Iodine Nutrition in Emilia-Romagna Region, Italy: A Successful Story of Prevention of Iodine Deficiency Disorders.

The Emilia-Romagna region, Italy, achieved iodine sufficiency many years before the approval of Law 55/2005, which introduced a nationwide salt iodization program voluntarily in the country. Indeed, more than 10 years before the law, the Emilia-Romagna region implemented a local program of iodine, carrying out information campaigns to promote the use of iodized salt in the population. Epidemiological studies conducted between 1998 and 2005 in this region showed a progressive increase in the use of iodized salt (IS) and a median urinary iodine concentration >100 μg/L in almost all the investigated towns and villages. In 2005, when the national Law 55/2005 was approved, the prevalence of IS consumers in the Emilia-Romagna region was 60%, while it was only 30% in the rest of the country. Further studies conducted between 2011 and 2019 confirmed an adequate iodine intake in the population and the disappearance of goitre in schoolchildren, demonstrating the sustainability of the regional iodine prophylaxis program. Of note, the success obtained in this region is the result of a close collaboration between local politicians, health services, school authorities, families, and salt producers that, in the absence of dedicated funds, moved voluntarily to spread knowledge on the importance of using IS. Multiple and reiterated "on-field" initiatives experienced at the local level yielded awareness in the population on the importance of IS, suggesting that tight cooperation among stakeholders is successful in promoting large-scale programs of prevention.