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The effect of sodium restriction on iodine prophylaxis: a review

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Abstract

Purpose

Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years.

Methods

Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status.

Results

To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal.

Conclusion

A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.

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Acknowledgements

The authors thank Antonella Olivieri* for her helpful comments that improved the manuscript. *Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Responsible for the Italian National Observatory for Monitoring Iodine Prophylaxis, Rome, Italy.

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No founds, grants, or other support was received for the preparation of this manuscript.

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Authors and Affiliations

  1. Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy

    F. Nista, M. Albertelli, M. Boschetti & D. Ferone

  2. Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy

    M. Bagnasco

  3. Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy

    F. Gatto, L. Vera, N. Musso & D. Ferone

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  1. F. Nista
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Contributions

Conceptualization: FN, NM and MB; Methodology: DF; Formal analysis and Investigation: FG, MA, FN, LV; Writing—original draft preparation: FN, NM and MB; Writing—review and editing: FG, LV, MA and MB; Supervision, DF, FG and MB. All authors have read and approved the final manuscript.

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Correspondence to F. Gatto.

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Conflict of interest

Diego Ferone has been a speaker for and participated on advisory boards and received research grants from Novartis, Ipsen and Pfizer. Diego Ferone is a member of the Editorial Board of Journal of Endocrinological Investigation. Federico Gatto has been a speaker for Novartis and has participated on advisory boards of Novartis, AMCo Ltd, and IONIS Pharmaceuticals. Diego Ferone and Manuela Albertelli are members of the Editorial Board of the Journal of Endocrinological Investigation. The other Authors have no conflicts of interest to declare.

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Nista, F., Bagnasco, M., Gatto, F. et al. The effect of sodium restriction on iodine prophylaxis: a review. J Endocrinol Invest 45, 1121–1138 (2022). https://doi.org/10.1007/s40618-022-01749-y

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