database on Iodine Deficiency [04.10.2023]. Available from: https://apps.who.int/iris/bitstream/handle/10665/43010/9241592001.pdf.
9. Hatch-McChesney A, Lieberman HR. Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue. Nutrients. 2022;14(17).
10. The Iodine Global Network. Global scorecard of iodine nutrition in 2020 in the general population based on school-age children (SAC). IGN: Ottawa, Canada. 2021. p: 1-6.
11. UNDP. Human Development Report 2021-22. UNDP (United Nations Development Programme). 2022.
12. National İnstitutes of Health Office of Dietary Supplements. Iodine Fact Sheet for Health Professionals [04.10.2023]. Available from: https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/.
13. Harvard T. H. Chan School of Public Health. The Nutrition Source Iodine 2023 [04.10.2023]. Available from: https://www.hsph.harvard.edu/nutritionsource/iodine/.
14. Pearce EN, Zimmermann MB. The Prevention of Iodine Deficiency: A History. Thyroid. 2023;33(2):143-9.
15. Krela-Kaźmierczak I, Czarnywojtek A, Skoracka K, Rychter AM, Ratajczak AE, Szymczak-Tomczak A, et al. Is There an Ideal Diet to Protect against Iodine Deficiency? Nutrients. 2021;13(2):513.
16. “TÜRKİYE BESLENME REHBERİ (TÜBER) 2022” Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Sağlık Bakanlığı Yayın No:1031, Ankara, 2022; pp.140-141.
17. Zimmermann MB, Andersson M. GLOBAL ENDOCRINOLOGY: Global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020. European Journal of Endocrinology. 2021;185(1):R13-R21.
18. World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination : a guide for programme managers. 3rd ed. Geneva: World Health Organization; 2007.
19. Hetzel B. IODINE DEFICIENCY DISORDERS (IDD) AND THEIR ERADICATION. The Lancet. 1983;322(8359):1126-9.
20. World Health Organization. Iodine deficiency [03.10.2023]. Available from: https://www.who.int/data/nutrition/nlis/info/iodine-deficiency.
21. Paolo Vitti M. Iodine deficiency disorders [04.10.2023]. Available from: https://www.uptodate.com/contents/iodine-deficiency-disorders?search=iodine%20deficiency&source=search_result&selectedTitle=1~43&usage_type=default&display_rank=1.
22. Eastman CJ, Zimmermann MB. The Iodine Deficiency Disorders. [Updated 2018 Feb 6]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285556/.
23. Magri F, Zerbini F, Gaiti M, Capelli V, Rotondi M, Ibañez MM, Chiovato L. Migration flows affect women’s dietary iodine intake and jeopardize their iodine sufficiency: a pilot study. Endocrine. 2017;56(1):205-7.
24. Lindorfer H, Krebs M, Kautzky-Willer A, Bancher-Todesca D, Sager M, Gessl A. Iodine deficiency in pregnant women in Austria. European Journal of Clinical Nutrition. 2015;69(3):349-54.
25. Mian C, Vitaliano P, Pozza D, Barollo S, Pitton M, Callegari G, et al. Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol (Oxf). 2009;70(5):776-80.
26. Capdevila Bert R, Marsal Mora JR, Pujol Salud J, Anguera Farran R. [Prevalence study of iodine deficiency in a 6-year-old school population]. An Pediatr (Barc). 2010;72(5):331-8.
27. Madar AA, Meltzer HM, Heen E, Meyer HE. Iodine Status among Somali Immigrants in Norway. Nutrients. 2018;10(3):305.
28. Watutantrige Fernando S, Barollo S, Nacamulli D, Pozza D, Giachetti M, Frigato F, et al. Iodine status in schoolchildren living in northeast italy:the importance of iodized-salt use and milk consumption. European Journal of Clinical Nutrition. 2013;67(4):366-70.
29. Mousavi SM, Brandt A, Sundquist J, Hemminki K. Risks of papillary and follicular thyroid cancer among immigrants to Sweden. Int J Cancer. 2011;129(9):2248-55.
30. Khan S, Fischer L, Ghaziani S, Jeremias T, Scherbaum V. Nutritional Habits of Asylum Seekers Living in Communal Accomodation in Stuttgart, Germany. Ernaehr Umsch. 2019;66:18-25.
31. T.C. SAĞLIK BAKANLIĞI HALK SAĞLIĞI GENEL MÜDÜRLÜĞÜ Çocuk ve Ergen Sağlığı Dairesi Başkanlığı. Küresel İyot Eksikliği Bozukluklarını Önleme Günü [21.10.2023]. Available from: https://hsgm.saglik.gov.tr/tr/haberler-cocukergen/kuresel-iyot-eksikligi-bozukluklarini-onleme-gunu.html.
32. UNICEF. Iodine Mart 2023 [03.10.2023]. Available from: https://data.unicef.org/topic/nutrition/iodine/.
33. UNICEF. Sustainable Elimination of Iodine Deficiency Progress since the 1990 World Summit for Children. 2008.
34. United Nations Department of Economic and Social Affairs Sustainable Development. Sustainable Development Goals [08.08.2023]. Available from: https://sdgs.un.org/goals.
35. Türk Gıda Kodeksi Tuz Tebliği, Resmi Gazete: 28737 (16.08.2013), Tebliğ No: 2013/48, md. 4,5.
36. T. C. Sağlık Bakanlığı Adıyaman İl Sağlık Müdürlüğü. İyot Yetersizliği Hastalıklarının Önlenmesi Ve Tuzun İyotlanması Programı 2018 [03.10.2023]. Available from: https://adiyamanism.saglik.gov.tr/TR,78307/iyot-yetersizligi-hastaliklarinin-onlenmesi-ve-tuzun-iyotlanmasi-programi.html.
37. T. C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Çocuk ve Ergen Sağlık Dairesi Başkanlığı. Küresel İyot Eksikliği Bozukluklarını Önleme Günü [04.10.2023]. Available from: https://hsgmdestek.saglik.gov.tr/tr/cocukergen-haberler/kuresel-i-yot-eksikligi-bozukluklarini-onleme-gunu.html.
38. Türkiye Beslenme ve Sağlık Araştırması (TBSA), T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Yayın No:1132, Ankara 2019 p: 90.
39. Kisling LA, M Das J. Prevention Strategies. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537222/.
40. Aslan D. Halk Sağlığı ve Beslenme. Hipokrat Kitabevi, 2021, p 3-4.
41. Demircioğlu EÖ, Aslan D. Halk sağlığı uygulamalarında gıda zenginleştirilmesi. STED 2023;32(1):69-27.

