Improved cassava-processing can help reduce iodine deficiency disorders in the Central African Republic

Cassava roots are the dominant staple food in the Central African Republic (CAR). A study on Iodine Deficiency Disorders (IDD) comparing two areas in the western and central parts of CAR revealed that cassava roots were consumed daily in all interviewed households. High-yielding potentially toxic “bitter” varieties dominated the cultivations in both areas. Iodine-excretion was equally low in both areas studied but total goitre rate was 28% in the central area and 50% in the western area. The thorough traditional processing-method strictly adhered to in the central study area effectively removed cyanogens as indicated by low urinary thiocyanate. Frequent shortcuts in processing in the western area resulted in cyanide exposure as indicated by urinary thiocyanate levels three times higher. We conclude that insufficiently processed cassava aggravates IDD in parts of CAR. However, the goitrogenic effect is due to shortcuts in traditional processing practices and not to the consumption per se of this high-yielding tropical staple crop. Since low iodine intake is the main cause of IDD and well-processed cassava is not goitrogenic, iodine supplementation should be the main preventive intervention but promotion of effective cassava processing can be complementary. Promotion of cassava varieties with low levels of cyanogenic glucosides should not be attempted until it has been demonstrated that such varieties perform well in the local farming and food system.