After 15 years of promoting the use of iodized salt, Italy is ‘iodine-sufficient’, with a strong reduction in the risks linked to nutritional iodine deficiency, first of all goiter and its evolution into nodular goiter, even if there are still some critical issues remains pregnant. The safety of the program has been confirmed. This was recorded in a study coordinated by the National Observatory for the Monitoring of Iodoprophylaxis in Italy (Osnami) of the ISS published by the Journal of Clinical Endocrinology & Metabolism, conducted between 2015 and 2019 with the PASSI surveillance system, also coordinated by ISS, the Regional Observatories for the Prevention of Goiter, the Regional Neonatal Screening Laboratories and the AIFA Medicines Observatory.
Despite the progressive reduction in salt consumption, Italy was found to be ‘iodo-sufficient’, with a prevalence of use of iodized salt of 71.5% in adults and 78% in school canteens. Consumption is higher in the North, in women and in people with a higher socioeconomic status.
The prevalence of goiter in school age was 2.2%, much lower than the 5% threshold above which this pathology is defined as endemic. The presence of thyroid nodules in the infant population was also low (2%).
The percentage of newborns with a TSH value (thyroid hormone TSH, a marker used to screen for congenital hypothyroidism and useful for evaluating iodine intake during pregnancy) greater than 5 microunits per liter is 5.1%, a significantly lower than in the past but still higher than the 3% limit considered sufficient.
The use of iodized salt was found to be safe, with a low frequency of thyroid autoimmunity in school age and hyperthyroidism in the entire population.
“There remains some concern about iodine nutrition during pregnancy when the requirement increases” comments Antonella Olivieri, scientific director of OSNAMI.
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