Iodine is an essential micronutrient and an integral component of the thyroid hormones, which are required for normal growth and development. The iodine deficiency disorders (IDD) encompass a spectrum of adverse health effects including goiter, cretinism, hypothyroidism, growth retardation, and increased pregnancy loss and infant mortality. This volume summarizes the current understanding of the effects of iodine deficiency as well as iodine excess. It also discusses best practices for salt iodization, the mainstay of global IDD prevention efforts, and other forms of food fortification. The effectiveness of iodine supplementation for vulnerable populations, an evolving strategy in many regions, is also described. Low level environmental exposure to chemicals such as perchlorate and thiocyanate, which competitively block thyroidal iodine uptake, appears to be ubiquitous worldwide. There has been recent concern that such environmental exposures might pose a health hazard by inducing or aggravating underlying thyroid dysfunction. This up-to-date volume explores both the effects of iodine deficiency as well as the best strategies for IDD prevention.

Over two billion people worldwide are at risk for the spectrum of disorders known as "The Iodine Deficiency Disorders." 1-10% will suffer cretinism; 5-30% will have some sort of brain damage or neurological impairment and 30-70% will be hypothyroid. The causes of iodine deficiencies can be considered from both simplistic and more complex perspectives: From the leaching of iodine from soil resulting in crops with low iodine content to malnutrition resulting in impaired iodine absorption. Poor dietary diversification and impoverished socio-economic development can also lead to iodine deficiencies. Although it is possible to diagnose and treat deficiencies, there is still an ongoing dialogue regarding the detailed molecular pathology of iodine homeostatis, how hypothyroidism impacts the body tissues, and efficient diagnosis and treatment of the Iodine Deficiency Disorders. This Handbook provides a resource of information on the various pathways and processes based on different countries or diseases. Because there is a constant flow of new information on iodine and related disorders, the goal of this Handbook is to provide a base of scientific information upon which additional knowledge can be applied. - Provides important information on one of the most common micro-nutrient deficiencies in the world, the most important "single nutrient-multiple consequences" paradigm today - Includes information on iodine-related diseases, including those that are common, preventable and treatable - Provides insight from a broad perspective of viewpoints -- from subcellular transports to economic impact

This volume contains the proceedings of a conference held at the National Institutes of Health in Bethesda on March 21-23. 1988. jointly sponsored by the International Council for Control of Iodine Deficiency Disorders (ICCIDD) and the Fogarty International Center of the National Institutes of Health. Several themes converged to make this meeting timely. The first is an increasing awareness of iodine deficiency disorders as a world-wide problem of public health and a preventable cause of mental deficiency. and as a subject of scientific effort. Increased interest in these problems owes a great deal to accessibility to remote and under developed areas of the world where iodine deficiency persists. As with any subject. greater scrutiny yields unexpected complexity and interest. It is true that provision of iodine. typically as iodized salt, is the necessary and sufficient preventative for iodine deficiency disorders. without including endemic cretinism. This provision is a governmental, economic and social problem. Apart from this, however, the scientific and medical problem of iodine deficiency and its effect on brain development and function is one of great interest and importance for developmental neurology and psychology. Even though the specific preventative agent is known, we do not totally understand the neurobiological questions raised.

Micronutrient malnutrition affects approximately 2 billion people worldwide. The adverse effects of micronutrient deficiencies are profound and include premature death, poor health, blindness, growth stunting, mental retardation, learning disabilities, and low work capacity. Preventing Micronutrient Deficiencies provides a conceptual framework based on past experience that will allow funders to tailor programs to existing regional/country capabilities and to incorporate within these programs the capacity to address multiple strategies (i.e., supplementation/fortification/food-based approaches/public health measures) and multiple micronutrient deficiencies. The book does not offer recommendations on how to alleviate specific micronutrient deficienciesâ€"such recommendations are already available through the publications of diverse organizations, including the U.S. Agency for International Development, the Micronutrient Initiative, World Bank, United Nations Childrens' Fund, and the World Health Organization. Instead, this volume examines key elements in the design and implementation of micronutrient interventions, including such issues as: The importance of iron, vitamin A, and iodine to health. Populations at risk for micronutrient deficiency. Options for successful interventions and their cost. The feasibility of involving societal sectors in the planning and implementation of interventions. Characteristics of successful interventions. The book also contains three in-depth background papers that address the prevention of deficiencies of iron, vitamin A, and iodine.

