The legislative framework for salt iodization in Asia and the Pacific and its impact on programme implementation

Abstract

ObjectiveFortification of food-grade (edible) salt with iodine is recommended as a safe, cost-effective and sustainable strategy for the prevention of iodine-deficiency disorders. The present paper examines the legislative framework for salt iodization in Asian countries.DesignWe reviewed salt iodization legislation in thirty-six countries in Asia and the Pacific. We obtained copies of existing and draft legislation for salt iodization from UNICEF country offices and the WHO’s Global Database of Implementation of Nutrition Actions. We compiled legislation details by country and report on commonalities and gaps using a standardized form. The association between type of legislation and availability of iodized salt in households was assessed.ResultsWe identified twenty-one countries with existing salt iodization legislation, of which eighteen were mandatory. A further nine countries have draft legislation. The majority of countries with draft and existing legislation used a mandatory standard or technical regulation for iodized salt under their Food Act/Law. The remainder have developed a ‘stand-alone’ Law/Act. Available national surveys indicate that the proportion of households consuming adequately iodized salt was lowest in countries with no, draft or voluntary legislation, and highest in those where the legislation was based on mandatory regulations under Food Acts/Laws.ConclusionsLegislation for salt iodization, particularly mandatory legislation under the national food law, facilitates universal salt iodization. However, additional important factors for implementation of salt iodization and maintenance of achievements include the salt industry’s structure and capacity to adequately fortify, and official commitment and capacity to enforce national legislation.

Development of Databases on Iodine in Foods and Dietary Supplements

“…Iodine has emerged as a nutrient of concern in many developed countries, in part because retail sales (and home use) of non-iodized salts may be increasing [ 11 , 110 , 111 , 112 ] and iodized salt is not always used in the commercially prepared foods that make up an ever-increasing component of the food supply yet whose consumption often leads to excessive sodium intake [ 11 , 110 , 111 , 112 ]. Also, some countries have not yet implemented mandatory salt iodization programs [ 51 , 112 , 113 ]. Pregnant women and young children are at highest risk of inadequate intake but other groups within populations may also be at risk.…”

Understanding Quality Control with Urinary Iodine Estimation

“…In 2014 also, 70% households had access to adequately iodized salt. Within the years 2009-2013, it was estimated that 50-86% of households are consuming adequately iodized salt, ranging from the least developed countries to East Asia and Pacific countries [7].…”

Knowledge, attitude and behaviour of university students regarding salt and iodine: a multicentre cross-sectional study in six countries in Europe and Asia

“…According to the WHO, it is estimated that almost one third of the world’s population has an insufficient iodine intake. Salt iodisation has been introduced in many countries as a cost-effective and sustainable means of preventing or eliminating IDD [ 15 , 16 ]. However, even in countries with mandatory universal salt iodisation (USI) programmes, certain segments of the population may not attain an adequate iodine intake [ 17 ].…”