Publicado

2021-11-01

Política mundial de yodación de sal: desafíos

Global policy of salt iodization: challenges

DOI:

https://doi.org/10.15446/rsap.v23n6.98302

Palabras clave:

Yodo, Política Pública, cloruro de sodio (es)
Iodine, public policy, sodium chloride (en)

Descargas

Autores/as

Objetivo Identificar los desafíos que conlleva la implementación de la política mundial de yodación de sal para el consumo humano.

Métodos Se realizó una revisión de la literatura publicada entre el año 2000 y 2021 en PubMed, con los términos MeSH yodo, política pública, cloruro de sodio y los términos complementarios yodo/deficiencia, exceso. Se obtuvieron 141 artículos y se revisaron 50 aplicando como criterio de inclusión el abordaje de la implementación de la política de yodación.

Resultados Se identificaron siete desafíos: sostenibilidad de la política, eliminar la brecha entre la explotación y la comercialización de la sal, prevenir la fortificación indiscriminada de los alimentos, promover la educación sobre la ingesta de sal yodada, controlar la ingesta excesiva de yodo, equilibrar la ingesta óptima de yodo con la reducción del consumo de cloruro de sodio y producir suficiente información oficial sobre la política.

Conclusión La yodación universal de la sal es una política que requiere mayor sensibilidad a las situaciones locales de cada país para mitigar efectivamente el problema de salud pública de los desórdenes por deficiencia y exceso en la ingesta de yodo alrededor del mundo.

Objective To identify the challenges involved in the implementation of the global policy on salt iodization for human consumption.

Methods A review of the literature published between 2000 and 2021 in PubMed was carried out with the MeSH terms iodine, public policy, sodium chloride and supplementary terms iodine/deficiency, excess. 141 articles were obtained and 50 were reviewed, applying the iodization policy implementation approach as an inclusion criterion.

Results Seven challenges were identified: sustainability of the policy, closing the gap between exploitation and commercialization of salt, preventing indiscriminate fortification of food, promoting education on iodized salt intake, controlling excessive iodine intake, balance optimal iodine intake with reduced sodium chloride intake and produce sufficient official policy information.

Conclusion The universal iodization of salt is a policy that requires greater sensitivity to the local situations of each country to effectively mitigate the public health problem of disorders due to deficiency and excess intake of iodine around the world.

Referencias

Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. J Nutr. 2012 Apr 1; 142(4):744-50. https://doi.org/10.3945/jn.111.149393. DOI: https://doi.org/10.3945/jn.111.149393

Pearce EN, Andersson M, Zimmermann MB. Global Iodine Nutrition: Where do we stand in 2013. Thyroid. 2013 May; 23(5):523-8. https://doi.org/10.1089/thy.2013.0128. DOI: https://doi.org/10.1089/thy.2013.0128

Iodine Global Network (IGN). Ign.org. [Internet]; 2017 [cited 2020 Jul 2]. http://www.ign.org/scorecard.htm.

World Health Organization. Guideline: fortification of food-grade salt with iodine for the prevention and control of iodine deficiency disorders [Internet]. Geneva: WHO; 2014 [cited 2020 Jun]. https://bityl.co/Aa4y.

Asamblea Mundial de la Salud L58a AM. WHA58.24 Sostenimiento de la eliminación de los trastornos por carencia de yodo [Internet]. Geneva: WHO; 2005 [cited 2020 Apr 9]. https://bityl.co/Aa5B.

Organización Mundial de la Salud. 63.a WHA63/2010/REC/1. Asamblea Mundial de la Salud. Resoluciones y decisiones. Anexo [Internet]. Geneva: WHO; 2010 [cited 2020 Jan 20]. https://bityl.co/Aa5K.

World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers, 3rd ed [Internet]. Geneva: WHO [cited 2020 Jan 3]. https://bityl.co/Aa5Q.

World Health Organization. Indicators of assessing iodone diciency disorders and their control through salt iodization [Internet]. Geneva: WHO; 1994 [cited 2020 Feb 6]. https://bityl.co/Aa5e.

World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers, 2nd ed. [Internet]. Geneva: WHO; 2001 [cited 2020 Mar 15]. https://bityl.co/Aa5q.

