Guatemala proved unequivocally that iodized salt — salt treated with potassium iodine or iodide — dramatically reduces the incidence of IDDs. Mandatory iodization of salt, which was introduced by Switzerland in 1922, virtually eliminated the “village idiot” from the gallery of European archetypes, although IDD lingers on in pockets there and is quite severe in poorer countries such as Bulgaria and Romania. The United States and a few other developed nations, including Australia and the Scandinavian countries, have completely conquered the problem. There are certain geographical areas where soil and therefore crops and grazing animals do not provide sufficient dietary iodine to the populace. This can be in areas with excessive rains and flooding, mountainous habitations.

In the developing world, the roadblocks to wiping out such a widespread public health scourge are much higher. Sub-Saharan Africa, China, Indonesia and the vast region bordering the Himalayas are particularly affected. But there, too, the disease is on the run: UNICEF, which has led the international battle against IDDs, estimates that iodized salt programs have protected 12 million children a year from brain damage.

Iodine is a micronutrient, a trace element that occurs naturally in the soil. Although replenished somewhat by the cycle of evaporation and rain, the earth’s soil is gradually being stripped of iodine. Because the human body cannot retain iodine (unlike most other micronutrients), the vegetables and pulses that are iodine-rich must be consumed daily. Hence the worst cases of iodine deficiency are found in the highland regions of the world, areas of greatest soil degradation, where vegetables and pulses have the lowest content of iodine (seaweed, which was used in ancient times as a cure for goiter, has the highest iodine content). However, there is no region in India free of IDD. It is found in the major cities as well as in distant villages.

list of problems: cretinism, stunting, deaf-mutism, malformed limbs, spastic motor disorders, stillbirths, reproductive failure, and poor vision.

• Severe iodine deficiency in pregnant women can result in babies being born with physical and mental retardation.

• Goiter (a grotesque swelling of the thyroid gland on the neck), as well as milder forms of mental and physical impairment. Goiter, a large swelling of the thyroid gland in the neck, is a chronic iodine deficiency disease.

• Goiter, cretinism, and delayed mental and physical development are collectively known as IDD.

• Irregular heartbeat, hardening of the arteries, obesity, low blood pressure, angina, arthritis, hair and skin problems, breast cancer, etc. can all be traced to chronic low levels of iodine.

• Excessive salivation, feeling as if something has been neglected, forgotten or left unfinished (which prevents contentment and peace), hearing deterioration, sense of odor is missing, and restlessness at sunset (sensitivity to the electrical changes in the environment).

• The problem of cataracts comes from the calcium being out of solution (in the blood), due to lack of iodine.

Iodine Deficiency is the world’s most prevalent – yet easily preventable – cause of brain damage. Today we are on the verge of eliminating it – an achievement that will be hailed as a major public health triumph, ranking together with smallpox and poliomyelitis. Less than 20 years ago, few people realized the magnitude of the problem, let alone the solution. However, since the 1980s, WHO has been at the forefront of a worldwide public health drive to eliminate this under-publicized yet devastating deficiency. The WHO’s Department of Nutrition for Health and Development (NHD) provides both technical tools – scientifically sound standards, guidelines and methodologies – and guidance to build up countries’ national salt iodization programmes. Progress has been significant since the primary intervention strategy for IDD control – Universal Salt Iodization (USI) – was adopted in 1993. Salt was chosen because it is widely available and consumed in regular amounts throughout the year, and because the costs of iodizing it are extremely low. In 1990, the World Summit for Children, UNICEF and the World Health Organization committed to virtually eliminate IDD by promoting the iodisation of salt and its use. However, to date, while global significant progress towards reducing iodine deficiency disorders has taken place over the past decade, much still remains to be accomplished.

Iodine deficiency, one of the world’s oldest and most devastating nutrition-related health problems. Iodine deficiency disorders (IDDs) are the leading cause of mental retardation in the world.

Iodine Deficiency Disorders (IDD) is a public health problem and in India, no state is free from iodine deficiency. About 200 million people are ‘at risk’ of IDD in India.

