ELIMINATION OF IODINE DEFICIENCY IN LATVIA

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ELIMINATION OF IODINE DEFICIENCY IN LATVIA

• Dr.Med. Guntars Selga,
• Latvian Food Center

2
Historical divisions of Latvia
ESTONIA
Vidzeme
Kurzeme
Latgale
Zemgale
LITHUANIA
BELORUSIA
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Population

• Latvia (January 8, 1998) 2,434,469. Ethnic
  composition (1998) 57.1 Latvian, 29.5 Russian,
  4.1 Belarusian, 2.7 Ukrainian, 2.5 Polish,
  2.3 Lithuanian, 1.8 others. Riga (January
  1998) 790,608.
• Citizens 1,770,355 (72.72 of total population)
• Non-Citizens 646,723 (26.56 of total
  population)
• Foreigners 17,391 (0.72 of total population)

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The definition of the degrees of severity of
iodine deficiency (WHO)

• Severe lt 2,0 ?g/dl
• Moderate 2,0-4,9 ?g/dl
• Mild 5,0-9,9 ?g/dl
• Normal gt 10,0 ?g/dl

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FREQUENCY DISTRIBUTION OF IODINE EXCRETION in
Baltic States (1995) n5762 86 Schools Mean9,6
Urinary iodine in Latvia - 98 ?g/l
50
LATVIA n 30 schools, 1500 children age 8-12 years
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23-80 ?g/l
65 ?g/l
98?g/l
60 ?g/l
70-90 ?g/l
30-90 ?g/l
60-70 ?g/l
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PATIENTS WITH GOITRE IN CHILDRENS CLINICAL
HOSPITAL
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CHRONICAL THYREOIDITIS IN CHILDRENS CLINICAL
HOSPITAL
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PATIENTS WITH THYROTOXICOSIS IN CHILDRENS
CLINICAL HOSP.
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20 SCHOLS INCLUDED IN THE IODINE SURVAY 2000 (n
- 600) age 8-12 years
Svetciema vsk.
Ventspils Tarales pamatsk.
Valmieras Kauguru 9 g. sk.
- K.Videnieka Rigas 77.vidusskola - Rigas
1.barenu internatskola -Rigas
33.vidusskola -Bergu pamatskola
Talsu 2.vsk.
Tukuma 2. vsk
Varaklanu vsk.
Kandavas vsk.
Vainodes 1.vsk.
Matkules vsk.
Laudonas vsk.
Jekabpils 4.vsk.
Liepajas 15.vsk
Vilanu vsk.
Annenieku vsk.
Viesites p.sk
Livanu 1.vsk
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Median Urinary Iodine Excretion Among Latvian
Schoolchildren in 2000 (n-600).
23
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20 SCHOLS INCLUDED IN THE IODINE SURVAY 2000 (n
- 600) age 8-12 years
5.44
7.09
7.26
5.77- 7.26
6.7
5.51
3.63
5.82
5.09
6.07
5.14
3.68
8.65
4.9
8.65
5.76
3.96
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Iodine In The Food(J 200 ?g RDA draft in
Latvia)

• Source Iodine ?g/100g
• Cod 135
• Salmon 62
• Sea perch 57
• Mackerel 45
• Goose meet 42
• Herring 41
• Chockbery 40
• Egg 20
• Shampinion 18
• Milk 16

• Source Iodine ?g/100g
• Kefir 14
• Yoghurt 14
• Set milk 13
• Beans 12
• Swine liver 12
• Wheat (summer)11
• Lard 10
• Rue 9
• Cream 9
• Garlic 9
• Barlay 9

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Synergistic assimilation

• Mineral or vitamin deficiency
• Iodine
• Ca
• P
• Zn
• Vit. B6

• For assimilation necessary
• Iron, manganese, phosphorum
• Boron, PUFA, lisin, Mg
• Ca, Fe, Vit. B (comlex), Vit. E
• Ca, Cu, P, Vit. B6
• K, Vit. B (comlex), Vit.C, Vit. E

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Intake Of Kcalories From Food Group By Sex In
Latvia
Nutrition and lifestyle in the Baltic Republics.
1999
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Estimated requirement for edible salt in Latvia

• ? 8750 tonnes of salt/year
• (3,5 kg/person year x 2,5 million populatio of
  Latvia)
• Salt situation Analysis in Latvia (1999)
• (during 10 months)
• - 7000 tonnes of edible salt
• - 60 tonnes iodized salt

Less than 0,9
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(No Transcript)
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Nutrition and lifestyle in the Baltic Republics.
1999

• During summer 1997, cross sectional survays were
  conducted among representative national samples
  of adults in each country (Estonia n2108
  Latvia n2308 Lithuania n2153).

• salt consumption

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Proportion of Respondents Adding Salt at the
Table (males in all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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PROPORTION OF RESPONDENTS (womens) ADDING SALT AT
THE TABLE(all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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Proportion Of Respondents Never Adding Salt At
The Table(males in all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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PROPORTION OF RESPONDENTS (womens) NEVER ADDING
SALT AT THE TABLE
Nutrition and lifestyle in the Baltic Republics.
1999
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Proportion Of Respondents Almost Always Adding
Salt Before Tasting(males in all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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PROPORTION OF RESPONDENTS (womens) ALMOST ALWAYS
ADDING SALT BEFORE TASTING
Nutrition and lifestyle in the Baltic Republics.
1999
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USE OF SALT WITH ADDITIVES (mens all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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USE OF SALT WITH ADDITIVES (womens all age
groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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TYPE OF SALT WITH ADDITIVES USED BY COUNTRY
(mens all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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TYPE OF SALT WITH ADDITIVES USED BY COUNTRY
(womens all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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Dietary belief by country More dietary salt in
the diet is of no consequence for your health
(mens all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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Dietary belief by country More dietary salt in
the diet is of no consequence for your health
(womens all age groups)
Nutrition and lifestyle in the Baltic Republics.
1999
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ELIMINATION OF IODINE DEFFICIENCY IN LATVIA

• To meet iodine requirements, the current
  recommmended daily iodine intakes necessary
• 50 ?g for infants (first 12 months of age)
• 90 ?g for children (2-6 years of age)
• 120 ?g for school children (7-12 years age)
• 150 ?g for adults (beyond 12 years of age)
• 200 ?g for pregnant and lacting women
• Recommended iodine levels in salt and
  guidelines for monitoring their adequacy and
  effectiveness, WHO, 1996

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Required iodine levels in salt

• In order to provide 150 ?g/day of iodine via
  iodized salt, iodine concentration in salt at the
  point of production should be in the range 20-40
  mg of iodine per kg of salt.
• When all salt used in processed food is iodized,
  the lower limit (20 mg) is recommended.
• Under these circumstances median urinary iodine
  levels will vary from 100-200 ?g/l.
  Recommended iodine levels in salt and
  guidelines for monitoring their adequacy and
  effectiveness, WHO, 1996

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Process Model for IDD Elimination Program in
Latvia