Friday, 19 April 2013

Salt reduction, iodine fortification and the challenge for the international consumer movement

Angela McDougall, Food Policy Advisor for CHOICE (the Australian Consumers Association), asks how we tackle the 'impossible challenge' of reducing salt consumption from the current, dangerously high levels while addressing widespread iodine deficiency - especially as salt is the primary vehicle for iodine fortification. 

According to experts at a recent meeting in Sydney, Australia, it’s not impossible – in fact, they believe that salt reduction and iodine fortification strategies are thoroughly compatible.

But the real challenge for the international consumer movement – and public health advocates – is ensuring that improvements in the food supply in some markets extend to other countries.

I can’t resist mentioning the gloriously long title of the meeting – the ‘WHO and The George Institute for Global Health Jointly Convened Information Exchange Forum with the Private Sector and Nongovernmental Organisations on Salt Reduction and Iodine Fortification Strategies in Public Health’.

Representing CHOICE (the Australian Consumer Association) and Consumers International, I joined government officials, eminent academics, industry and public health representatives from around the world to discuss strategies to address iodine deficiency disorders and reduce salt consumption.

The difficulty is that iodine deficiency is a major problem in many parts of the world - 54 countries, to be precise, including Australia – while at the same time there is a global increase in chronic diseases linked to excessive salt consumption. The World Health Organisation recognises the need to act on both problems, but this presents a challenge because salt is the primary vehicle for iodine fortification.

The key message is: eat less salt, but make sure any salt consumption is adequately iodised. This not only means that table salt should be iodised, but also that salt added to processed foods should be iodised.

Professor Dorothy Mackerras, Chief Public Health Nutrition Adivisor at Food Standards Australia New Zealand, spoke about efforts to address iodine deficiency in Australia. Here, a 2007 regulation mandated iodisation of salt in bread (with the exception of organic bread to allow for consumer choice). The most recent data is currently being assessed and Professor Mackerras expects it will show that this strategy has largely addressed iodine deficiency in Australia.

When it comes to innovative ways to reduce salt, we heard about a potassium chloride product from Nu-Tek. According to the company, their product does not have the bitterness commonly associated with potassium chloride because a special process they have developed, allowing reductions of up to 50% of sodium.

Australian consumer and public health advocates are not alone in despairing at the glacial pace of salt reduction through industry reformulation commitments.

When industry is pressed on why it doesn’t do more, the common response is that consumers won’t buy the product if they reduce salt too quickly.

And while there is much talk of the need for legislated reduction targets and mandatory, effective front-of-pack labelling, such interventions may be a long way off.

In this context, products like Nu-Tek are attractive to companies scared that reducing salt will also reduce market share and therefore have the potential to improve the food supply and health outcomes.

According to Nu-Tek, many companies are using the product in the United States (where there is also retail version available for consumers to purchase) and there is considerable interest in Australia.

Despite this glimmer of hope, it seems that even where companies act to reduce salt, their actions are often limited to markets like Australia where there is pressure from governments and strong public health and consumer groups.

Similarly, we heard from a Nestle nutritionist representing the International Food and Beverage Alliance who stated that her company fortified a popular two-minute noodle product with iodine in Papua New Guinea.

While giving the company credit for this action, it was recognised that there are many other markets where iodine deficiency is a problem that haven’t benefitted from this good corporate citizenship.

I think these examples suggest an opportunity for the international consumer movement to act.

Our organisations should call on multinational companies to extend salt reduction programs in developed countries to developing countries and offer iodised food products they develop across markets where there is iodine deficiency.

As the Australian example shows, iodine deficiency is not limited to developing countries but it is a problem that can be fixed. And as developing countries are increasingly targeted by multinational food companies, chronic health problems caused by excessive salt consumption will spread.

With so many governments reluctant to regulate to reduce diet-related disease, consumer groups should join forces and push for private sector action to address these problems. 

1 comment:

  1. Dear Angela McDougall,
    Greetings from Hararay Tripathi, ahmedabad, India.
    Thanks for sharing the crucial and always ongoing problem of salt and iodine in our daily diets. We require to focus on the total sodium contents we consumed and not only the iodized salt used in foods !!!
    When we drink good quality and quantity of water having low or small amount of sodium content - water with total dissolved solids(TDS) of less than 200 ppm - we will have some passage to use pinch of salt content in our daily foods !!!!
    When we drink and use water with higher TDS of 500 ppm or more in daily foods,the multiple addition effect of total sodium will increase beyond our control !
    In-fact doctor always advise us to cut down the intake of sodium content from what foods we consumed including drinking water and other drinks !!!
    May be the information regarding total sodium contents( per 100 gm or per serving) on the food products label can help us to decide what to eat and what amount to eat.
    Hararay Tripathi