Experts have called on the Government of Vietnam to make salt iodisation mandatory once again or at least promote the production and use of iodised salt in food processing and breeding.

Iodised salt is sold in a supermarket. (Photo: nld.com.vn)

This is urgent as the country is one of just 19 iodine-deficient countries in the world, according to the Iodine Global Network, a non-profit organisation for the sustainable elimination of iodine deficiency worldwide.

Thanks to iodised salt, the number of iodine-deficient countries has decreased from 110 in 1993 to only 19 in 2017.

In Vietnam, salt iodisation was mandatory from 1994 to 2005, during that time 93 percent of households were using adequately iodised salt.

Under the subsequent period of voluntary iodisation (2005 –2016), however, the proportion of households using iodised salt rapidly declined to 45 percent in 2010.

A survey conducted by the National Hospital of Endocrinology in 2013 and 2014 revealed that some 60 percent of Vietnamese households use sufficient amounts of iodine, a decrease of 33 percent from 2005. Moreover, some 10 percent of children aged 8-10 had goiter (abnormal enlargement of the thyroid gland), while the rate of children with goiter during years prior 2005 was less than five percent.

Another survey by National Institute of Nutrition showed that only 6 percent of asked people said they used iodised salt while the 75 percent of asked people said that seasoned their food with fish sauce, soy sauce or other seasonings.

It is estimated that processed foods provide about 75 percent of salt intake to people and just 15 percent of salt intake is from eating salt directly. Thus, in countries where iodine is not used in processing food, the salt intake of people could be reduced.

The institute’s Director Le Danh Tuyen said that between 1994 and 2005, Vietnam successfully implemented a national programme on Iodine Deficiency Disorders Control, through which, iodine was added to all salt used by people in the country.

However, the result was not maintained after the national iodine programme was stopped, he said.

Don Hong Phuong, an officer from the United Nations Children’s Emergency Fund (UNICEF), clarified that authorities had closed down mandatory iodine fortification after 2005, and stopped funding the national goiter prevention plan.

"In recent years, Vietnamese people used more food seasonings rather than iodine in cooking, which has resulted in increasing iodine deficiency," said Phuong, adding that food seasonings were convenient and seemingly made the food tastier.

"In 2016, Vietnam’s Government issued a decree on adding micronutrition to food, in which salt used for direct eating or food processing must contain iodine. The decree took effect in March 2017, but few food producers have followed the guidelines.

“Food producers say that adding iodine increased their production cost, disrupted production lines, and even change the taste, colour and expiration date of their products,” she said.

According to UNICEF, iodine deficiency will cause miscarriages, goitre and brain damage in the fetus during pregnancy. The recommended dietary allowance of iodine is 90-120 mcg/day for children aged 1 to 11 years old and 150 mcg/day for adults and adolescents. Besides iodised salt, people can take iodine from sea fish, seaweed, amaranth, watercress or algal.-VNA