A PUBLIC HEALTH ISSUE: IODINE DEFICIENCY

Year 2023, Volume: 8 Issue: 3, 541 - 551, 29.10.2023

Gökçe Uğurlu Dilek Aslan

https://doi.org/10.35232/estudamhsd.1370984

Abstract

Iodine deficiency is a significant and preventable public health problem in the world. In this paper, we aimed to assess iodine deficiency, a significant public health problem in the world and Türkiye, using current scientific data from a public health point of view to evaluate the data using different variables and to develop recommendations for prevention. During the review process, a literature review was conducted within the defined scope. The information presented in the visual presentations regarding the status of various countries concerning iodine was acquired from the Iodine Global Network. This data was gathered through population-based surveys conducted at national and regional levels from 2005 to 2020 across multiple countries. The report published by the United Nations was used for the Human Development Index (HDI). The Microsoft Excel program was utilized for mapping to present the data visually. It has been observed that iodine deficiency is a significant issue in specific regions, and among groups with high needs, there is limited access to iodine worldwide. Based on data from the Iodine Global Network, there are 26 countries where iodine intake is inadequate. Out of the 26 countries evaluated for inadequate intake, eight had a low HDI, five had a medium HDI, four had a high HDI, and eight had a very high HDI. The HDI of one country was not specified. Of the 26 countries classified as having iodine deficiency, nine were found to be inadequate in women at reproductive age, 15 in school-age and/or adolescents, two in adults, and one in all age groups. Problems caused by iodine deficiency can be prevented by appropriate public health interventions. Studies in this direction are recommended.

