potassium-iodate and Goiter

Iodine deficiency is the main cause of potentially preventable mental retardation in childhood, as well as causing goitre and hypothyroidism in people of all ages. It is still prevalent in large parts of the world.. To assess the effects of iodine supplementation overall, and of different forms and dosages of iodine supplementation separately, in the prevention of iodine deficiency disorders in children.. The Cochrane Library, MEDLINE, EMBASE and reference lists, databases of ongoing trials and the Internet were searched. Date of latest search: October 2003.. We included randomised controlled trials and prospective controlled trials not using randomisation of iodine supplementation in children living in areas of iodine deficiency.. Two reviewers did the initial data selection and quality assessment of trials independently. As the studies identified were not sufficiently similar and not of sufficient quality, we did not do a meta-analysis but summarised the data in a narrative format.. Twenty-six prospective controlled trials were related to our question, assessing a total of 29613 children. Twenty of them were classified as being of low quality, six of moderate quality. Most studies used iodised oil as a supplement, but other supplements were also used. The intervention groups were compared to a non-supplemented control group, different doses or different forms of iodine supplementation. There was a clear tendency towards goitre reduction with iodine supplementation; this was significant in several studies. Significant differences in physical development were not seen, except in one study. Results for differences in cognitive and psychomotor measures were mixed, with only few studies showing a positive intervention effect. One study suggested that infant mortality was lowered after iodine supplementation. Most studies showed a significant increase in urinary iodine excretion and levels recommended by the WHO were reached in most cases after supplementation. Thyroid-stimulating hormone (TSH) levels were significantly reduced in one study. In 1.8% of the children investigated, adverse effects were found, most of them were minor and transient.. Despite most of the included studies being of low quality, the results suggest that iodine supplementation, especially iodised oil, is an effective means of decreasing goitre rates and improving iodine status in children. Indications of positive effects on physical and mental development and mortality were seen, although results were not always significant. Adverse effects were generally minor and transient. Insufficient evidence was available on non-oil supplements. High quality controlled studies investigating relevant long term outcome measures are needed to address the question of the best form of iodine supplementation in different population groups and settings.

Topics: Child; Congenital Hypothyroidism; Controlled Clinical Trials as Topic; Dietary Supplements; Goiter; Humans; Iodates; Iodine; Iodized Oil; Myxedema; Potassium Compounds; Potassium Iodide; Sodium Chloride, Dietary

Food fortification began in Ghana in 1996 when legislation was passed to enforce the iodization of salt. This paper describes the development of the Ghanaian fortification program and identifies lessons learned in implementing fortification initiatives (universal salt iodization, fortification of vegetable oil and wheat flour) from 1996 to date.. This paper identifies achievements, challenges, and lessons learned in implementing large scale food fortification in Ghana.. Primary data was collected through interviews with key members of the National Food Fortification Alliance (NFFA), implementation staff of the Food Fortification Project, and staff of GAIN. Secondary data was collected through desk review of documentation from the project offices of the National Food Fortification Project and the National Secretariat for the Implementation of the National Salt Iodization in Ghana.. Reduction of the prevalence of goiter has been observed, and coverage of households with adequately iodized salt increased between 1996 and 2006. Two models were designed to increase production of adequately iodized salt: one to procure and distribute potassium iodate (KIO3) locally, and the second, the salt bank cooperative (SBC) model, specifically designed for small-scale artisanal salt farmers. This resulted in the establishment of a centralized potassium iodate procurement and distribution system, tailored to local needs and ensuring competitive and stable prices. The SBC model allowed for nearly 157 MT of adequately iodized salt to be produced in 2011 in a region where adequately iodized salt was initially not available. For vegetable oil fortification, implementing quantitative analysis methods for accurate control of added fortificant proved challenging but was overcome with the use of a rapid test device, confirming that 95% of vegetable oil is adequately fortified in Ghana. However, appropriate compliance with national standards on wheat flour continues to pose challenges due to adverse sensory effects, which have led producers to reduce the dosage of premix in wheat flour.. Challenges to access to premix experienced by small producers can be overcome with a central procurement model in which the distributor leverages the overall volume by tendering for a consolidated order. The SBC model has the potential to be expanded and to considerably increase the coverage of the population consuming iodized salt in Ghana. Successful implementation of the cost-effective iCheck CHROMA rapid test device should be replicated in other countries where quality control of fortified vegetable oil is a challenge, and extended to additional food vehicles, such as wheat flour and salt. Only a reduced impact on iron deficiency in Ghana can be expected, given the low level of fortificant added to the wheat flour. An integrated approach, with complementary programs including additional iron-fortified food vehicles, should be explored to maximize health impact.