Iodine Global Network (IGN). Ign.org. [Internet]; 2020 [cited 2020 Dec 22]. https://www.ign.org/scorecard.htm.

Iodine Global Network (IGN). Eliminación sostenible de los desórdenes por deficiencia de yodo en Latinoamérica [Internet]; 2015 [cited 2017 Feb 8]. https://bityl.co/Aa6M.

Sullivan KM. The challenges of implementing and monitoring of salt iodisation programmes. Best Pract Res Clin Endocrinol Metab. 2010 Feb; 24(1): 101-6. https://doi.org/10.1016/j.beem.2009.09.001. DOI: https://doi.org/10.1016/j.beem.2009.09.001

Bailey LB, Stover PJ, McNulty H, Fenech MF, Gregory JF, Mills JL, et al. Biomarkers of Nutrition for Development-Folate Review. J Nutr. [Internet]. 2015 Jul; 145(7):1636S-1680S. https://doi.org/10.3945/jn.114.206599. DOI: https://doi.org/10.3945/jn.114.206599

Charlton K, Skeaff S. Iodine fortification: why, when, what, how, and who? Curr Opin Clin Nutr Metab Care. 2011 Nov; 14(6):618-24. https://doi.org/10.1097/mco.0b013e32834b2b30. DOI: https://doi.org/10.1097/MCO.0b013e32834b2b30

Pretell Zárate EA, Higa Yamashiro AM. Eliminación sostenida de los desórdenes por deficiencia de yodo en Perú. 25 años de experiencia. Acta Med Peru [Internet]. 2008 Dic 01 [cited 2020 Feb 15];25(3):128- 34. https://bityl.co/Aa6Z.

Untoro J, Timmer A, Schultink W. The challenges of iodine supplementation: a public health programme perspective. Best Pract Res Clin Endocrinol Metab. 2010 Feb; 24(1):89-99. https://doi.org/10.1016/j.beem.2009.08.011. DOI: https://doi.org/10.1016/j.beem.2009.08.011

Völzke H, Caron P, Dahl L, de Castro JJ, Erlund I, Gaberšček S, et al. Ensuring Effective Prevention of Iodine Deficiency Disorders. Thyroid. 2016 Feb; 26(2):189-96. https://doi.org/10.1089/thy.2015.0543. DOI: https://doi.org/10.1089/thy.2015.0543

Li M, Eastman CJ, Waite KV, Ma G, Zacharin MR, Topliss DJ, et al. Are Australian children iodine deficient? Results of the Australian National Iodine Nutrition Study. Med J Aust. 2008 Jun; 184(4):165-9. https://doi.org/10.5694/j.1326-5377.2008.tb01831.x. DOI: https://doi.org/10.5694/j.1326-5377.2006.tb00177.x

Vila L, Lucas A, Donnay S, de la Vieja A, Wengrovicz S, Santiago P, et al. Iodine nutrition in Spain: Future requirements. Endocrinol Diabetes Nutr (Engl). 2020 Jan; 67(1):61-9. https://doi.org/10.1016/j.endinu.2019.02.009. DOI: https://doi.org/10.1016/j.endien.2019.12.005

Khattak RM, Khattak MNK, Ittermann T, Völzke H. Factors affecting sustainable iodine deficiency elimination in Pakistan: A global perspective. J Epidemiol. 2017 Jun; 27(6):249-57. https://doi.org/10.1016/j.je.2016.04.003. DOI: https://doi.org/10.1016/j.je.2016.04.003

Sullivan KM, Houston R, Gorstein J, Cervinskas J, World Health Organization. Monitoring Universal Salt Iodization Programmes [Internet]. Ottawa: Micronutrient Initiative; 1995 [cited 2020 Mar 21]. https://bit.ly/3FYcHmZ.