Keywords

Iodine deficiency, public health, prevention and control

References

1. Kapil U. Health consequences of iodine deficiency. Sultan Qaboos Univ Med J. 2007;7(3):267-72.
2. T. C. Sağlık Bakanlığı Bingöl İl Sağlık Müdürlüğü. İyot Yetersizliği Hastalıklarının Önlenmesi Haftası 2020 [03.10.2023]. Available from: https://bingolism.saglik.gov.tr/TR,81167/iyot-yetersizligi-hastaliklarinin-onlenmesihaftasi.html#:~:text=%C4%B0yot%20ve%20%C4%B0yotlu%20tuz%20kullan%C4%B1m%C4%B1n%C4%B1n,Hastal%C4%B1klar%C4%B1n%C4%B1n%20%C3%96nlenmesi%20Haftas%C4%B1'%20olarak%20belirlenmi%C5%9Ftir.
3. Yevglevsky A, Gostev A, editors. Iodine deficiency: socio-economic problems and new approaches to its solution in veterinary medicine. BIO Web of Conferences; 2021: EDP Sciences Pages: 04002.
4. World Health Organization. Nutrition: Effects of iodine deficiency [03.10.2023]. Available from: https://www.who.int/news-room/questions-and-answers/item/nutrition-effects-of-iodine-deficiency.
5. Magri F, Zerbini F, Gaiti M, Capelli V, Croce L, Bini S, et al. Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation. Journal of Endocrinological Investigation. 2019;42(4):435-42.
6. Fereja M, Gebremedhin S, Gebreegziabher T, Girma M, Stoecker BJ. Prevalence of iodine deficiency and associated factors among pregnant women in Ada district, Oromia region, Ethiopia: a cross- sectional study. BMC Pregnancy and Childbirth. 2018;18(1):257.
7. Wei R, Wang Z, Zhang X, Wang X, Xu Y, Li Q. Burden and trends of iodine deficiency in Asia from 1990 to 2019. Public Health. 2023;222:75-84.
8. World Health Organization. Iodine status worldwide WHO Global Database on Iodine Deficiency [04.10.2023]. Available from: https://apps.who.int/iris/bitstream/handle/10665/43010/9241592001.pdf.
9. Hatch-McChesney A, Lieberman HR. Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue. Nutrients. 2022;14(17).
10. The Iodine Global Network. Global scorecard of iodine nutrition in 2020 in the general population based on school-age children (SAC). IGN: Ottawa, Canada. 2021. p: 1-6.
11. UNDP. Human Development Report 2021-22. UNDP (United Nations Development Programme). 2022.
12. National İnstitutes of Health Office of Dietary Supplements. Iodine Fact Sheet for Health Professionals [04.10.2023]. Available from: https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/.
13. Harvard T. H. Chan School of Public Health. The Nutrition Source Iodine 2023 [04.10.2023]. Available from: https://www.hsph.harvard.edu/nutritionsource/iodine/.
14. Pearce EN, Zimmermann MB. The Prevention of Iodine Deficiency: A History. Thyroid. 2023;33(2):143-9.
15. Krela-Kaźmierczak I, Czarnywojtek A, Skoracka K, Rychter AM, Ratajczak AE, Szymczak-Tomczak A, et al. Is There an Ideal Diet to Protect against Iodine Deficiency? Nutrients. 2021;13(2):513.
16. “TÜRKİYE BESLENME REHBERİ (TÜBER) 2022” Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Sağlık Bakanlığı Yayın No:1031, Ankara, 2022; pp.140-141.
17. Zimmermann MB, Andersson M. GLOBAL ENDOCRINOLOGY: Global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020. European Journal of Endocrinology. 2021;185(1):R13-R21.
18. World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination : a guide for programme managers. 3rd ed. Geneva: World Health Organization; 2007.
19. Hetzel B. IODINE DEFICIENCY DISORDERS (IDD) AND THEIR ERADICATION. The Lancet. 1983;322(8359):1126-9.
20. World Health Organization. Iodine deficiency [03.10.2023]. Available from: https://www.who.int/data/nutrition/nlis/info/iodine-deficiency.
21. Paolo Vitti M. Iodine deficiency disorders [04.10.2023]. Available from: https://www.uptodate.com/contents/iodine-deficiency-disorders?search=iodine%20deficiency&source=search_result&selectedTitle=1~43&usage_type=default&display_rank=1.
22. Eastman CJ, Zimmermann MB. The Iodine Deficiency Disorders. [Updated 2018 Feb 6]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285556/.
