Iodine policy in Australia

Iodine is a trace element and is responsible for the synthesis of thyroid hormones that are critical for brain development especially in the foetal and early childhood development. Dietary iodine deficiency results in a broad spectrum of disorders, collectively known as iodine deficiency disorders (IDD), comprising endemic goitre, hypothyroidism, obstetric complications, increased neonatal mobility and mortality, and mild to severe brain damage that may vary from small loss of IQ to frank cretinism. Fortunately, with the implementation of universal salt iodisation (USI) programme, IDD can be prevented. In a typical Australian diet, iodine comes mainly from milk and dairy products and to a lesser extent from seafood and processed foods with added iodised salt. Vegetables, fruits and cereals are poor sources of iodine in general. The disappearance of iodine deficiency in Australia in the mid 20th century could be best described as 'an accidental public triumph' due to widespread use of iodophors introduced over decades ago as sanitising agents in the dairy industry. A re-emergence of mild iodine deficiency in Australia was confirmed by a National Iodine Nutrition Study (NINS) conducted in 2004.This coincided with replacement of iodophors used in the dairy industry with chlorine-based and organic sanitizers. The mild IDDin Australia is considered to bethe silent epidemic causing damage to current and future generations of Australia children if no actions were taken immediately. Active public health advocacy coupled with strong research data became the primary driver for the development of new health policy on food fortification to correct iodine deficiency in Australia. As a result, mandatory fortification of bread with iodised salt was implemented in October 2009. Challenges exist to other vulnerable groups in the community which may not be adequately covered by simple addition of iodised salt to bread.