Results from the National Strategy for Improvement of Iodine Nutrition in Bulgaria. A study of children and pregnant women living in an iodine-deficient area

Background A significant part of Bulgaria is considered an iodine-deficient area. The National Strategy for Prevention and Control of Iodine Deficiency Disorders (IDD) was developed in 1994, and regular surveys undertaken in 2000-2003 indicated a normalization of the iodine supply in the Bulgarian population, including some at-risk population groups (children, schoolchildren, pregnant women). Despite the results achieved, mandating periodic cohort surveys for tracking the elimination of iodine deficiency is necessary. Objective The aim of this study was to evaluate the results of the the national strategy for improvement of iodine nutrition in children and pregnant women living in an iodine-deficient area in Bulgaria 15 years after its update. Subjects and methods Study subjects were 73 children aged 9.21 +/- 2.07 years (29 boys and 44 girls) and 16 pregnant women living in the town of Asenovgrad. Urinary iodine concentration was measured and used as an index of iodine intake. Results The median urinary iodine of the inspected children was between 100-199 mu g/l, which is an indicator of optimal iodine nutrition. Almost 1/3 of the children (31.5%) had iodine deficiency. The median urinary iodine concentration of the 16 pregnant women investigated was 127.0 mu g/l, which is an indicator of insufficient iodine intake. Conclusion Despite the normalization of the iodine supply in the past years in the at-risk population groups of children and pregnant women, a considerable portion of them still has iodine deficiency. Recommendations for improving health education and iodine nutrition in at-risk population groups were made.