Need for coordinated programs to improve global health by optimizing salt and iodine intake
Need for coordinated programs to improve global health by optimizing salt and iodine intake
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DOI：
10.1590/s1020-49892012001000006
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发表时间：
2012-10-01
期刊：
影响因子：
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通讯作者：
Zimmermann, Michael B.
中科院分区：
文献类型：
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作者：
Campbell, Norm R. C.;Dary, Omar;Zimmermann, Michael B.
高食盐是导致血压升高的主要原因，而血压升高是世界范围内死亡的主要风险。世界卫生组织(WHO)建议每天盐的摄入量不超过5克，这一目标只有一小部分人能实现。缺碘会导致认知和运动障碍，如果严重，还会导致甲状腺功能减退，并伴有严重的智力和发育迟缓。全世界有20多亿人面临缺碘的风险。使用碘强化盐预防碘缺乏症是全球公共卫生的一项重大成就。减少食盐的计划在技术上与通过食盐强化来预防碘缺乏的计划是一致的。然而，为了让人们充分受益于盐和碘的最佳摄入量，这些计划必须整合在一起。本文综述了减少食盐和强化碘计划的科学基础，这些计划的兼容性，以及世卫组织、各国政府和非政府组织为确保人们充分受益于盐和碘的最佳摄入量而需要采取的步骤。具体而言，必须召集专家组，帮助各国实施综合方案和成功综合方案的具体情况案例研究；需要汇编和传播吸取的经验教训。综合监测计划将更加有效，并将加强目前优化碘和盐摄入量的努力。为了让民众充分受益，各国政府需要高度重视整合这两个重要的公共卫生项目。
High dietary salt is a major cause of increased blood pressure, the leading risk for death worldwide. The World Health Organization (WHO) has recommended that salt intake be less than 5 g/day, a goal that only a small proportion of people achieve. Iodine deficiency can cause cognitive and motor impairment and, if severe, hypothyroidism with serious mental and growth retardation. More than 2 billion people worldwide are at risk of iodine deficiency. Preventing iodine deficiency by using salt fortified with iodine is a major global public health success. Programs to reduce dietary salt are technically compatible with programs to prevent iodine deficiency through salt fortification. However, for populations to fully benefit from optimum intake of salt and iodine, the programs must be integrated. This review summarizes the scientific basis for salt reduction and iodine fortification programs, the compatibility of the programs, and the steps that need to be taken by the WHO, national governments, and nongovernmental organizations to ensure that populations fully benefit from optimal intake of salt and iodine. Specifically, expert groups must be convened to help countries implement integrated programs and context-specific case studies of successfully integrated programs; lessons learned need to be compiled and disseminated. Integrated surveillance programs will be more efficient and will enhance current efforts to optimize intake of iodine and salt. For populations to fully benefit, governments need to place a high priority on integrating these two important public health programs.