Use of Iodized Salt in Processed Foods in Select Countries Around the World and the Role of Food Processors

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The Food Engineering program from Universidad de las Americas Puebla (UDLAP) is approved by the Institute of Food Technologists (IFT) and accredited by the Consejo de Acreditacion de la Ensenanza de la Ingenieria (CACEI), which is the peer-accrediting agency of the US Accreditation Board for Engineering and Technology (ABET) in Mexico. Graduates of UDLAP’s Food Engineering program (FE) shall attain thirteen outcomes; eleven of them are similar to ABET Criterion 3 (a-k) program outcomes; as well as specific IFT core competencies regarding major areas: food chemistry and analysis; food safety and microbiology; food processing and engineering; applied food science; and success skills. As part of assessment efforts at FE, the Food Engineering Undergraduate Curriculum Committee designed a strategy that uses both direct and indirect assessment measures. Direct assessments of the FE program outcomes were conducted through the analysis of evidence collected (since spring 2009) in the food engineering undergraduate thesis and corresponding defenses (by means of specific rubrics), as well as in the capstone course Design and Development of Food Products and Processes (by means of self-, peer-, instructor-, and outside evaluators-assessment results, as well as final grades received by students). In the case of theses and their defenses, the outcome with the highest score was for the program outcome “An ability to use the techniques, skills, and modern engineering tools necessary for food engineering practice”. Regarding the degree to which students utilized program outcomes in the design and development of its product as well as in their oral and written work-products at the capstone course, the mean scores from surveyed stakeholders were higher than the 3.0 out of 5.0 points. Indirect assessment was fulfilled through surveys and curricular mapping: 1) curricular mapping analysis of FE outcomes and IFT competencies; and 2) design and implementation of a survey that asked to assess with a Likert scale the perception of program outcomes in two respects: importance of the outcomes and progress made by students in achieving these outcomes. This survey has been applied since 2008 to the following groups: faculty, graduating seniors, alumni, employers, as well as to students enrolled in the program at their 1st, 3rd, 5th, 6th, 7th, 8th, and 9th semester and earlier results are discussed elsewhere. FE curricular mapping was carried out with collaboration of program faculty who were asked to rate for each of the courses they teach the degree to which they are promoting FE thirteen outcomes and IFT core competencies. Responding whether they do not cover, initiate, develop, or emphasize each outcome and/or IFT competency in their classes. Faculty felt that the outcome that they promote and emphasize less is “an ability to communicate effectively in English in written form”. The following areas of improvement have been found from IFT core competencies mapping: “understand the basic principles and practices of cleaning and sanitation in food processing operations”, and “understand the requirements for water utilization and waste management in food and food processing”. FE program using of assessment results to improve student learning through curricular modifications as well as a summary of improvements and modifications up to date (such as using a plan to perform embedded assessments in several FE courses) are presented.

The program of universal salt iodization (USI) was intensified in the 1990s. Unfortunately, a recent World Health Organization review finds that there was a global increase of 31.7 percent in total goiter rate from 1993 to 2003. However, the WHO review places only 1 country as severely, 13 as moderately, and 40 as mildly deficient in populations' iodine nutrition, and places 43 countries at optimal, 24 at high, and 5 at excessive levels of iodine nutrition. Thus, it is imperative to weigh the benefits and risks of intensifying USI further. The WHO review places India in the category of "adequate" iodine nutrition, but in 2005 the Government of India promulgated a universal ban on sale of non-iodized salt, calling iodine deficiency disorders (IDDs) a major public health problem. This article attempts to understand these contradictions and weigh the benefits and costs of USI. Based on a review of studies since the 1920s, the authors reconstruct the evolution of IDD control in India. Conceptual and methodological limitations challenge the evidence base and rationale of stricter implementation of USI now. Finding evidence for its negative impact, the authors recommend a reexamination of the USI strategy and propose a safer, people-centered, ecosocial epidemiological approach rather than a universal legal ban.

ABSTRACT: The safety of food worldwide remains challenged by the potential for emergence of new pathogens and re‐emergence of known pathogens. Microorganisms have an inherent ability to evolve—to mutate and adapt to environmental stressors—allowing them to survive otherwise lethal conditions. The Institute of Food Technologists (IFT), the 22000‐member nonprofit scientific and educational society, convened a panel of internationally renowned experts to address the concern that the use of antimicrobials in food production, manufacturing, and elsewhere may lead to the emergence of foodborne pathogens that are resistant to antimicrobials, thus compromising the ability to subsequently control them, whether in production agriculture, food processing, or human medicine. The outcome of the panel's deliberations is presented in this Expert Report. IFT's objective for this Expert Report is to increase the understanding—among IFT members, senior policy officials, and other interested groups—of the state of the science on the public health impact of the use of antimicrobials in the food system, and development and control of antimicrobial resistance. This report is the fourth Expert Report produced by IFT.