Tulchinsky TH, Kaluski DN, Berry EM. Food fortification and risk group supplementation are vital parts of a comprehensive nutrition policy for prevention of chronic diseases. Eur J Public Health. 2004 Sep 1; 14(3):226-8. https://doi.org/10.1093/eurpub/14.3.226. DOI: https://doi.org/10.1093/eurpub/14.3.226

Drewnowski A, Garrett GS, Kansagra R, Khan N, Kupka R, Kurpad AV, et al. Key Considerations for Policymakers-Iodized Salt as a Vehicle for Iron Fortification: Current Evidence, Challenges, and Knowledge Gaps. J Nutr. 2021 Feb 15; 151(Suppl 1):64S–73S. https://doi.org/10.1093/jn/nxaa377. DOI: https://doi.org/10.1093/jn/nxaa377

Zimmermann MB. Symposium on ‘Geographical and geological influences on nutrition’: Iodine deficiency in industrialised countries: Conference on ‘Over- and undernutrition: Challenges and approaches’. Proc Nutr Soc. 2010 Feb; 69(1):133-43. https://doi.org/10.1017/S0029665109991819. DOI: https://doi.org/10.1017/S0029665109991819

Nazeri P, Mirmiran P, Tahmasebinejad Z, Hedayati M, Delshad H, Azizi F. The Effects of Iodine Fortified Milk on the Iodine Status of Lactating Mothers and Infants in an Area with a Successful Salt Iodization Program: A Randomized Controlled Trial. Nutrients. 2017 Feb 9(2):180. https://dx.doi.org/10.3390%2Fnu9020180. DOI: https://doi.org/10.3390/nu9020180

Bailey RL, West KP Jr, Black RE. The Epidemiology of Global Micronu- trient Deficiencies. Ann Nutr Metab. 2015; 66(Suppl. 2):22-33. https://doi.org/10.1159/000371618. DOI: https://doi.org/10.1159/000371618

Cakmak I, Prom-u-thai C, Guilherme LRG, Rashid A, Hora KH, Yazici A, et al. Iodine biofortification of wheat, rice and maize through fertilizer strategy. Plant Soil. 2017 Sep; 418(1-2):319-35. https://doi.org/10.1007/s11104-017-3295-9. DOI: https://doi.org/10.1007/s11104-017-3295-9

Bouga M, Lean MEJ, Combet E. Contemporary challenges to iodine status and nutrition: The role of foods, dietary recommendations, fortification and supplementation. Proc Nutr Soc. 2018 Aug; 77(3):302-13. https://doi.org/10.1017/s0029665118000137. DOI: https://doi.org/10.1017/S0029665118000137

Elias E, Tsegaye W, Stoecker BJ, Gebreegziabher T. Excessive intake of iodine and low prevalence of goiter in school age children five years after implementation of national salt iodization in Shebedino woreda, southern Ethiopia. BMC Public Health. 2021 Jan 19; 21(1):165. https://doi.org/10.1186/s12889-021-10215-y. DOI: https://doi.org/10.1186/s12889-021-10215-y

Horton S. The economics of food fortification. J Nutr. 2006 Apr 1; 136(4):1068-71. https://doi.org/10.1093/jn/136.4.1068. DOI: https://doi.org/10.1093/jn/136.4.1068

Eastman CJ, Jooste P. Current challenges in meeting global iodine requirements. Nestle Nutr Inst Workshop Ser. 2012 Aug 31; 70:147-60. https://doi.org/10.1159/000337679. DOI: https://doi.org/10.1159/000337679

Henjum S, Brantsæter AL, Kurniasari A, Dahl L, Aadland EK, Gjengedal ELF, et al. Suboptimal Iodine Status and Low Iodine Knowledge in Young Norwegian Women. Nutrients. 2018 Jul 21; 10(7):E941. https://doi.org/10.3390/nu10070941. DOI: https://doi.org/10.3390/nu10070941

Dunn JT. Correcting iodine deficiency is more than just spreading around a lot of iodine. Thyroid. 2001 Apr; 11(4):363-4. https://doi.org/10.1089/10507250152039109. DOI: https://doi.org/10.1089/10507250152039109

Charlton KE, Gemming L, Yeatman H, Ma G. Suboptimal iodine status of Australian pregnant women reflects poor knowledge and practices related to iodine nutrition. Nutrition. 2010 Oct; 26(10):963-8. https://doi.org/10.1016/j.nut.2009.08.016. DOI: https://doi.org/10.1016/j.nut.2009.08.016

