By Dr Ranjana Dhanu
Micronutrients such as iodine are essential for a child’s proper growth and development. Nutritional deficiencies especially the missing “I” (iodine) from diets of infants and growing children have always been a concern, as they are often related to the cognitive potential and physical lifelong consequences. Iodine may not be commonly found in food, but it is needed for the synthesis of thyroid hormones. It is an essential trace element for thyroid function; iodine intake in the desired quantities also becomes very important for neurodevelopment, including for school-aged children.
India has made some progress in reducing child malnutrition, but a lot needs to be done, according to the first Comprehensive National Nutrition Survey (CNNS) released recently. Government schemes have been able to prevent Vitamin A and iodine deficiency among children aged one to four years. The CNNS figures reveal that school-age children and adolescents are still at risk of malnutrition and a lot of ground still needs to be covered. It also states that micronutrients like Iodine, Zinc, Folate, Iron, B12, Vitamin A and Vitamin D are necessary for healthy growth and development.
The nutrients a child receives in the early years influence their brain development for life. A UNICEF report emphasises that the first 1,000 days of life, or the time between conception and the age of two years, is the period when the foundations of optimum health, growth, and development of brain and nervous system across the life of the child are built. Micronutrient deficiencies, that is, deficiencies of iodine, iron, folic acid, vitamin A and zinc cause what is known as “hidden hunger” and is a global public health problem, more so in developing countries like India.
A teaspoon of iodine is all a person requires in a lifetime, but because iodine cannot be stored for long periods by the body, tiny amounts are needed regularly. Several international groups have made recommendations, which are fairly similar. IGN (formerly ICCIDD), WHO, and Unicef recommend the following daily amounts:
· Age 0-5 years: 90 micrograms (mcg)/day;
· Age 6-12 years: 120 mcg;
· Older than 12 years: 150 mcg;
· Pregnant and lactating women: 250 mcg
Iodine deficiency is the world’s single greatest cause of preventable mental retardation. The deficiency causes irreparable damage to the developing brain. It is especially damaging during the early stages of pregnancy and in early childhood, responsible for a vast spectrum of mental disorders and loss of intellectual capacity.
A Unicef report indicates that iodised salt is now available to 86 per cent of the world’s households. This has led to an improvement in iodine nutrition with a near elimination globally of new cases of cretinism (the most serious form of iodine deficiency) and decreased the incidence of goitre, stillbirths and adverse pregnancy outcomes, while protecting the mental development and growth of hundreds of millions of children globally. However, there are still nearly 19 million babies around the world at risk of permanent brain damage every year from insufficient iodine intake during pregnancy. It is here that iodised salt plays a crucial role in the protection of newborn cognitive health, as well as protecting the brains of children between the ages of six months and 15 years old from the devastating effects of iodine deficiency.
Some of the sources of dietary iodine are seafood, eggs, dairy products as well as iodised table salt, which is the easiest source of iodine. However, most countries are at an inherent risk of iodine deficiency because the mineral is unevenly distributed in soil and the environment. In many regions, the soil is becoming increasingly depleted of iodine and consequently in the food derived from it. The geographical characteristics of a country determine how much iodine makes it into the food chain. To overcome this and ensure that populations at large are protected from iodine deficiency, the simple act of iodising food grade salt that is, adding iodine to salt (universal salt iodisation) was implemented.
Hence, it is important to monitor that a child is getting enough iodine through their food. Many children are picky eaters and only consume certain foods. Or a child may be allergic to some foods and hence the parents may avoid giving the child certain foods. If there is not enough iodine in the food or not enough iodised salt in it, then the deficiency will lead to development of a goitre or enlarged thyroid. It is therefore important that parents discuss their child’s iodine intake with their doctor and paediatrician, especially in these cases.
In conclusion, don’t skip the iodised salt. It is a crucial part of your children’s diet!
(The writer is Consultant-Obstetrician Gynaecologist, Hinduja Hospital, Khar.)