title: Iodine fortification:  why, when, what, how, and who?
abstract: OBJECTIVE
  To highlight current issues regarding the role of iodine fortification in correcting and preventing iodine deficiency. Universal salt iodization (USI) is recommended, wherein all salt is iodized; however, a more graduated approach may be warranted.
  
  
  RESULTS
  Iodine deficiency is widespread and has re-emerged in countries such as Australia, New Zealand and the UK. As well as supplementation in groups such as pregnant and lactating women who have increased iodine requirements, public health strategies to improve iodine intakes include voluntary or mandatory fortification of the food supply. A key player in the process of fortification is the food industry, wherein misperceptions that the addition of iodized salt to foods alters taste and colour still persist and legislation in some countries that prohibits its addition to manufactured foods, can result in a reluctance to support USI.
  
  
  CONCLUSIONS
  Ameliorating iodine deficiency on a population level in countries with mild-to-moderate deficiency is warranted. Risk of both inadequate and excess iodine intakes requires regular monitoring to accompany fortification programmes as well as strategies to address subpopulations at risk. More sensitive indicators of recent iodine status are needed to rapidly assess the impact of fortification on improving the status.
authors: School of Health Sciences, Faculty of Health & Behavioural Sciences, University of Wollongong, Wollongong, New South Wales, Australia. karenc@uow.edu.au
authors: Karen
authors: K
authors: Charlton
authors: Sheila
authors: S
authors: Skeaff
mesh_terms: D001315:Australia / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005502:Food; D005527:Food, Fortified; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000172:deficiency*; D009520:New Zealand / Q000453:epidemiology; D018673:Nutrition Policy; D011247:Pregnancy; D011634:Public Health; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D013959:Thyroid Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine