Monitoring salt Iodization in Indonesia: the Need to Account for Iodine from Household and Food Industry Salt

Abstract

Objectives: Universal iodization of all edible salt (USI), including household and food industry salt, is the most cost-effective intervention to improve dietary iodine intake. The main metric to track USI programs is the proportion of households consuming adequately iodized salt. However, this does not capture salt consumed from processed foods, such as instant noodles, which are widely consumed in Indonesia. Analyze the association between iodine in household salt, consumption of instant noodles and iodine status, while accounting for the level of iodine in local water, as a possible confounder. Methods: We are currently undertaking analysis of data from the 2013 Indonesia National Health Survey (Riskedas) which included estimates of iodine in household salt, frequency of instant noodle consumption, iodine in local water sources and iodine status. Results: We will have results ready for presentation at the MN Forum. It is expected that estimates of iodine in household salt and the consumption of instant noodles will predict iodine status better than from household salt alone, and suggest that iodized salt is used in most instant noodle production. Conclusions: It was feasible to collect data on the consumption of instant noodles as part of a large nationally representative survey in Indonesia, which enables the analysis of presumed iodine intake from multiple sources. Information from this survey can be used to optimize the salt iodization level in Indonesia and provide important lessons on tools, methods and interpretation that can lead to improved salt iodization program guidance.