Iodine deficiency in the world: Where do we stand at the turn of the century?

Iodine deficiency is the leading cause of preventable mental retardation. U niversal salt iodization (USI), calling for all salt used in agriculture, f ood processing, catering and household to be iodized, is the agreed strateg y for achieving iodine sufficiency. This article reviews published informat ion on programs for the sustainable elimination of the iodine deficiency di sorders and reports new data on monitoring and impact of salt iodization pr ograms at the population level. Currently, 68% of households from areas of the world with previous iodine deficiency have access to iodized salt, comp ared to less than 10% a decade ago. This great achievement, a public health success unprecedented in the field of noncommunicable diseases, must be be tter recognized by the health sector, including thyroidologists. On the oth er hand, the managers and sponsors of programs of iodized salt must appreci ate the continuing need for greatly improved monitoring and quality control . For example, partnership evaluation of iodine nutrition using the ThyroMo bil model in 35,223 schoolchildren at 378 sites of 28 countries has shown t hat many previously iodine deficient parts of the world now have median uri nary iodine concentrations well above 300 mug/L, which is excessive and car ries the risk of adverse health consequences. The elimination of iodine def iciency is within reach but major additional efforts are required to cover the whole population at risk and to ensure quality con h ol and sustainabil ity.