title: Eliminating Iodine Deficiency in China: Achievements, Challenges and Global Implications.
abstract: The prevention of iodine deficiency through salt iodization has been recognized as a global success story, and China stands at the forefront of this achievement with one of the most successful programs in the world. High level political commitment, national mandatory legislation, a state-managed edible salt industry and a complex and highly sophisticated surveillance system have facilitated the success of the program. Challenges have arisen however, including: (i) concern that adequate iodine status in pregnant women cannot be achieved without causing above adequate iodine intakes in children; (ii) declining iodine intake as a result of reductions in salt consumption and increased consumption of processed foods, which may not be made with iodized salt; (iii) the existence of areas with high iodine content in the water; and (iv) declines in household use of iodized salt due to concerns about excess iodine intake and thyroid disease. This article reviews the achievements and challenges of the Chinese Iodine Deficiency Disorders (IDD) Elimination Program and reflects on lessons learned and implications for other national salt iodization programs.
authors.affiliation: Centre for Endemic Disease Control, China Chinese Centre for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, China. hrbmusdj@163.com.
authors.forename: Dianjun
authors.initials: D
authors.lastname: Sun
authors.affiliation: United Nations Children's Fund, 12 Sanlitun Lu, Beijing 100600, China. shenhm119@126.com.|Iodine Global Network, P.O. Box 51030, 375 des Epinettes, Ottawa, ON K1E 3E6, Canada. shenhm119@126.com.
authors.forename: Karen
authors.initials: K
authors.lastname: Codling
authors.affiliation: United Nations Children's Fund, 12 Sanlitun Lu, Beijing 100600, China. Suxiaohui8@163.com.
authors.forename: Suying
authors.initials: S
authors.lastname: Chang
authors.affiliation: Parasitic and Endemic Disease Prevention and Control Division of the National Health and Family Planning Commission of China, 14 Zhichun Road, Beijing 100088, China. karen@publicnutritionsolutions.com.
authors.forename: Shubin
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Centre for Endemic Disease Control, China Chinese Centre for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, China. kcodling@ign.org.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Shen
authors.affiliation: Centre for Endemic Disease Control, China Chinese Centre for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, China. schang@unicef.org.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Su
authors.affiliation: Iodine Global Network, P.O. Box 51030, 375 des Epinettes, Ottawa, ON K1E 3E6, Canada. zpchentj125@sina.com.
authors.forename: Zupei
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Iodine Global Network, P.O. Box 51030, 375 des Epinettes, Ottawa, ON K1E 3E6, Canada. rscherpbier@unicef.org.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Scherpbier
authors.affiliation: Parasitic and Endemic Disease Prevention and Control Division of the National Health and Family Planning Commission of China, 14 Zhichun Road, Beijing 100088, China. yanjun@nhfpc.gov.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
mesh_terms: D002681:China / Q000453:epidemiology; D016208:Databases, Factual; D003677:Deficiency Diseases / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency*; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D009752:Nutritional Status; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine
keywords: China; iodine deficiency; iodine status; salt iodization