A new report highlights a persistent and likely re-emerging problem

The problem of iodine deficiency in Europe has been a concern for IGN for many years.  Iodine deficiency can easily be addressed through the consumption of iodized salt, but a 1999 WHO survey showed Europe lagging behind Africa, Asia and South America, with the lowest salt iodization coverage of all the WHO regions at 28%.  In 2018, the EUthyroid Project funded by Horizon Europe noted that due to lack of valid data, they were uncertain about the scale of the problem, but suggested that up to half of all newborns in Europe are at risk of iodine deficiency.

Motivated by this concern, IGN and our partner organization, Kiwanis International, advocated for and worked with WHO to support the writing and production of a new report that would give us a comprehensive picture of the real situation with regard to iodine deficiency in the WHO European Region, and present a case for government, industry, and Europe’s citizens to take action to prevent iodine deficiency.

The report’s findings highlighted problems beyond lack of access to iodized table salt. Salt iodization remains the main strategy in the region to ensure adequate intake. But the growing popularity of foods produced or cooked outside the home, such as bread, processed meats or ready-to-eat meals, are now the major sources of salt in a Western diet (70–80% of total), and this salt also needs to be iodized. Recent market surveys found just 9% of salt in processed food products in Germany and 34% in Switzerland was iodized. In 24 countries with voluntary or no iodization, commonly consumed foods are often produced with non-iodized salt. Increasing popularity and availability of plant-based alternatives to other key animal food sources of iodine (milk, dairy, fish) is reducing iodine consumption still further.

To achieve adequate iodine nutrition in Europe it is important for consumers, governments and the salt industry to collaborate and engage with each other to solve this problem. The report presents some clear paths forward:

• Because of the importance of dairy to iodine sufficiency in the region, regulations for animal feeds and milk iodine concentrations should be part of iodine deficiency prevention programs. And to address the increased popularity and availability of plant-based alternatives to key sources of iodine (milk, dairy, fish), coordinated action is needed to ensure appropriate fortification of alternative milk and dairy products with iodine.
• Iodine status in adults and pregnant women is less than optimal in several countries with voluntary or no salt iodization. In 24 countries with voluntary or no iodization, commonly consumed foods are often produced with non-iodized salt. In countries where the use of iodized food grade salt in households and processed foods is mandatory, particularly domestic products such as bread, bakery, and processed meats, population iodine status is generally adequate.  In countries with over 80% use of iodized salt in the bakery industry (Armenia, Belarus, Belgium, Georgia, Moldova, the Netherlands, others), population iodine intake and status is optimal.  This is something that governments, policymakers and food producers need to consider.
• Poor knowledge of the consequences of iodine deficiency among the public, health authorities, health professionals, and food producers is a barrier to improving iodine intake. There is little understanding that advice to reduce salt intake for health reasons is compatible with using iodized salt. Engaging professional and patient groups, industry bodies, industry and most importantly, young people, can help safeguard iodine nutrition for the future.
• The report presents a growing body of knowledge about the costs associated with the existence of mild iodine deficiency throughout Europe, showing a major impact on population health and the economy. More research to understand the extent and cost of this impact is needed to support the case for action.

IGN, together with WHO and Kiwanis International, believe this comprehensive report provides governments, industry, the health community and civil society with the information needed to address this problem and safeguard the region’s future from the impact of iodine deficiency.