On integration of the iodine deficiency elimination and salt reduction programs

Abstract

Excessive salt intake is a risk factor for noncommunicable diseases, but salt iodization is the most effective method of population-based prevention of iodine deficiency. Therefore, an assessment of dietary iodine intake from the use of iodized salt in the food industry and potential reductions in salt intake is needed.

Objective. To assess the feasibility of integrating iodine deficiency prevention and salt reduction programmes among the adult population in the Republic of Belarus.

Material and methods. Using the thiocyanate-nitrite method, the determination of iodine in various types of foods was carried out. Taking into account the actual dietary intake, estimated using the frequency method among 583 respondents over 18 years old, living in Minsk, from various socioeconomic groups, alimentary iodine intake was assessed at different levels of salt use in households. The level of iodine sufficiency was additionally estimated on the base of urinary excretion data obtained by the cerium-arsenite spectrophotometric method in 100 healthy adults over the age of 18 living in Minsk (65 women and 35 men).

Results. As part of the legal framework for the use of iodized salt in food production, there has been a steady increase in iodine levels in the target products (bakery and meat products to 42.0 and 133.3 µg/100 g respectively). The content of the discussed micronutrient in the diet of the adult population has raised at least 1.9-fold in recent decades, to 237.3 µg/day in the most realistic consumption model. The main source of iodine among this subpopulation is commercially produced foods with iodized salt, which forms 30–58% of the alimentary iodine exposure. Consumption of salt in Belarus averages 10.6 g per day, which poses a risk of developing noncommunicable diseases and necessitates programmes to reduce the level of salt in the diet. Modeling of scenarios with reduction of salt use in households in accordance with the recommendations of the World Health Organization (WHO) shows that the main contribution to dietary iodine exposure will be made by bread products (38%), about 1/3 will be formed by table salt, the value of non-target fortified products (milk and eggs) will increase (up to 21%). The contribution of table iodized salt to the dietary iodine exposure reaches 43% at actual consumption levels and will decrease to 18% if it is reduced to the WHO recommended values. The median of ioduria among those surveyed is 136.8 µg/l, indicating adequate iodine supply.

Conclusion. In implementing joint programs on prevention of iodine deficiency and cardiovascular diseases associated with excessive salt intake, it is necessary to consider national conditions – mandatory use of iodized salt in food industry, its level of fortification, content of this micronutrient in foodstuffs and structure of their consumption among certain population groups.

Keywords:iodine deficiency diseases; iodized salt; integration of prevention programs; salt intake reduction

Funding. The research used the results obtained within the framework of task 03.01 “To develop and implement methodological approaches and criteria for assessing the alimentary load of contaminants, food additives and enriching biologically active substances” (No. GR 20100927, 2010–2012) of the branch scientific and technical program “Health and Environment”.

Conflict of interest. The authors declare no conflict of interest.

For citation: Fedorenko E.V., Kolomiets N.D., Mokhort T.V., Sychik S.I., Belysheva L.L., Mokhort E.G., Petrenko S.V. On integration of the iodine deficiency elimination and salt reduction programs. Voprosy pitaniia [Problems of Nutrition]. 2022; 91 (3): 53–63. DOI: https://doi.org/10.33029/0042-8833-2022-91-3-53-63 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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