Iodine prophylaxis

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Iodized salt is the most important means of iodine prophylaxis.

Iodine prophylaxis refers to the enrichment of food and feed with iodine in the form of iodized salt to combat iodine deficiency symptoms. The possible protective measure in the event of a serious nuclear accident, however, is called iodine blockade .

background

See also: Biological meaning of iodine .

The essential trace element iodine is required for the production of the thyroid hormones thyroxine and triiodothyronine . The human body contains between 10 and 30 µg iodine, about 80% of which is found in the thyroid gland . The thyroid hormones regulate metabolism, growth and development. An iodine deficiency can lead to childhood development disorders ( cretinism ), enlargement of the thyroid gland, goiter ( goiter ) and lump formation. Conversely, an excess of iodine can lead to impairments and damage.

history

Switzerland

From 1918 onwards, the Swiss doctor Otto Bayard introduced iodized salt into the communities in his practice area in the Nikolaital, using the right amount of iodine in the table salt, and showed that development disorders, the enlargement of the thyroid gland, goiter and nodule formation were not undesirable and have damage treated successfully.

Building on this, the Swiss Goiter Commission, founded by the Federal Office of Public Health in 1922, recommended the use of iodine-containing table salt to the population and the twenty-five cantonal authorities, and based on these empirical studies it determined the amount of calcium iodine added to table salt. The introduction of structured iodine prophylaxis according to Bayard throughout Switzerland in the following years had a worldwide pioneering character.

Austria

In Austria, iodine has been added to table salt since 1963. On November 15, 2005, a request to Maria Rauch-Kallat , the then Federal Minister for Health and Women , that the Swiss food company Nestlé was taking baby milk products off the market in China because their iodine content was too high for the conditions there was answered as follows : “Since Austria is considered an iodine deficiency area, it is hardly possible to take in dubious amounts of iodine through our usual diet. This also applies to the consumption of foods that have been prepared with iodized salt, as the amount of iodine added is low. Patients with illnesses in which excessive iodine intake should be avoided should therefore only be advised to limit the consumption of foods that naturally have a high iodine content (e.g. fish, seafood) and to avoid dietary supplements containing iodine. Due to the enrichment of feed with iodine, milk, milk products and eggs can also have a relatively high iodine content, so that affected persons can be recommended to reduce the consumption of these products if specific complaints occur and after analyzing their eating habits. "

Germany

Iodized salt was available in Germany since 1959. At first it was used exclusively as a dietary food in the presence of thyroid diseases due to iodine deficiency. After the WHO classified Germany as an iodine deficiency area, a broad-based so-called iodine prophylaxis began in 1981: to avoid thyroid diseases, the population should also be supplied with iodine nationwide. Until now, iodine salt packaging had the imprint “only if iodine deficiency was determined by a doctor”, which has now been removed.

In order to increase the social acceptance of iodine prophylaxis, members of the Thyroid Section of the German Society for Endocrinology and the German Society for Nutrition e. V. (DGE) founded the “ Iodine Deficiency Working Group ”. The working group receives financial support from companies in the German salt industry and the pharmaceutical manufacturers of iodine tablets.

Since the late 1980s, iodized salt has been considered a food for general consumption. From then on it was used in food production, gastronomy and communal catering. Since 1993, iodized curing salt has been used extensively for sausage and meat product production. Later, the obligation to declare unpackaged food such as bread, baked goods or sausages was no longer required. Since 1995 the mineral feed mixes for cattle and poultry in conventional livestock breeding as well as in the organic sector have been iodized. In 1996 the Federal Center for Health Education (BzgA) introduced the iodine seal ("healthier with iodized salt").

In 2006 the EU reduced the amount of permitted iodine additives for cattle feed for dairy cows and laying hens from 10 mg to 5 mg iodine per kg feed, for all other animal species (e.g. pigs, fattened poultry) to a maximum of 10 mg per kg feed.

In 2007 the WHO lifted Germany's classification as an iodine deficiency area. The Federal Institute for Risk Assessment (BfR) continued to refer to Germany as an iodine deficiency region in 2012. The iodine concentrations naturally contained in food are therefore insufficient and iodine prophylaxis is still necessary. Also at the beginning of 2013, the DGE stated that the iodine supply of school children had initially improved since the 1990s, but had declined since 2004. A possible cause is the reduced use of iodized salt in food production: an estimated less than 30% of food manufacturers use iodized salt. The reasons given by the salt producers were: trade barriers at EU level, cheap imports of non-iodized table salt and non-iodized finished products as well as price differences between iodized and non-iodized table salt. The DGE proposed increasing the iodine content of table salt used industrially and by hand.

Criticism and recognition

Some people may be intolerant to iodine . In addition, a connection between iodine intake and autoimmune diseases of the thyroid such as Graves' disease and Hashimoto's thyroiditis is suspected.

According to the Working Group on Iodine Deficiency , iodine prophylaxis does not pose a health risk. Patients with thyroid disorders do not have any problems with additional iodine intake, and neither do iodine allergy sufferers.

Web links

Individual evidence

  1. ^ A b Richard Lux, Ulla Walter: Prevention strategies by fortifying basic foods with iodine, fluoride and folic acid: a chronology . (PDF) In: Nutrition review . 52, No. 2005, Issue 11, p. 445; accessed on Aug. 27, 2015.
  2. ↑ About the working group Jodmangel e. V. , accessed on Aug. 28, 2015.
  3. ↑ Regulation (EC) No. 1459/2005 (PDF) of the Commission of September 8, 2005 amending the conditions for the approval of a number of feed additives belonging to the group of trace elements.
  4. ^ BfR: Questions and answers on iodine supply and iodine deficiency prevention , February 7, 2012; accessed on Aug. 27, 2015.
  5. ↑ DGE: iodine deficiency on the rise again? DGE aktuell 01/2013 of January 29, 2013; accessed on Aug. 27, 2015.
  6. ↑ NR Rose, L. Rasooly, AM Saboori, CL Burek: Linking iodine with autoimmune thyroiditis . In: Environmental Health Perspectives . 107 Suppl 5, October 1, 1999, ISSN  0091-6765 , p. 749-752 , PMID 10502541 .
  7. ↑ C. Ruwhof, HA Drexhage: Iodine and thyroid autoimmune disease in animal models . In: Thyroid: Official Journal of the American Thyroid Association . tape 11 , no. 5 , May 1, 2001, ISSN  1050-7256 , p. 427-436 , doi : 10.1089 / 105072501300176381 , PMID 11396701 .
  8. ↑ Daniela Čiháková, Rajni Sharma example, DeLisa Fairweather, Marina Afanasyeva, Noel R. Rose: Animal models for autoimmune myocarditis and autoimmune thyroiditis . In: Methods in Molecular Medicine . tape 102 , January 1, 2004, ISSN  1543-1894 , p. 175-193 , doi : 10.1385 / 1-59259-805-6: 175 , PMID 15286386 .
  9. ↑ Petra-Maria Schumm-Draeger: Iodine and thyroidal autoimmunity . In: Journal for Medical Training and Quality in Health Care. Vol. 98, No. 4, Issue Supplement V, 2004, pp. 73-76 doi: 10.1078 / 1431-7621-00167 ( abstract ( memento of March 4, 2016 in the Internet Archive )).
  10. ^ Iodine deficiency and iodine supply in Germany . (PDF) 4th edition. Iodine Deficiency Working Group, January 2013, p. 4; accessed on Aug. 27, 2015.