The story behind the story – and why it’s important

A story and a leader article in the Economist last week shone a light on something we at IGN have been speaking about for some time now – the fact that new lifestyles and diets, and a lack of government attention, are eroding protection to the developing brains of children from lack of iodine.

The leader article points out that a scourge that damages babies’ brains is returning in affluent countries, even though iodine deficiency is “startlingly easy” to prevent through salt iodization and consumption of dairy products, which contain iodine because it is used in cattle feed to keep cows healthy, and in sterilizing processes used in milking.

The Economist story that led its editors to write the leader, points out that iodine nutrition status in the United States is falling for a number of reasons.  Salt iodization in the US has never been mandated, and only about half of American table salt is iodized. Specialty salts like sea salt or pink Himalayan, tend not to be iodized. The increasing consumption of processed foods is also a contributor, as the salt used in their production generally does not contain iodine. The rise in veganism and climate conscious eating has also reduced appetites for fish and meat, which are sources of iodine. Demands for iodine during pregnancy are higher and studies have shown that a quarter of pregnant women in the US do not meet minimum iodine thresholds.

The story goes on to mention the WHO/IGN report on iodine intake in Europe, published in June, which sounded the alarm about deficiencies resulting from changing diets.  The Economist article does not mention IGN, yet we played a major role in advising its publication by generating most of the content upon which it was based, pointing clearly to the importance of our work.

The first expert quoted is Dr. Elizabeth Pearce, IGN’s Regional Coordinator for North America, who has championed the gathering of data on iodine status in pregnant US women. To address this lack of information, a multi-center cross-sectional survey of US pregnant women has recently been completed in collaboration with investigators at Michigan State. Under Elizabeth’s leadership, as part of this survey, IGN has supported the  collection of  additional UIC measurements in a representative sample of pregnant women from Michigan (which was the most profoundly iodine deficient US region prior to salt iodization). The second person interviewed, Dr. Michael Zimmermann, a professor of nutrition at Oxford University, is the Chair of IGN’s Board of Directors and a world-renowned authority on iodine deficiency.

IGN advocated for, and partnered with, WHO to produce the major publication about prevention and control of iodine deficiency in Europe, which provided the information on diet and lifestyle changes that are causing iodine deficiency to re-emerge. Funding to support the writing and publication came from Kiwanis International through IGN. The authors are all directly associated with IGN.  Dr. Rodrigo Moreno-Reyes is IGN’s Regional Coordinator for Western and Central Europe.  Dr. Sarah Bath, of the University of Surrey, is an IGN Board member. Dr. Gregory Gerasimov is IGN’s Regional Coordinator for Eastern Europe and Central Asia, and Dr. Maria Andersson is a former IGN Board member who works with WHO on data on behalf of IGN.

The leader calls out some simple remedies governments can apply – identifying commonly-consumed food products and mandating their iodization, including dairy alternatives and salt used in processed foods; adding iodised salt to bread; and incentivising farmers to add more iodine to animal feeds where needed.  These recommendations – and many others – are laid out in the WHO/IGN report on deficiency in Europe.  The report also quotes a study on the cost-effectiveness of salt iodization, with improvements to cognitive development and earning power between 1993 and 2019 leading to a net economic benefit of $32 billion a year, and preventing some 720 million cases of deficiency worldwide – authored by a former Executive Director of IGN, Jonathan Gorstein, and others including Elizabeth Pearce and Michael Zimmermann.

We are proud that IGN work provided the story behind the story, allowing a light to be shone on a re-emerging problem.  That is an important part of our work.  But beyond that, our work with governments and partners around the world has led to improvements in salt iodization programs, protecting populations, large and small, from iodine deficiency. The leader says that the world has relied too much on luck to keep people supplied with this life-enhancing mineral, and that the fact that so many countries succeeded without mandatory iodization programs was an accidental public-health triumph. We at IGN would argue that it wasn’t accidental, but definitely more difficult than when governments mandate iodization, especially with regard to compliance and quality control.

The leader ends with the message that it would not take much for the global situation to become an accidental disaster. While we agree, IGN, along with partners such as UNICEF and the Bill & Melinda Gates Foundation, and the many individual donors who contribute us through The Life You Can Save, Founders Pledge, CanadaHelps, and other funding platforms who recommend us, are working very hard to ensure that doesn’t happen. We hope that all of you will continue to support this work.