Ages 9 through 13 Years. The prevalence of goiter was estimated in European boys and girls aged 6 to 15 years (Delange et al., 1997). Goiter prevalence in a population increases inversely with iodine intake. Because iodine deficiency is rare in the United States, data from Europe are used to relate goiter, as determined by ultrasound, to urinary iodine excretion. As urinary iodine excretion increases, the goiter prevalence decreases and eventually changes only slightly (Figure 8-1). Although data from this figure are not available for estimating a 50 percent prevalence of goiter, the level of urinary iodine concentration at which there is only a 2 percent prevalence

FIGURE 8-1 Inverse relationship between median urinary iodine concentrations and the prevalence of goiter in schoolchildren. The dotted line represents the upper limit of the prevalence of goiter (WHO Nutrition Unit, 1994). Adapted from Delange et al. (1997).