Topics: Developing Countries; Flour; Food, Fortified; Ghana; Goiter; Humans; Iodates; Iodine; Potassium Compounds; Prevalence; Program Evaluation; Sodium Chloride, Dietary; Triticum

The stability of table salt double-fortified with iron as ferrous fumarate, and with iodine as potassium iodide or potassium iodate, has been investigated under actual field conditions of storage and distribution in the coastal and highland regions of Kenya. Seven 200-g sample packets of double-fortified salt in sealed polyethylene bags and a similar packet containing a datalogger for monitoring temperature and humidity were packaged with 21 sample bags of salt from another study into a bundle, which then entered the distribution network from a salt manufacturer's facility to the consumer. Iodine retention values of up to 90% or more were obtained during the three-month study. Double-fortified salt was prepared using ferrous fumarate microencapsulated with a combination of binders and coloring agents and coated with soy stearine, in combination with either iodated salt or salt iodized with potassium iodide microencapsulated with dextrin and coated with soy stearine. Most of the ferrous iron was retained, with less than 17% being oxidized to the ferric state. The polyethylene film overwrap of salt packs in the bundles provided significant protection from ambient humidity. Salt double-fortified with iodine and microencapsulated iron ferrous fumarate premix was generally quite stable, because both iodine and ferrous iron were protected during distribution and retail in typical tropical conditions in Kenya's highlands and humid lowlands.

Topics: Anemia, Iron-Deficiency; Drug Compounding; Drug Stability; Ferrous Compounds; Food Handling; Food Packaging; Food Preservation; Food, Fortified; Goiter; Humans; Humidity; Iodates; Iron, Dietary; Kenya; Potassium Compounds; Potassium Iodide; Sodium Chloride, Dietary; Temperature; Time Factors

Severe iodine deficiency still occurs in many countries, and causes cretinism and mental impairment. In southern Xinjiang province, China, after usual methods of iodine supplementation had failed, we iodinated irrigation water to increase iodine in soil, crops, animals, and human beings. 5% potassium iodate solution, dripped into an irrigation canal for 12 or 24 days, increased soil iodine 3-fold, and crop and animal iodine 2-fold. Median urinary iodine excretion in children increased from 18 to 49 micrograms/L (two groups of similar age). The cost for iodine was US $0.05 per person per year. Soil iodine remained stable over one winter, and dripping of iodine during the second year (US $0.12 per person per year) resulted in a further 4-fold increase in soil iodine and a 1.8-fold increase in iodine in crops. We conclude that iodination of irrigation water is an advantageous and cost-effective method of supplying iodine in southern Xinjiang, and may be useful in other areas dependent on irrigation.

Topics: Agriculture; Animals; Child; Child, Preschool; China; Food Analysis; Goiter; Humans; Iodates; Iodine; Plants; Potassium Compounds; Rural Health; Soil; Water

This report incorporates the results of an investigation designed to test the effectiveness of potassium iodide and potassium iodate in the control of Himalayan endemic goitre when these compounds are added in small physiological doses to the domestic salt habitually consumed by the people in the endemic belt. In a prospective study lasting five years, a striking reduction in the prevalence of goitre was observed in areas receiving salt fortified with either potassium iodide or potassium iodate. During the same period, goitre prevalence remained unchanged in the control zone, which received plain, unfortified salt. The study has an important bearing on the problem of goitre control in developing countries that use moist, coarsely crystalline salt.

Topics: Biomedical Research; Developing Countries; Diet; Diet Therapy; Environment; Goiter; Goiter, Endemic; Humans; India; Iodates; Iodine; Potassium Compounds; Potassium Iodide; Prevalence; Prospective Studies; Sodium Chloride; Sodium Chloride, Dietary

Although it has long been known that endemic goitre exists in Basutoland, there was no clear information on its prevalence until a survey, reported on here, was conducted in 1957-58 by a nutrition survey team sent by the World Health Organization at the request of the Basutoland Government. Seven of the nine districts were covered by this survey, which revealed an average prevalence of endemic goitre (mainly diffuse) of 41%, with a range of from 30% to 50% according to the district. The problem is thus clearly a serious one, and the authors recommend the use of salt iodized at a level of 1 part of potassium iodate in 10 000-20 000 parts of salt.

Topics: Goiter; Goiter, Endemic; Humans; Iodates; Lesotho; Nutrition Surveys; Potassium Compounds; Prevalence; Sodium Chloride, Dietary; World Health Organization

Topics: Child; Goiter; Goiter, Endemic; Humans; Iodates; Iodine; Potassium Compounds

The methods employed for iodizing free-running salts are discussed. They are not suitable for the iodization of coarse crystalline salts and a new process has been devised by the Chilean Iodine Educational Bureau of London for the iodization of open-pan and solar evaporated salts. This process is described and illustrated by photographs of suitable plants. Attention is drawn to the advantages of potassium iodate as an iodizing agent.

Topics: Chile; Goiter; Iodates; Iodine; Potassium Compounds; Salts; Sodium Chloride; Sodium Chloride, Dietary