23. Magri F, Zerbini F, Gaiti M, Capelli V, Rotondi M, Ibañez MM, Chiovato L. Migration flows affect women’s dietary iodine intake and jeopardize their iodine sufficiency: a pilot study. Endocrine. 2017;56(1):205-7.
24. Lindorfer H, Krebs M, Kautzky-Willer A, Bancher-Todesca D, Sager M, Gessl A. Iodine deficiency in pregnant women in Austria. European Journal of Clinical Nutrition. 2015;69(3):349-54.
25. Mian C, Vitaliano P, Pozza D, Barollo S, Pitton M, Callegari G, et al. Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol (Oxf). 2009;70(5):776-80.
26. Capdevila Bert R, Marsal Mora JR, Pujol Salud J, Anguera Farran R. [Prevalence study of iodine deficiency in a 6-year-old school population]. An Pediatr (Barc). 2010;72(5):331-8.
27. Madar AA, Meltzer HM, Heen E, Meyer HE. Iodine Status among Somali Immigrants in Norway. Nutrients. 2018;10(3):305.
28. Watutantrige Fernando S, Barollo S, Nacamulli D, Pozza D, Giachetti M, Frigato F, et al. Iodine status in schoolchildren living in northeast italy:the importance of iodized-salt use and milk consumption. European Journal of Clinical Nutrition. 2013;67(4):366-70.
29. Mousavi SM, Brandt A, Sundquist J, Hemminki K. Risks of papillary and follicular thyroid cancer among immigrants to Sweden. Int J Cancer. 2011;129(9):2248-55.
30. Khan S, Fischer L, Ghaziani S, Jeremias T, Scherbaum V. Nutritional Habits of Asylum Seekers Living in Communal Accomodation in Stuttgart, Germany. Ernaehr Umsch. 2019;66:18-25.
31. T.C. SAĞLIK BAKANLIĞI HALK SAĞLIĞI GENEL MÜDÜRLÜĞÜ Çocuk ve Ergen Sağlığı Dairesi Başkanlığı. Küresel İyot Eksikliği Bozukluklarını Önleme Günü [21.10.2023]. Available from: https://hsgm.saglik.gov.tr/tr/haberler-cocukergen/kuresel-iyot-eksikligi-bozukluklarini-onleme-gunu.html.
32. UNICEF. Iodine Mart 2023 [03.10.2023]. Available from: https://data.unicef.org/topic/nutrition/iodine/.
33. UNICEF. Sustainable Elimination of Iodine Deficiency Progress since the 1990 World Summit for Children. 2008.
34. United Nations Department of Economic and Social Affairs Sustainable Development. Sustainable Development Goals [08.08.2023]. Available from: https://sdgs.un.org/goals.
35. Türk Gıda Kodeksi Tuz Tebliği, Resmi Gazete: 28737 (16.08.2013), Tebliğ No: 2013/48, md. 4,5.
36. T. C. Sağlık Bakanlığı Adıyaman İl Sağlık Müdürlüğü. İyot Yetersizliği Hastalıklarının Önlenmesi Ve Tuzun İyotlanması Programı 2018 [03.10.2023]. Available from: https://adiyamanism.saglik.gov.tr/TR,78307/iyot-yetersizligi-hastaliklarinin-onlenmesi-ve-tuzun-iyotlanmasi-programi.html.
37. T. C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Çocuk ve Ergen Sağlık Dairesi Başkanlığı. Küresel İyot Eksikliği Bozukluklarını Önleme Günü [04.10.2023]. Available from: https://hsgmdestek.saglik.gov.tr/tr/cocukergen-haberler/kuresel-i-yot-eksikligi-bozukluklarini-onleme-gunu.html.
38. Türkiye Beslenme ve Sağlık Araştırması (TBSA), T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Yayın No:1132, Ankara 2019 p: 90.
39. Kisling LA, M Das J. Prevention Strategies. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537222/.
40. Aslan D. Halk Sağlığı ve Beslenme. Hipokrat Kitabevi, 2021, p 3-4.
41. Demircioğlu EÖ, Aslan D. Halk sağlığı uygulamalarında gıda zenginleştirilmesi. STED 2023;32(1):69-27.

There are 41 citations in total.

Details

Primary Language	Turkish
Subjects	Public Health (Other)
Journal Section	Review
Authors	Gökçe Uğurlu 0000-0002-6976-8451 Dilek Aslan 0000-0002-4053-2517
Early Pub Date	October 29, 2023
Publication Date	October 29, 2023
Submission Date	October 4, 2023
Published in Issue	Year 2023 Volume: 8 Issue: 3

Cite

Vancouver	Uğurlu G, Aslan D. BİR HALK SAĞLIĞI SORUNU: İYOT YETERSİZLİĞİ. ESTUDAM Public Health Journal. 2023;8(3):541-5.

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