Iodine deficiency is a global issue; however, no comparable assessments of the burden of iodine deficiency have been conducted worldwide. Hence, we measured the estimated annual percentage changes (EAPCs) from 1990 to 2019. Our aim was to quantify the geographic differences in the burden of iodine deficiency worldwide.

Material and methods:
The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 methodology was employed to investigate the worldwide, regional, and national incidence of iodine deficiency and the accompanying disability-adjusted life years (DALYs).

The global age-standardized incidence (ASI) and DALY rates of iodine deficiency declined from 1990 to 2019, with an EAPC of –0.44 and –1.35, respectively. Low and low-middle SDI had much higher ASI and DALY rates of iodine deficiency than other SDI regions. At the regional level, the largest growth in the ASI rate of iodine insufficiency from 1990 to 2019 occurred in East Asia, and at the national level, the greatest increases in the ASI rate of iodine deficiency occurred in the Philippines, Pakistan and Nepal. In addition, males had a lower worldwide ASI rate of iodine insufficiency than females did, with the incidence rate peaking in populations aged 20–24.

Between 1990 and 2019, there was a decline in the global ASI and DALY rates of iodine deficiency. However, East Asia, the Philippines, Pakistan and Nepal exhibited the largest increases in the ASI rates of iodine deficiency, demonstrating their significant burden of iodine insufficiency. These regions must therefore be targeted for intervention.

