Improve quality of iodised salt to prevent iodine deficiency disorders
The term iodised salt is the general name used for common salt that is mixed with a controlled amount of edible salt of iodine.
In Ghana, iodised salt is used as table salt and cooking salt. The production is monitored by the Food and Drugs Authority, while the standards for the production are set by the Ghana Standards Authority. This is to ensure that it is safe for consumption.
Advertisement
Iodine deficiency disorders
The iodised salt upon consumption provides iodine to the consumer. This iodine then helps the body to produce a chemical substance called thyroid hormone. The hormone eventually contributes to the proper functioning and health of the consumer.
Failure of the iodised salt to provide sufficient amount of iodine to the consumer results in a combination of health complications collectively called iodine deficiency disorders (IDDs). These disorders include thyroid disorders (goitre, dry eyes, dry mouth and yellow skin); breast disorders (breast cancer); brain disorders (mental retardation, poor academic performance); heart disorders (irregular heart beat); reproductive disorders (miscarriages, foetal complications), and growth disorders (myxedemia, cretinism).
There are combination of other factors with respect to salt that could increase iodine deficiency disorders. The consumption of iodised salt which contains the right amount of iodine, however, prevents iodine deficiency disorders.
Economic implications of IDDs in Ghana
According to Ghana Nutrition Profiles 2011, iodine deficiency disorders have resulted in three per cent of children in Ghana being cretins, 10 per cent being severely mentally impaired, 87 per cent mildly mentally impaired and their intelligence reduced permanently by 13.5 IQ points.
Again, 1.5 million of these children have also been estimated to be affected by mild to severe mental impairment from 2011 to 2020. Loss of productivity to the prevalence of the disease is about $22m annually and productivity losses by 2020 was estimated to be GH¢5,974 million.
National Surveys of IDDs
Ghana embarked on its first national survey in 1992 to determine the incidence of iodine deficiency disorders. The results of the survey showed extensive incidence of the disorder (goiter) especially in the Upper East Region.
Another national survey between 2009 and 2013 reported that 47.8 per cent of households were using adequately iodised salt and 16.5 per cent of households were using salt with no added iodine (5ppm). In spite of this, iodine status had improved substantially since this survey.
Though recent survey in 2015 showed a national adequacy in iodine status, a significant and progressive increase in the prevalence has also been reported.
Based on the public health importance of IDDs, the first standard for iodisation of household salt in Ghana was adopted in 1996. The standard has subsequently been reviewed to the current standard of at least 50 ppm iodine during production and a minimum of 25 ppm iodine at the retail and 15 ppm at household levels.
Concerns
Two types of salt are sold in the Ghanaian market. These are packaged and unpackaged salts, both of which are supposed to be iodised by law.
Some of the packaged salt on sale are Annapurna, U2, Concord plus, Cerebos, Buffalo, Ritebrand, Mr Chef, Lele and Ante Dede. The unpackaged salt, however, are sold in open trays or in transparent unlabeled polythene sachets.
In recent times, there have been concerns about sub-standard iodised salt in the markets. These concerns have come from consumers and other stakeholders.
For instance, according to Ghana Nutrition Profiles 2011, only 32 per cent of iodised salt is properly iodised in Ghana. Analysis of salt iodine content by brand found median iodine content of 73ppm for one leading brand.
Such careless addition of iodine to salts could lead to “iodine excess”, consumption of which could worsen the plight of iodine deficient populations.
In view of this, a study was undertaken to also assess the quality of the iodised salt and to make recommendations to improve the quality.
Study
The salt samples were collected across the then 10 regions of Ghana. In the Greater Accra Region were the Accra Mall, Agbogbloshie, Malata, Kaneshie, Makola, Madina, Nima, Ashiaman, Tema, Sege and Kasei.
Ho, Aflao, Blekusu, Adina, Anlo-Afiadenyigba, Anloga and Dabala made up the areas from the Volta Region. Tamale, Wa and Bolgatanga constitute the areas in the Northern, Upper West and Upper East regions, respectively. Sunyani in the Brong Ahafo Region; Koforidua, Krobo Odumase and Akim Oda in the Eastern Region.
Other areas include Kumasi in the Ashanti Region; Cape Coast, Kasoa, Mankessim, Kuntu, Apam, Agona Swedru and Elmina in the Central Region. In the Western Region, the areas were Sekondi, Takoradi, Axim, Half Assini, and Jarway Wharf.
The salts were tested for their amounts of iodine and substances such as lead and aluminium (pollutants). The lead and aluminium are chemical substances that are considered to be harmful to the health of the consumer if they exceed certain limits.
Findings
The results revealed that the packaged salts sampled were generally iodised though inconsistent with the set standards. Ten per cent of the samples had less iodine, another 10 per cent though labelled as iodised did not have any iodine, 30 per cent had more (excess) iodine, while 60 per cent were adequately iodised.
With regard to the pollutants, 30 per cent of the samples were found to contain lead in harmful amounts, while none of the samples was found to contain aluminium in harmful amounts.
The unpackaged salts were largely not iodised. A total of 10 per cent of the samples from Upper East and Greater Accra regions were found to be iodised.
However, the sample from Upper East had a little more iodine than required. None of the samples were found to contain lead and aluminium in harmful amounts.
Conclusion
The quality of iodised salts on the Ghanaian markets generally need to be improved. For instance, the amount of iodine in the unpackaged salt may not have the potential to eliminate iodine deficiency disorders.
Iodised salts in the markets are, therefore, to be monitored by the appropriate state agencies to ensure improvement in the quality. This will help fight iodine deficiency disorders in Ghana.
The writer is a lecturer, Labtech Department of School of Physical Sciences, College of Agriculture and Natural Sciences, U.C.C, Cape Coast
