Tamil Nadu has the lowest consumption of iodised salt despite being the third biggest producer of salt in the country, according to a first-of-its-kind national survey to measure the coverage of iodised salt.
The study shows that 76.3% of Indian households consumed adequately iodised salt, which is salt with at least 15 parts per million of iodine. The five worst performers were Tamil Nadu (61.9%), Andhra Pradesh (63.9%), Rajasthan (65.5%), Odisha (65.8%) and Jharkhand (68.8%). The survey was conducted by Nutrition International in collaboration with the All India Institute of Medical Sciences and the Indian Coalition for the Control of Iodine Deficiency Disorders (ICCIDD). The survey tested the iodine content in samples of cooking salt from households to estimate the coverage of iodised salt.
The survey covered a total of 21,406 households in 29 States and 7 Union Territories in India. The fieldwork was undertaken between October 2018 and March 2019.
Largest producers
Rajasthan, which is the second largest producer of salt, also figured among the five worst covered States. Gujarat produces 71% of salt in the country, followed by Rajasthan at 17% and Tamil Nadu at 11%. The rest of the country accounts for a mere 1% of salt produced.
“The northeastern States are doing very well with respect to iodised salt consumption at the household level because of the distance they have from the three salt producing centres — Gujarat, Rajasthan and Tamil Nadu. By and large most States get their salt from Gujarat and Rajasthan and because of the distance, it is sent by rail. This salt is strictly monitored by the Salt Commissioner’s office and if it is inadequately iodised, they don’t allot rakes. Secondly, salt-producing States have access to common (or non-iodised) salt and, therefore, they start consuming it since it is readily available,” explained Dr. Chandrakant S. Pandav, president, ICCIDD. Dr. Pandav is also called the Iodine Man of India
India made fortification of salt with iodine mandatory for direct human consumption in 1992. This was relaxed in 2000 and then reimposed in 2005. In 2011, the Supreme Court, too, mandated universal iodisation for the control of iodine deficiencies.
Vital micro-nutrient
Iodine is a vital micro-nutrient for optimal mental and physical development of human beings. Deficiency of iodine can result in a range of disabilities and disorders such as goitre, hypothyroidism, cretinism, abortion, still births, mental retardation and psychomotor defects. Children born in iodine deficient areas may have up to 13.5 IQ points less than those born in iodine sufficient areas.
The survey also revealed that 13 out of 36 States have already achieved Universal Salt Iodisation or have 90% of households with access to adequately iodised salt.
The study also examined the urinary iodine concentration in samples from pregnant, lactating and non-pregnant, non-lactating women of reproductive age (15-49 years) to estimate the iodine status among them. These three categories of women were taken as a proxy for the population and the iodine status of the population was found to be adequate as per World Health Organisation guidelines.
Key recommendation
The key recommendation of the study is to sustain the momentum so that iodine coverage does not fall below current levels. It also recommends that the States and the Centre work together to address the current gaps and look into issues that vary from one State to another, leading to adequately iodised salt not being produced.