The standard approach to max-margin parameter learning for Markov random fields (MRFs) involves incrementally adding the most violated constraints during each iteration of the algorithm. This requires exact MAP inference, which is intractable for many classes of MRF. In this paper, we propose an exact MAP inference algorithm for binary MRFs containing a class of higher-order models, known as lower linear envelope potentials. Our algorithm is polynomial in the number of variables and number of linear envelope functions. With tractable inference in hand, we show how the parameters and corresponding feature vectors can be represented in a max-margin framework for efficiently learning lower linear envelope potentials.

Salt policy is an important element of European nutrition policy. Whereas the per-capita intake of salt in the population is viewed as being too high for health reasons, the intake of iodized salt helps to counteract iodine deficiency. Given this tradeoff, the principle “If salt, then iodized salt!” is formulated in German health and nutrition policy. We address the question whether food processors follow this rule and why this is so. A market study for German grocery retailing and 30,345 processed foods in the food groups bread, meat and milk reveals that the share of products with iodized salt is low and much below the use of iodized salt in private houzseholds. Expert interviews and online surveys of food processors suggest at least three reasons for this evidence: (i) There is incomplete information among food processors with regard to the health benefits of iodized salt. (ii) A minority of salt consumers is actively opposing the iodization of salt. (iii) The reduced use of iodized salt due to (i) and (ii) is not compensated by governmental regulation and an active information and support policy for salt fortification.

Food industry and engineering—Quo vadis?

Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status. A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization. Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. The median UIE level was 200 mcg/L. The 20% the population had iodine deficiency, 28.9% population had adequate iodine nutrition and 51.1% population had either more than adequate level of iodine. The 72.4% of the population consume adequately iodized salt (>=15 ppm). Our study concludes that Tikamgarh district is non-endemic for IDDs against the earlier classification as an IDD-endemic district. About 20% population has 'iodine deficiency' and approximately 51.1% population has 'more than adequate iodine intake'. We recommend stringent programme monitoring, undertake periodic assessment of IDD and explore manifestations of excess iodine intake (>=300 mcg/L) such as Iodine-induced hyperthyroidism in future.

Reducing dietary salt is one of the most effective interventions to lessen the burden of premature death and disability. In high-income countries and those in nutrition transition, processed foods are a significant if not the main source of dietary salt. Reformulating these products to reduce their salt content is recommended as a best buy to prevent chronic diseases across populations. In the Americas, there are targets and timelines for reduced salt content of processed foods in 8 countries--Argentina, Brazil, Canada, Chile, Ecuador, Mexico, and the National Salt Reduction Initiative in the United States and Paraguay. While there are common elements across the countries, there are notable differences in their approaches: 4 countries have exclusively voluntary targets, 2 countries have combined voluntary and regulated components, and 1 country has only regulations. The countries have set different types of targets and in some cases combined them: averages, sales-weighted averages, upper limits, and percentage reductions. The foods to which the targets apply vary from single categories to comprehensive categories accounting for all processed products. The most accessible and transparent targets are upper limits per food category. Most likely to have a substantive and sustained impact on salt intake across whole populations is the combination of sales-weighted averages and upper limits. To assist all countries with policies to improve the overall nutritional value of processed foods, the authors call for food companies to supply food composition data and product sales volume data to transparent and open-access platforms and for global companies to supply the products that meet the strictest targets to all markets. Countries participating in common markets at the subregional level can consider harmonizing targets, nutrition labels, and warning labels.

Transparent, Actionable Framework for Food and Nutrition Research Public-Private Partnerships.

Iodine: It's Important in Patients that Require Parenteral Nutrition

In September 2011, the U.S. Food and Drug Administration (FDA) asked the Institute of Food Technologists (IFT) to execute product tracing pilot projects as described in Section 204 of the FDA Food Safety Modernization Act (FSMA). IFT collaborated with representatives from more than 100 organizations-including the U.S. Dept. of Agriculture, state departments of agriculture and public health, industry, and consumer groups, as well as not-for-profit organizations-to implement the pilots. The objectives of the pilot projects were 1) to identify and gather information on methods to improve product tracing of foods in the supply chain and 2) to explore and evaluate methods to rapidly and effectively identify the recipient of food to prevent or mitigate a foodborne illness outbreak and to address credible threats of serious adverse health consequences or death to humans or animals as a result of such food being adulterated or misbranded. IFT conducted evaluations to determine the impact of currently available technologies, types of data and formats, and the data acquisition process, as well as the use of technology on the ability to follow product movement through the supply chain. Results from the pilots found inconsistencies in the terminology, numbering systems, formatting, legibility, and occasionally the language that sometimes required IFT to contact the submitting firm to gain clarity, thus increasing the time required to capture data before any meaningful analysis could begin. However, the pilot participants appeared to have many of the tools and processes in place which are required to allow the capture and communication of critical track and trace information (such as, key data elements) at critical points of product transfer and transformation (such as, critical tracking events). IFT determined that costs associated with implementing a product tracing system can vary widely as determined by numerous factors: the size of the firm/facility, the method of product tracing already in use (manual or electronic), and the range of each firm's capabilities to implement or improve its product tracing system, to name a few. IFT found that there are several areas (such as uniformity and standardization, improved recordkeeping, enhanced planning and preparedness, better coordination and communication, and the use of technology) in which industry improvements and enhancements to FDA's processes would enable tracebacks and traceforwards to occur more rapidly. IFT developed 10 recommendations for FDA to consider for improving the state of system-wide food product tracing. The recommendations outlined in the report will enable FDA to conduct more rapid and effective investigations during foodborne illness outbreaks and other product tracing investigations, thus significantly enhancing protection of public health.