Fingland D, Thompson C, Vidgen HA. Measuring food literacy: Progressing the development of an International Food Literacy Survey Using a content validity study. Int J Environ Res Public Health. 2021 Jan; 18(3):1141. https://doi.org/10.3390/ijerph18031141. DOI: https://doi.org/10.3390/ijerph18031141

Trieu K, McMahon E, Santos JA, Bauman A, Jolly K-A, Bolam B, et al. Review of behaviour change interventions to reduce population salt intake. Int J Behav Nutr Phys Act. 2017 Feb 8; 14(1):17. https://doi.org/10.1186/s12966-017-0467-1. DOI: https://doi.org/10.1186/s12966-017-0467-1

Dunn JT. Complacency: the most dangerous enemy in the war against iodine deficiency. Thyroid. 2000 Aug; 10(8):681-3. https://doi.org/10.1089/10507250050137752. DOI: https://doi.org/10.1089/10507250050137752

Ismail HTH. The Impact of Iodine Exposure in Excess on Hormonal Aspects and Hemato-Biochemical Profile in Rats. Biol Trace Elem Res. 2022 Feb; 200(2):706-719. https://pubmed.ncbi.nlm.nih.gov/33783684/. DOI: https://doi.org/10.1007/s12011-021-02681-7

Delange F, Lecomte P. Iodine supplementation: benefits outweigh risks. Drug Saf. 2000 Feb; 22(2):89-95. https://doi.org/10.2165/00002018-200022020-00001. DOI: https://doi.org/10.2165/00002018-200022020-00001

Fiore E, Tonacchera M, Vitti P. Influence of iodization programmes on the epidemiology of nodular goitre. Best Pract Res Clin Endocrinol Metab. 2014 Aug; 28(4):577-88. https://pubmed.ncbi.nlm.nih.gov/25047207/. DOI: https://doi.org/10.1016/j.beem.2014.04.002

Luo Y, Kawashima A, Ishido Y, Yoshihara A, Oda K, Hiroi N, et al. Iodine excess as an environmental risk factor for autoimmune thyroid disease. Int J Mol Sci. 2014 Jul 21; 15(7):12895-912. https://doi.org/10.3390/ijms150712895. DOI: https://doi.org/10.3390/ijms150712895

Wang Y, Cui Y, Chen C, Duan Y, Wu Y, Li W, et al. Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. Ecotoxicol Environ Saf. 2020 Jan 30; 188(109930). https://doi.org/10.1016/j.ecoenv.2019.109930. DOI: https://doi.org/10.1016/j.ecoenv.2019.109930

Rohner F, Zimmermann M, Jooste P, Pandav C, Caldwell K, Raghavan R, et al. Biomarkers of nutrition for development-Iodine review. J Nutr. 2014 Aug;144(8):1322S-1342S. https://doi.org/10.3945/jn.113.181974. DOI: https://doi.org/10.3945/jn.113.181974

Krela-Kaźmierczak I, Czarnywojtek A, Skoracka K, Rychter AM, Ratajczak AE, Szymczak-Tomczak A, et al. Is there an ideal diet to protect against iodine deficiency? Nutrients. 2021 Feb 4; 13(2):513. https://doi.org/10.3390/nu13020513. DOI: https://doi.org/10.3390/nu13020513

Xu T, Ren Z, Li S, Tan L, Zhang W. The relationship of different levels of high iodine and goiter in school children: a meta-analysis. Nutr Metab (Lond). 2021 May 3;18(1):46. https://doi.org/10.1186/s12986-021-00563-2. DOI: https://doi.org/10.1186/s12986-021-00563-2

Carvalho AL, Meirelles CJC de S, Oliveira LA, Costa TMB, Navarro AM. Excessive iodine intake in schoolchildren. Eur J Nutr. 2012 Aug; 51(5):557-62. https://doi.org/10.1007/s00394-011-0239-7. DOI: https://doi.org/10.1007/s00394-011-0239-7

Zimmermann MB, Galetti V. Iodine intake as a risk factor for thyroid cancer: a comprehensive review of animal and human studies. Thyroid Res. 2015 Jun; 8(1):1-21. https://doi.org/10.1186/s13044-015-0020-8. DOI: https://doi.org/10.1186/s13044-015-0020-8