Responding to a renewed interest in the growing problem of iodine deficiency worldwide, Drs. Charles Oxnard and Peter Obendorf, along with experienced translator and anatomist John Dennison, take a fresh look at the classic text, Der endemische Kretinismus, published in 1936 by Springer. Translated here for the first time into English, this landmark text will be a welcome resource for researchers confronting the problem of iodine deficiency. Oxnard and Obendorf point out that there is very little detailed knowledge or numerical data on cretinism available in the English-speaking world. In addition, highly-renowned Professor Basil S. Hetzel, recently-retired World Health Organization Chairman of the International Council for Control of Iodine Deficiency Disorders, published in 2009 with Dr Chen Zu-pei on the resurgence of iodine deficiency in China. Indeed, throughout the entire developing world there may be as many as two billion people at risk to iodine deficiency; perhaps three quarters of a billion have goiter, and ten million may be cretins. Even in developed countries, iodine deficiency is re-emerging (as in New South Wales in 19% of children) with the result of significantly reduced numbers of gifted children (though this is not cretinism per se). Certain to be of significant interest to a wide range of researchers, health providers and professionals, including government health administrators, this English translation of Endemic Cretinism is a major contribution to the literature.

The disorders induced by iodine deficiency affect at least one billion people. Because ofits effects on brain development, iodinedeficiency is the single most preventable cause of mental retardation in the world. Therefore, the United Nations and the Heads of State of almost all the world's countries represented at the Summit for Children in 1990 adopted resolutions to eradicate the disorders induced by iodine deficiency (IDD) by the year 2000. For geological and socio-economic reasons, most of the populations affected by iodine deficiency disorders live in isolated and usually mountainous areas, in pre industrialized parts ofthe world. The problem of iodine deficiency in Europe has been greatly underestimated in the last decades. After the remarkable studies on the effects of iodine deficiency and their prevention and correction in Switzerland, IDD was generally considered no longer a significant public health problem in Europe. However, surveys carried out in the early 1980's under the auspices of the European Thyroid Association, clearly demonstrated the persistence of moderately or even severely affected areas. These surveys also highlighted the lack ofinformation about large parts ofEurope, especially its eastern part. It is only quite recently, following major changes in international relations and thanks to the support of UNICEF, WHO, the International Council for the Control of Iodine Deficiency Disorders and the European Thyroid Association, that more extensive surveys have been conducted in several parts of Europe hitherto almost unexplored. These surveys showed that most European countries were iodine deficient.

This book is an up-to-date and comprehensive guide to all the common thyroid disorders that may be seen by internists, endocrinologists, nuclear medicine physicians, and endocrine surgeons. While the fundamentals of thyroid hormone function and regulation in health and disease are well covered, the primary focus is on the clinical approach to thyroid disease, with detailed coverage of both initial diagnosis and management and the role of imaging. Because most endocrine diseases are chronic and lifelong, special emphasis is placed on long-term management and the common pitfalls that may be encountered by the clinician. The editors are internationally acknowledged leaders in the field of thyroid disease and have gathered an outstanding team of authors, all of whom are also highly expert in their respective areas, but who, equally importantly, write in a clear and lucid style. The numerous isotope scan and ultrasonographic images ensure that the book will serve as a valuable reference atlas to which the physician will return again and again.

Food Fortification in a Globalized World outlines experiences over the past 50 years—and future potential—for the application of food fortification across a variety of foods in the industrialized and developing world. The book captures recent science and applications trends in fortification, including emerging areas such as biofortification, nutraceuticals and new nutrient intake recommendations, standards, policy and regulation. The book proposes a balanced and effective food fortification strategy for nations to adopt. In covering the most technical scientific details in an approachable style, this work is accessible to a range of practitioners in industry, government, NGOs, academia and research. Food fortification has become an increasingly significant strategy to address gaps in micronutrient intakes in populations with measurable impact in both industrialized and developing countries. While the positive impacts are well recognized there are new concerns in some countries that excessive fortification of foods, outdated nutritional labeling rules and misleading marketing tactics used by food manufacturers may result in young children consuming harmful amounts of some vitamins and minerals. - Presents the latest science on fortification for the prevention of micronutrient deficiencies - Includes emerging areas such as biofortification, nutraceuticals and new nutrient intake recommendations, standards, regulations, practices and policies from around the world - Summarizes evidence of application of food fortification and measured impact on public health - Discusses how public policy impacts fortification of foods and nutritional deficiencies - Considers the complex economics of and market for fortified foods