Objective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders(IDD) in Shanxi Province after universal salt iodization(USI), and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy. Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995, and from iodized salt surveillance of the province after 2004. According to the statistics and analysis of children's goiter rate, median urinary, median and mean of salt iodine, coverage rate of iodized salt, qualified rate of iodized salt, consumption rate of qualified iodized salt and their relationship. Results Since 1995, the children's goiter rate by palpation and B-ultrasound showed a steady descending trend. The median salt iodine, mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline. Namely: The three indicators began to rise year by year from 1995 (29.1 mg/kg, 31.7 ± 15.0 mg/kg, 199.3 μg/L), in 1999 (48.7 mg/kg, 53.4 ± 29.4 mg/kg, 407.5 μg/L) reached its climax; and then decreased, in 2001 (34.7 mg/kg, 36.2 ± 11.9 mg/kg, 282.1 μg/L) stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg, 26.5 ± 6.3 mg/kg, 192.0 μg/L), a significant decline began. The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable. Two indexes began to decline circuitously from 1995 (72.61%, 68.25%), and dipped to a low point in 1999 (44.80%, 43.67%); then began to rise, until 2002 (94.73%, 91.80%) reached basic stability; and remained steady from 2002 to 2013. Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province, with the depth understanding of the range of adequate iodine nutrition, according to the monitoring-feedback mechanism, the strategy of salt iodization has been adjusted several times, the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable. Salt iodization strategy should continue to adhere to. Key words: Iodine; Deficiency disorders; Epidemiology; Analysis

Physiological changes in pregnancy result in increased iodine demand, which may not be met in areas of mild-to-moderate iodine deficiency or borderline sufficiency. As a pregnant woman is the only source of thyroid hormones for her child during early gestation, iodine deficiencyinduced hypothyroxinemia may have deleterious effects on fetal development. To present the current approach to iodine deficiency and its prophylaxis during pregnancy. A review of the current literature including patents on iodine deficiency in pregnancy has been performed. Negative influence of severe iodine deficiency on fetal development has been proved, and evidence on a deleterious impact of milder forms of iodine deficiency on cognition of the offspring is rapidly growing. Although the WHO has addressed the issues of monitoring iodine status during pregnancy, prophylactic measures and assessment of their effectiveness, there are some controversies, regarding for example the best methods for control of iodine status. New patents in urinary iodine measurement methods may make iodine nutrition monitoring easier. The main method of iodine prophylaxis, in pregnancy also, is universal salt iodization. However, particularly if there is not sufficient coverage of the households with iodized salt, additional measures, such as oral supplementation with potassium iodide tablets, are necessary in pregnant women to provide adequate iodine nutrition. Iodine supplementation improves maternal thyroid function indices; particularly, it prevents goiter formation. Stronger evidence on beneficial effects of iodine supplementation of mild-to-moderate iodine deficient pregnant women on cognitive function of their children is still needed. It may be provided by randomized controlled trials and international initiatives. Changes in the iodine prophylaxis system should be monitored, both to prevent decreased or excessive iodine intake.

Since 1994, China has launched the Universal Salt Iodization strategy to prevent and control the prevalence of iodine deficiency disorders (IDD). In 2005, China achieved the elimination of IDD at the national level. During the last decade, comprehensive measures such as adjusting the iodine content in salt has been taken and the iodine nutrition is optimal for children and pregnant women, the prevention and control of IDD in China has made remarkable achievement. However, there are still many issues during the process of prevention and control of IDD in the future. The mandated requirements of the prevention and control measures should be weaken, the evaluation of residents' iodine nutrition level should be paid attention, and residents' iodine nutrition should be focused on in assessing the elimination of IDD in China. Key words: Iodine; Deficiency diseases; Nutrition assessment; Evolution