Farebrother J, Zimmermann MB, Andersson M. Excess iodine intake: sources, assessment, and effects on thyroid function. Ann NY Acad Sci. 2019 Jun; 1446(1):44-65. https://doi.org/10.1111/nyas.14041. DOI: https://doi.org/10.1111/nyas.14041

Tamang MK, Gelal B, Tamang B, Lamsal M, Brodie D, Baral N. Excess urinary iodine concentration and thyroid dysfunction among school age children of eastern Nepal: a matter of concern. BMC Res Notes. 2019 May 27; 12(1):294. https://doi.org/10.1186/s13104-019-4332-y. DOI: https://doi.org/10.1186/s13104-019-4332-y

Zimmermann MB. Iodine requirements and the risks and benefits of correcting iodine deficiency in populations. J Trace Elem Med Biol. 2008 May 7; 22(2):81-92. https://doi.org/10.1016/j.jtemb.2008.03.001. DOI: https://doi.org/10.1016/j.jtemb.2008.03.001

Smoleń S, Czernicka M, Kowalska I, Kȩska K, Halka M, Grzebelus D, et al. New aspects of uptake and metabolism of non-organic and organic iodine compounds—the role of vanadium and plantderived thyroid hormone analogs in lettuce. Front Plant Sci. 2021 Apr; 16(12). https://doi.org/10.3389/fpls.2021.653168. DOI: https://doi.org/10.3389/fpls.2021.653168

Aakre et al. Commercially available kelp and seaweed products – valuable iodine source or risk of excess intake? Food Nutr Res. 2021 Mar; 30(65). https://doi.org/10.29219/fnr.v65.7584. DOI: https://doi.org/10.29219/fnr.v65.7584

World Health Organization. Guideline: sodium intake for adults and children [Internet]. Geneva: WHO; 2012 [cited 2020 Mar 2]. https://bit.ly/3KCseMS.

Newson RS, Elmadfa I, Biro G, Cheng Y, Prakash V, Rust P, et al. Barriers for progress in salt reduction in the general population. An in- ternational study. Appetite. 2013 Dec; 71:22-31. https://doi.org/10.1016/j.appet.2013.07.003. DOI: https://doi.org/10.1016/j.appet.2013.07.003

Delange F. Iodine deficiency as a cause of brain damage. Postgrad Med J. 2001 Apr; 77(906):217-20. https://doi.org/10.1136/pmj.77.906.217. DOI: https://doi.org/10.1136/pmj.77.906.217

Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008 Oct 4; 372(9645):1251-62. https://doi.org/10.1016/s0140-6736(08)61005-3. DOI: https://doi.org/10.1016/S0140-6736(08)61005-3

He FJ, MacGregor GA. Reducing population salt intake worldwide: from evidence to implementation. Prog Cardiovasc Dis. 2010 Mar-Apr; 52(5):363-82. https://doi.org/10.1016/j.pcad.2009.12.006. DOI: https://doi.org/10.1016/j.pcad.2009.12.006

Bhana N, Utter J, Eyles H. Knowledge, attitudes and behaviours related to dietary salt intake in high-income countries: A Systematic review. Curr Nutr Rep. 2018 Dec; 7(4):183-97. https://doi.org/10.1007/s13668-018-0239-9. DOI: https://doi.org/10.1007/s13668-018-0239-9

Leshem M. Salt need needs investigation. Br J Nutr. 2020 Jun; 123(11):1312-20. https://doi.org/10.1017/s0007114520000173. DOI: https://doi.org/10.1017/S0007114520000173

World Health Organization. Degree of public health significance of iodine nutrition based on median urinary iodine [Internet]. Geneva: WHO; 2004 [cited 2020 Jan 4]. https://bit.ly/346DZKs.

World Health Organization. Degree of public health significance of iodine nutrition based on median urinary iodine: 1993-2006 [Internet]. 2008 [cited Feb 21]. https://bit.ly/3H9XYGM.

