国内外关于碘缺乏病的共识
近些年，由于国内甲状腺疾病的检出率增加，有些人对我国的普遍食盐碘化政策产生了质疑。为此，国内外学者、专家展开了广泛的讨论和研究。学者们达成了如下的共识：①我国采用食盐加碘政策消除碘缺乏病，取得了举世瞩目的成就，功不可没。我国大部分地区为环境缺碘地区，若不坚持食盐加碘政策，碘缺乏病会卷土重来。②中国的食盐加碘政策保证了我国居民的碘摄入量处于适宜水平，儿童和大多数孕妇碘摄入基本适宜。③食盐加碘政策的成功关键在于政府的高度重视、食盐工业提供了高品质的碘盐、严格的监管体系以及该政策在全国各省市各人群的广泛普及。④孕妇、婴幼儿、儿童监测是预防碘缺乏病的重点，也是指导政策调整的重要监测内容。⑤随着碘缺乏相关疾病的减少，与其他国家一样，中国甲状腺疾病的发生模式正在改变。甲状腺疾病特别是甲状腺癌上升的原因是多方面的，其中主要的原因为诊断方法的提高。目前，还没有证据表明中国及其他国家的甲状腺癌上升与食盐加碘政策有关。⑥我国居民膳食结构仍处于快速变化期，对人群碘营养状况有不同程度的影响，如城市育龄妇女每日食盐摄入的中位数已降为6.3g。我们应该更加关注膳食中碘的来源以及这些来源对于碘摄入的贡献。这些数据对于调整食盐加碘标准以及是否在食品生产过程中使用碘盐提供依据。
表17-8 不同年龄组人群肠外营养期间每天碘摄入推荐量
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