Abstract
ObjectivesThis study was conducted to assess household coverage with iodized salt in Saudi Arabia, and to determine adequacy of salt iodization.MethodsA school-based cross-sectional study using WHO 30-cluster survey methodology.ResultsAnalysis of 4242 salt samples using qualitative rapid test kit (RTK) revealed that 68.7% (95% CI 67.3–70.1%) were iodized with significant regional differences (p < 0.001). The highest iodized salt samples came from Makkah (82.3%), Riyadh (81.1%) and Maddinah (76.2%) regions, while the least iodized salt samples came from Hail (31.3%), Baha (53.0%), and Northern Borders (57.5%) regions. The national weighted proportion of households consuming iodizes salt was 69.8% (95% CI 69.4–71.2), which is below the Universal Salt Iodization (USI) goal (≥90% coverage). For validation, a quantitative iodometric titration method was used to analyze 775 representative salt samples screened iodized by RTK; iodine content of ≥15 ppm was found in 95.2% (95% CI 93.9–96.5) of samples with median iodine content 51 ppm (mean 50.4 ± 21.8). More than 70% of the iodized salt samples contained iodine concentration higher than the recommended national level (15–40 ppm).ConclusionsThe study revealed inadequate consumption of iodized salt among Saudi households and explored marked regional heterogeneity. The majority of iodized salt samples contained iodine concentration more than the recommended level. These findings imply the need to launch a public awareness campaign on use of iodized salt. Legislation to ban production and sale of non-iodized salt sale for human consumption might be considered. A well-functioning monitoring system at factory level and surveillance system are crucially needed to ensure proper salt iodization and intake.
Highlights
Iodine is essential for healthy brain development in the fetus and young child
This study was based on the dataset of the National Survey on Iodine Deficiency Disorders conducted in 2012, which provided valuable information on the situation of iodine nutrition status in Saudi Arabia [5]
Iodometric titration method was used for validation of iodine content in samples tested by the rapid test kit (RTK)
Summary
Iodine deficiency negatively affects the health of women, as well as economic productivity and quality of life. It is the most common cause of preventable mental impairment throughout the world [1]. Al-Dakheel et al Nutrition Journal (2018) 17:35 the prevalence of goiter due to iodine deficiency affected 110 countries globally. Despite the scarcity of substantial historical data on iodine deficiency in Saudi Arabia, the two national surveys, carried out nearly two decades apart, have shown that Saudi population has a sufficient iodine nutrition at the national level, both surveys and other regional studies demonstrated a degree of mild to moderate iodine deficiency especially in the southern regions based in goiter prevalence indicator [4,5,6,7]
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