Executive Summary: The Micronutrient Initiative (MI) issued the Institute of Food Technologists (IFT) a project to assess the extent to which iodized salt is used in processed foods, as well as food processors' level of knowledge on iodine nutrition. Iodine is an essential micronutrient required by the body that is found in a limited number of foods, thus many individuals require additional sources of iodine to meet their daily requirement. Without these additional sources, a range of disorders referred to as iodine deficiency disorders (IDD), including mental impairment, may become present, with over 2 billion people worldwide at risk due to insufficient iodine nutrition. IDD is especially damaging during the early stages of pregnancy and in early childhood. In their most severe form, IDD includes cretinism, stillbirth, and miscarriage, and increased infant mortality. Since 1994 the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) have recommended universal salt iodization (USI) as a safe, cost-effective, and sustainable strategy to ensure sufficient intake of iodine by all individuals. However, USI has in practice tended to focus only on table salt and not all salt destined for human consumption. Recent trends, particularly in industrialized countries, show that individuals are consuming the majority of their salt through processed foods, in which iodized salt is generally not used, rather than through iodized table salt. Additionally, recent initiatives to encourage reduced sodium consumption have prompted many consumers to reduce their intake of iodized table salt. While these trends in sodium consumption are more frequently observed in industrialized countries, they are expanding into many developing countries where iodine deficiency is also a concern. Thus countries which focus on iodization of table salt alone may not achieve optimal iodine nutrition of their population. This report provides an overview of the 2 Phases of this project. Phase I was to conduct an environmental scan/desk review of processed food consumption patterns in 39 countries selected by MI (see Table 1). Phase II was to conduct an electronic survey of food processors and detailed telephone interviews with a small sample of select company representatives from 16 countries (see Table 2). Per the scope of work, IFT conducted a desk review to determine the types and level of processed food consumption in the 39 countries of interest, as well as to identify suppliers of the major processed foods consumed and the use of salt as an ingredient in those products. Whenever possible, IFT also gathered information on the sodium content of widely consumed processed foods and the sources of salt currently used in these products; the types of processed foods and extent to which they are consumed by different socioeconomic groups; if iodized salt was used in processed foods; and whether or not there are policies in place to influence dietary salt reduction and how these efforts are implemented. For Phase II, IFT reached...
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