A few salient facts

o IDD affects over 740 million people, 13% of the world’s population; 30% of the remainder are at risk.

o IDD preys upon poor, pregnant women and preschool children, posing serious public health problems in 130 developing countries.

o Iodine deficiency is a problem for the developing brains of foetuses and young children. According to the WHO, it is the single greatest cause of mental retardation. In the first 12 weeks of pregnancy, the foetus relies on its mother directly for thyroid hormone. After that, it uses iodine from the mother to make its own.

o Iodine-deficient people may forfeit 15 IQ points.

o Nearly 50 million people suffer from some degree of IDD-related brain damage. Yet we have the means to prevent it – small quantities of iodine at low cost.

The answer to iodine deficiency disorders is iodized salt. A spectacularly simple, universally effective, wildly attractive and incredibly cheap technical weapon – IODIZED SALT.

Calcium is present in a wide range of foods. Dairy products, leafy green vegetables, nuts and seeds (almonds, brazils, sesame seeds), tofu, and dried fruit are all good sources of calcium for vegetarians. Most flour is fortified with calcium carbonate so cereals can also be a good source. Hard water may also provide calcium. Meat is a very poor source of calcium.

Calcium balance can be affected by a range of other factors. Vitamin D is essential for absorption of calcium from the gut. This is because calcium is transported into the body by a special carrier protein which requires vitamin D for its synthesis.

A number of substances can inhibit the absorption of calcium. Phytic acid, found in bran, whole cereals and raw vegetables is one of these. Uronic acid, a component of dietary fibre, and oxalic acid, found in certain fruits and vegetables can also bind calcium. However, diets habitually high in these acids are not thought to have a major effect on calcium absorption. Saturated fats can also lessen calcium absorption.

Calcium is lost in the faeces, urine and sweat. Calcium loss is roughly equal to dietary calcium in adults. Calcium loss is reduced if dietary calcium is low. Adaptation to both high and low calcium intakes occur. Reduced intake leads to increased efficiency of absorption. In infants and children calcium is retained for new bone growth. Calcium is also lost during lactation in breast milk.

Foods rich in calcium are :

• Ragi, a millet, is a rich source of calcium and known as poor man’s milk.

• Green leafy vegetables are very rich sources of Vitamin B, carotene, iron, calcium, Vitamin B complex and Vitamin C .

• Milk is a good source of protein, calcium and vitamins.

• Yogurt (Curds), paneer, fenugreek leaves, drumstick leaves, Almond, Dried Figs (Anjeer) are great source of protein, riboflavin and calcium.

• Pineapple is tropical fruit. It is a good source of Vitamin A and B and rich in Vitamin C and calcium. It also contains phosphorus and iron.

• Sea Food: Small fish like sprats and sardines can be a useful source of calcium when eaten whole together with bones and may supply up to 400 mg of calcium/ 100 gms. Fish also contains fair amount of copper.

A calcium rich diet and weight bearing exercise play a critical role in helping to build and maintain strong bones.

Calcium requirements should be met everyday: however the majority of women fall far short of this.

On an average, women get only 500-700mg of calcium from their daily diets, while the National Institutes of Health’s Consenses Conference on Optimal Calcium Intakes recommends 1000-1500mg for women over 50 years. Based on these average levels most women require calcium supplementation.

DIET

• Throughout life, dietary intake of calcium is essential for bone formation and maintenance
• Vitamin D, which aids in the absorption of calcium, is also essential

• Maintaining a healthy diet which includes a sufficient amount of calcium and Vitamin D is very important

A diet that includes an adequate amount of calcium, vitamin D and protein should be maintained. This will not completely stop bone loss, however it will guarantee that a supply of materials tha body uses for bone formation and maintenance is available.

EXERCISE

Regular exercises can reduce the likelihood of the bone fractures associated with osteoporosis. Exercises, requiring muscles to pull on bones, cause the bones to retain and perhaps even gain in density.

Some of the recommended exercises include:

• Weight bearing exercises
• Riding stationary bicycles
• Using rowing machines
• Walking
• Jogging

It is important to remember that any exercise that presents a risk of falling should be avoided

There are no symptoms associated with the onset of the disease

Symptoms occuring late in the disease
• Low back pain
• Neck pain
• Bone pain or tenderness
• Loss of height over time
• Stooped posture
• Fractures of the spine, wrists or hips
Investigations :Your doctor would make the diagnosis of Osteoporosis based on investigations such as Bone mineral density, Spine CT, X-ray, etc. among other findings.

• Asian women
• Menopause
• Old age
• Family history of osteoporosis
• Smoking
• Eating disorders
• Diet deficient in calcium
• Alcohol consumption
• Use of certain medications such as steroids