Iodine Deficiency Disorders represent a significant public health threat. IFT research assessing the use of iodized salt shows the food industry is willing to use iodized salt, although numerous barriers exist around the world.
Iodine is an essential micronutrient required by the body that is found in a limited number of foods, which means that many individuals require additional sources of iodine to meet their daily requirement. Without these additional sources, a range of disorders referred to as Iodine Deficiency Disorders (IDDs) may present themselves. IDDs are the leading cause of preventable mental impairment, with more than two billion people worldwide at risk due to insufficient iodine nutrition. IDD is especially damaging during the early stages of pregnancy and in early childhood. In their most severe form, IDDs include cretinism, stillbirth, miscarriage, and increased infant mortality.
Since 1994, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended universal salt iodization (USI) as a safe, cost-effective, and sustainable strategy to ensure sufficient intake of iodine by all individuals. However, USI has, in practice, tended to focus only on table salt and not all salt destined for human consumption. Recent trends, particularly in industrialized countries, show that individuals are consuming the majority of their salt through processed foods, in which iodized salt is generally not used, rather than through iodized table salt. Additionally, recent initiatives to encourage reduced sodium consumption have prompted many consumers to reduce their intake of iodized table salt. While these trends in sodium consumption are more frequently observed in industrialized countries, they are expanding into many developing countries where iodine deficiency is also a concern. Thus, countries that focus on iodization of table salt alone may not achieve optimal iodine nutrition of their population.
Iodized Salt Project Parameters
The Institute of Food Technologists, under contract to the Micronutrient Initiative (MI), assessed the use of iodized salt in processed foods in 39 countries of interest to MI’s USI program (Table 1). MI is a nonprofit organization dedicated to ensuring that the world’s most vulnerable individuals, especially women and children in developing countries, get the vitamins and minerals they need to survive and thrive. The project aimed to determine if iodized salt was used in processed foods, whether or not there are policies in place to influence dietary salt reduction and how these efforts are implemented, as well as iodine nutrition knowledge among food processors in the countries of interest.
In Phase 1 of the work, IFT conducted a desk review to determine the types and level of processed food consumption in the 39 countries of interest to MI, as well as to identify suppliers of the major processed foods consumed and the use of salt as an ingredient in those products. Sixteen countries were then further evaluated in Phase 2 (Table 2). IFT reached out to food company representatives to determine their use of iodized salt in processed food products, their sources of salt, their awareness of iodine nutrition and salt as a fortification vehicle, and their interest in learning more about salt iodization.