PMID- 35089975
OWN - NLM
STAT- MEDLINE
DCOM- 20220222
LR  - 20220222
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 17
IP  - 1
DP  - 2022
TI  - Modelling the contribution of iodised salt in industrially processed foods to 
      iodine intake in Macedonia.
PG  - e0263225
LID - 10.1371/journal.pone.0263225 [doi]
LID - e0263225
AB  - Evidence from the 1950s showed that Macedonia was iodine deficient. After the 
      introduction of mandatory universal salt iodisation, the country saw a steady 
      increase in iodine intake and decline in goitre prevalence, earning 
      iodine-deficiency free status in 2003. Iodine status assessments in 2007 and 2016 
      showed adequate iodine intake among school age children (median urinary iodine 
      concentration of 241 mug/L and 236 mug/L respectively). Macedonia participated in 
      piloting the Iodine Global Network Programme Guidance on the use of iodised salt 
      in industrially processed foods to better understand potential iodised salt 
      intake from processed foods. One objective of implementation was to identify the 
      need, opportunities, and required actions to strengthen the processed food 
      component of the national salt iodisation policy. Data from the 2017 Household 
      Consumption and Expenditure Survey (HCES) was used to determine household salt 
      consumption, to identify widely-consumed, salt-containing industrially processed 
      foods, and estimate typical daily intake of these foods. Their estimated 
      contribution to iodine intake was estimated based on their salt content and the 
      percentage of food industry salt that is iodised. Although the study has 
      limitations, including a relatively small selection of foods, the results 
      indicate potential iodine intake from iodised household salt and iodised salt in 
      the selected foods of nearly 300% of the Estimated Average Requirement and over 
      220% of the Recommended Nutrient Intake for adults. This was approximately 50% of 
      the tolerable safe Upper Level for iodine intake. The study confirmed high daily 
      salt intake (11.2 grams from household salt only). Successful salt reduction 
      would be expected to reduce iodine intake, however, modelling with 10% and 30% 
      reduction implied this is unlikely to put any population group at risk of 
      deficiency. It is recommended that implementation of salt iodisation and salt 
      reduction policies are harmonized, alongside continued regular iodine status 
      monitoring for different population groups.
FAU - Milevska-Kostova, Neda
AU  - Milevska-Kostova N
AUID- ORCID: 0000-0003-1596-9036
AD  - Institute for Social Innovation, Skopje, Macedonia.
FAU - Karanfilski, Borislav
AU  - Karanfilski B
AD  - National Committee on Iodine Deficiency, Ministry of Health, Skopje, Macedonia.
FAU - Knowles, Jacky
AU  - Knowles J
AUID- ORCID: 0000-0003-1453-2107
AD  - Iodine Global Network, Ontario, Canada.
FAU - Codling, Karen
AU  - Codling K
AD  - Iodine Global Network, Ontario, Canada.
FAU - Lazarus, John H
AU  - Lazarus JH
AD  - University of Cardiff, Cardiff, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220128
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Sodium Chloride, Dietary)
RN  - 0 (iodized salt)
RN  - 9679TC07X4 (Iodine)
SB  - IM
MH  - Family Characteristics
MH  - *Food
MH  - *Food Industry
MH  - Greece
MH  - Humans
MH  - Iodine/*analysis
MH  - *Models, Theoretical
MH  - Sodium Chloride, Dietary/*analysis
PMC - PMC8797217
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/01/29 06:00
MHDA- 2022/02/23 06:00
PMCR- 2022/01/28
CRDT- 2022/01/28 17:11
PHST- 2020/12/11 00:00 [received]
PHST- 2022/01/14 00:00 [accepted]
PHST- 2022/01/28 17:11 [entrez]
PHST- 2022/01/29 06:00 [pubmed]
PHST- 2022/02/23 06:00 [medline]
PHST- 2022/01/28 00:00 [pmc-release]
AID - PONE-D-20-39014 [pii]
AID - 10.1371/journal.pone.0263225 [doi]
PST - epublish
SO  - PLoS One. 2022 Jan 28;17(1):e0263225. doi: 10.1371/journal.pone.0263225. 
      eCollection 2022.