El Ammari L, Saeid N, Talouizte A, Gamih H, Labzizi S, Mendili JE, et al. A household-based survey of iodine nutrition in Moroccan children shows iodine sufficiency at the national level but risk of deficient intakes in mountainous areas. Children (Basel). 2021 Mar 19; 8(3):240. https://doi.org/10.3390/children8030240. DOI: https://doi.org/10.3390/children8030240

Codling K, Rudert C, Bégin F, Peña-Rosas JP. The legislative framework for salt iodization in Asia and the Pacific and its impact on pro- gramme implementation. Public Health Nutr. 2017 Nov; 20(16):3008- 18. https://doi.org/10.1017/s1368980017001689. DOI: https://doi.org/10.1017/S1368980017001689

Cómo citar

APA

Chávarro Bermeo, F. E., Arteaga Diaz , J. M. . y Roth Deubel, A. N. . (2021). Política mundial de yodación de sal: desafíos. Revista de Salud Pública, 23(6), 1–7. https://doi.org/10.15446/rsap.v23n6.98302

ACM

[1]
Chávarro Bermeo, F.E., Arteaga Diaz , J.M. y Roth Deubel, A.N. 2021. Política mundial de yodación de sal: desafíos. Revista de Salud Pública. 23, 6 (nov. 2021), 1–7. DOI:https://doi.org/10.15446/rsap.v23n6.98302.

ACS

(1)
Chávarro Bermeo, F. E.; Arteaga Diaz , J. M. .; Roth Deubel, A. N. . Política mundial de yodación de sal: desafíos. Rev. salud pública 2021, 23, 1-7.

ABNT

CHÁVARRO BERMEO, F. E.; ARTEAGA DIAZ , J. M. .; ROTH DEUBEL, A. N. . Política mundial de yodación de sal: desafíos. Revista de Salud Pública, [S. l.], v. 23, n. 6, p. 1–7, 2021. DOI: 10.15446/rsap.v23n6.98302. Disponível em: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98302. Acesso em: 25 abr. 2025.

Chicago

Chávarro Bermeo, Flor Elena, Juan Manuel Arteaga Diaz, y André Noël Roth Deubel. 2021. «Política mundial de yodación de sal: desafíos». Revista De Salud Pública 23 (6):1-7. https://doi.org/10.15446/rsap.v23n6.98302.

Harvard

Chávarro Bermeo, F. E., Arteaga Diaz , J. M. . y Roth Deubel, A. N. . (2021) «Política mundial de yodación de sal: desafíos», Revista de Salud Pública, 23(6), pp. 1–7. doi: 10.15446/rsap.v23n6.98302.

IEEE

[1]
F. E. Chávarro Bermeo, J. M. . Arteaga Diaz, y A. N. . Roth Deubel, «Política mundial de yodación de sal: desafíos», Rev. salud pública, vol. 23, n.º 6, pp. 1–7, nov. 2021.

MLA

Chávarro Bermeo, F. E., J. M. . Arteaga Diaz, y A. N. . Roth Deubel. «Política mundial de yodación de sal: desafíos». Revista de Salud Pública, vol. 23, n.º 6, noviembre de 2021, pp. 1-7, doi:10.15446/rsap.v23n6.98302.

Turabian

Chávarro Bermeo, Flor Elena, Juan Manuel Arteaga Diaz, y André Noël Roth Deubel. «Política mundial de yodación de sal: desafíos». Revista de Salud Pública 23, no. 6 (noviembre 1, 2021): 1–7. Accedido abril 25, 2025. https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98302.

Vancouver

1.
Chávarro Bermeo FE, Arteaga Diaz JM, Roth Deubel AN. Política mundial de yodación de sal: desafíos. Rev. salud pública [Internet]. 1 de noviembre de 2021 [citado 25 de abril de 2025];23(6):1-7. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98302

Descargar cita

CrossRef Cited-by

CrossRef citations1

1. Geraldine Morínigo Isla, José Acosta Escobar, Marcelo Galeano Miers, Carolina Bonzi, Elsi Ovelar, Natalia González Cañete. (2023). Concentración de yodo en la sal de consumo de hogares paraguayos en el periodo 2015-2019. Perspectivas en Nutrición Humana, 25(2) https://doi.org/10.17533/udea.penh.v25n2a03.

Dimensions

PlumX

Visitas a la página del resumen del artículo

493

Descargas