People in Europe at greater risk of iodine deficiency due to changing diets

A new report by the World Health Organization (WHO)/Europe and the Iodine Global Network (IGN) has highlighted that mild iodine deficiency is still a concern across the European region. The University of Surrey’s Dr Sarah Bath, Senior Lecturer in Public Health Nutrition, is one of the co-authors of the report, which calls for iodine fortification in salt and plant-based dairy alternatives across the region, helping to protect the long-term health of the population.

The report includes a review of dietary sources of iodine across the European region which shows that milk and dairy products are important sources in many Western and Central European countries, especially for children. However, the report highlights that the increasing popularity and availability of plant-based alternatives to these products may lead to a deficiency in consumers.

Adequate iodine intake is especially important prior to and during pregnancy, as it is needed to make thyroid hormones, which control fetal brain development. Insufficient intake of iodine can be harmful to human health – and can lead to thyroid nodules, multinodular goitre, and hyperthyroidism, particularly in adults and older people. Untreated hyperthyroidism increases the risk of cardiac arrhythmia, heart failure, osteoporosis, adverse pregnancy outcomes, and cognitive impairment in older people.

Dr Sarah Bath from the University of Surrey said:

“There is a lack of public awareness of the vital role that iodine plays in our health and the importance of iodine during pregnancy. Many people do not know that milk and dairy products are important sources of iodine and, therefore, are not looking to replace the iodine when choosing plant-based alternatives. Many of the plant-based drinks on the market, such as soy or oat drinks, are not fortified with iodine, and therefore consumers are at greater risk of iodine deficiency if they use unfortified alternatives.

“We know that food fortification – in the case of iodine the fortification of salt – can be an effective method of ensuring adequate iodine intake in countries. However, the UK does not have a salt iodisation policy, and the availability of iodised table salt is low.

“The new WHO/Europe report brings together data from a number of sources and provides evidence to underpin recommendations and policy.”

Although salt iodisation remains the main strategy to ensure adequate iodine intake in Europe, the report does acknowledge some issues as that, too is affected by dietary and lifestyle changes. Foods produced or cooked outside the home, such as bread, processed meats or ready-to-eat meals, are now the main sources of salt in a Western diet, comprising 70–80 percent of the total. Yet recent market surveys found that only 9 percent of salt in processed food products in Germany and 34 percent in Switzerland was iodised. In 24 countries with voluntary or no iodisation, commonly consumed foods are often produced with non-iodised salt.

Dr Gauden Galea, WHO/Europe Strategic Adviser to the Regional Director, Special Initiative on NCDs (noncommunicable diseases) and Innovation (SNI) said:

“Countries need more flexible policy strategies to protect people from iodine deficiency, including mandatory policies for the use of iodised food-grade salt in processed foods and integration of salt reduction and salt iodisation measures. Considering the change in dietary landscapes, there is also a need to ensure appropriate fortification of alternative milk and dairy products with iodine.”

NOTE TO EDITORS

The report ‘Prevention and control of iodine deficiency in the WHO European Region’ can be found here

• Dr Sarah Bath is available for interview on request

• For more information, please email mediarelations@surrey.ac.uk