Vaughn CJ. Drugs and Lactation Database: LactMed. J Electronic Resources Med Libraries 2012; 9: 272-7.
Shahid MA, Ashraf MA, Sharma S. Physiology, Thyroid Hormone. StatPearls. Treasure Island (FL); StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC 2023; 1-55.
Unit WHON. UNICEF. Global prevalence of vitamin A deficiency in populations at risk 1995-2005: WHO global database on vitamin A deficiency. World Health Organization 2005; 2: 10-29.
Tulchinsky TH. Correction to: micronutrient deficiency conditions: Global Health issues. Public Health Rev 2017; 38: 25.
Semba RD, Graham NM, Caiaffa WT, et al. Increased mortality associated with vitamin A deficiency during human immunodeficiency virus type 1 infection. Arch Intern Med 1993; 153: 2149-54.
Mailloux NA, Henegan CP, Lsoto D, et al. Climate solutions double as health interventions. Int J Environ Res Public Health 2021; 18: 13339.
Karwowska P, Breda J. The role of the world health organization in eliminating iodine deficiency worldwide. Recent Pat Endocr Metab Immune Drug Discov 2017; 10: 138-42.
Dineva M, Fishpool H, Rayman MP, et al. Systematic review and meta-analysis of the effects of iodine supplementation on thyroid function and child neurodevelopment in mildly-to-moderately iodine-deficient pregnant women. Am J Clin Nutr 2020; 112: 389-412.
Li Y, Teng D, Ba J, et al. Efficacy and safety of long-term universal salt iodization on thyroid disorders: epidemiological evidence from 31 provinces of Mainland China. Thyroid 2020; 30: 568-79.
Asfaw A, Belachew T. Magnitude of iodine deficiency disorder and associated factors in Dawro zone, Southwest Ethiopia; the hidden hunger: a cross-sectional study. BMC Nutr 2020; 6: 20.
Tessema M, Belay A, Zerfu D, et al. The prevalence of iodine deficiency (IDD) among vulnerable populations in Ethiopia. Eur J Nutr Food Safety 2015; 5: 1112-2.
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1204-22.
Sathishkumar K, NV, Badwe RA, et al. Trends in breast and cervical cancer in India under National Cancer Registry Programme: an age-period-cohort analysis. Cancer Epidemiol 2021; 74: 101982.
Yadav K, Pandav CS. National iodine deficiency disorders control programme: current status and future strategy. Indian J Med Res 2018; 148: 503-10.
Sun D, Codling K, Chang S, et al. Eliminating iodine deficiency in China: achievements, challenges and global implications. Nutrients 2017; 9: 361.
Dold S, Zimmermann MB, Jukic T, et al. Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: a cross-sectional multicenter study. J Nutr 2018; 148: 587-98.
Paudyal N, Chitekwe S, Rijal S, et al. The evolution, progress, and future direction of Nepal’s universal salt iodization program. Matern Child Nutr 2022; 18 Suppl 1: e12945.
Doggui R, Al-Jawaldeh H, Al-Jawaldeh A. Trend of iodine status in the eastern mediterranean region and impact of the universal salt iodization programs: a narrative review. Biol Trace Elem Res 2020; 198: 390-402.
Charlton K, Ware LJ, Baumgartner J, et al. How will South Africa’s mandatory salt reduction policy affect its salt iodisation programme? A cross-sectional analysis from the WHO-SAGE Wave 2 Salt & Tobacco study. BMJ Open 2018; 8: e020404.
Jooste P, Zimmermann M. Progress towards eliminating iodine deficiency in South Africa. Taylor & Francis 2008; 8-14.
Aburto NJ, Abudou M, Candeias V, et al. Effect and safety of salt iodization to prevent iodine deficiency disorders: a systematic review with meta-analyses. World health Organization 2014; 1-142.
Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. J Nutr 2012; 142: 744-50.
Kim BK, Jeong JY, Seok KH, et al. Current iodine nutrition status and awareness of iodine deficiency in tuguegarao, Philippines. Int J Endocrinol 2014; 2014: 210528.
Organization W. H. Revised WHO classification and treatment of childhood pneumonia at health facilities: evidence summaries. World Health Organization, Geneva 2014; 1-30.
Codling K, Rudert C, Bégin F, et al. The legislative framework for salt iodization in Asia and the Pacific and its impact on programme implementation. Public Health Nutr 2017; 20: 3008-18.
Khattak RM, Khattak MNK, Ittermann T, et al. Factors affecting sustainable iodine deficiency elimination in Pakistan: a global perspective. J Epidemiol 2017; 27: 249-57.
Han X, Ding S, Lu J, et al. Global, regional, and national burdens of common micronutrient deficiencies from 1990 to 2019: a secondary trend analysis based on the Global Burden of Disease 2019 study. EClinicalMedicine 2022; 44: 101299.
Colozza D, Avendano M. Urbanisation, dietary change and traditional food practices in Indonesia: a longitudinal analysis. Soc Sci Med 2019; 233: 103-12.
Reardon T, Tschirley D, Dolislager M, et al. Urbanization, diet change, and transformation of food supply chains in Asia. Michigan: Global Center for Food Systems Innovation 2014; 46.
Boysen O, Boysen-Urban K, Bradford H, et al. Taxing highly processed foods: what could be the impacts on obesity and underweight in sub-Saharan Africa? World Dev 2019; 119: 55-67.
Demmler KM, Qaim M. Africa’s changing food environments and nutritional effects on adults and children. World Rev Nutr Diet 2020; 121: 31-41.
Shan Z, Rehm CD, Rogers G, et al. Trends in dietary carbohydrate, protein, and fat intake and diet quality among US Adults, 1999-2016. JAMA 2019; 322: 1178-87.
Andersson M, Takkouche B, Egli I, et al. Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ 2005; 83: 518-25.
Delange F. Iodine deficiency as a cause of brain damage. Postgrad Med J 2001; 77: 217-20.
Hess SY. The impact of common micronutrient deficiencies on iodine and thyroid metabolism: the evidence from human studies. Best Pract Res Clin Endocrinol Metabol 2010; 24: 117-32.
Harding KB, Peña-Rosas JP, Webster AC, et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database Syst Rev 2017; 3: CD011761.
de Macedo AN, Macri J, Hudecki PL, et al. Validation of a capillary electrophoresis assay for monitoring iodine nutrition in populations for prevention of iodine deficiency: an interlaboratory method comparison. J Appl Lab Med 2017; 1: 649-60.
Bertinato J. Iodine nutrition: disorders, monitoring and policies. Adv Food Nutr Res 2021; 96: 365-415.
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