Israelis Have Among World's Worst Iodine Deficiency, Groundbreaking Study Warns

Acute iodine deficiency is costing Israelis IQ points and all we need to do to prevent neuro-damage is iodize salt like rest of world, say doctors.

Living by the Mediterranean Sea is a lovely way to live, perhaps, but contrary to conventional wisdom, it won't help even slightly with iodine deficiency in the diet.
Living by the Mediterranean Sea is a lovely way to live, perhaps, but contrary to conventional wisdom, it won't help counter iodine deficiency in the diet. Moshe Gilad

For the first time, Israelis have been surveyed for iodine levels and the discovered deficiencies have shocked scientists: 85 percent of pregnant women have insufficient iodine intake and the same goes for 62 percent of school-age children. Perhaps the chronic deficiency is even a cause behind the embarrassingly low scores by Israeli pupils in international exams.

The median iodine concentration found in urine of the test subjects indicate that the iodine status in Israel is amongst the lowest in the world, writes the team.

"Most of the world adds iodine to salt. We don't," explains researcher Prof. Aron Troen to Haaretz. Another issue is that arid Israel drinks a great deal of desalinated water, which could be exacerbating the problem of mineral deficiencies, including iodine.

Iodine deficiency can lead to hypothyroidism, a condition slowing the metabolism. In newborns, it can lead to neurological impairment, warns the international group of scientists from the Hebrew University of Jerusalem, Maccabi Healthcare Services, Barzilai University Medical Center in Ashkelon and ETH Zurich in Switzerland, with support of the Iodine Global Network.

Mild to moderate iodine deficiency is associated with the probability of cognitive impairment, or in other words, it can lower the IQ by some points.

"The cognitive risk is sub-clinical," Troen explained to Haaretz. "It does not cause cretinism, but loss of potential IQ. We call ourselves Startup Nation, but that's the top layer of the pyramid.  At the base of the pyramid, there are very poor results."

Iodine concentration is measured by urine tests, which is easy enough, but until now Israel has not only neglected to conduct iodine surveys: it hadn't done any tracking of hypothyroidism. Now the team did that very thing, testing the urine of 1,023 schoolchildren and 1,074 pregnant women from all regions and major sectors in Israel (Arab, Jewish secular and orthodox), during 2016.

They found no difference between communities: nationally, 62 percent of Israeli children and 85 percent of Israel's pregnant women have iodine concentrations below the World Health Organization's "adequacy range."

Severe iodine deficiency leads to goiter, characterized by swelling of the neck, and does cause cretinism, which involves mental impairments as well as malformation and dwarfism.

Goitre and cretinism in Styria, a copper engraving from 1815, before salt was iodized to prevent precisely these conditions.
Wikimedia Commons

Given the implications, the scientists call on the government to stop ignoring the public health issues at stake, given that – according to the findings – practically every child in Israel is at risk: "The majority of the population could be unlikely to realize its full intellectual potential," the team states.

“The immediate implication of our findings is that we need to improve the public’s intake of iodine,” said Troen, the principal investigator at the Nutrition and Brain Health Laboratory, School of Nutrition Science, at Hebrew University. “It seems that as in most other countries, Israel’s food supply and our collective dietary habits do not ensure iodine sufficiency. Thus eliminating iodine deficiency and achieving optimal iodine status in Israel’s population will require a sustainable, government-regulated program of salt or food iodization. The costs are small and the benefits substantial and have been proven in over 160 countries around the world where this is done.”

No, living next to the sea doesn't prevent iodine deficiency. But one does not have to stand around helplessly while the iodine-deficient government slowly mulls what to do.

“Individuals can improve their iodine status through increased consumption of iodine-rich foods such as milk, dairy and salt water fish. They can also replace regular table salt with iodized salt," counseled Yaniv Ovadia, the doctoral student and registered dietitian who performed the study. Interestingly, iodized salt is hardly sold in Israel, and where it is, it costs a mint.