title: A lowered salt intake does not compromise iodine status in Cape Town, South Africa, where salt iodization is mandatory.
abstract: OBJECTIVE
  Universal salt iodization is an effective strategy to optimize population-level iodine. At the same time as salt-lowering initiatives are encouraged globally, there is concern about compromised iodine intakes. This study investigated whether salt intakes at recommended levels resulted in a suboptimal iodine status in a country where salt is the vehicle for iodine fortification.
  
  
  METHODS
  Three 24-h urine samples were collected for the assessment of urinary sodium and one sample was taken for urinary iodine concentrations (UICs) in a convenience sample of 262 adult men and women in Cape Town, South Africa. Median UIC was compared across categories of sodium excretion equivalent to salt intakes lower than 5, 5 to 9, and greater than or equal to 9 g/d.
  
  
  RESULTS
  The median UIC was 120 μg/L (interquartile range 75.3-196.3), indicating iodine sufficiency. Less one-fourth (23.2%) of subjects had urinary sodium excretion values within the desirable range (salt <5 g/d), 50.7% had high values (5-9 g/d), and 22.8% had very high values (≥9 g/d). No association between urinary iodine and mean 3 × 24-h urinary sodium concentration was found (r = 0.087, P = 0.198) and UIC status did not differ according to urinary sodium categories (P = 0.804).
  
  
  CONCLUSIONS
  In a country with mandatory universal salt iodization, consumers with salt intakes within the recommended range (<5 g/d) are iodine replete, and median UIC does not differ across categories of salt intake. This indicates that much of the dietary salt is provided from non-iodinated sources, presumably added to processed foods.
authors.affiliation: School of Health Sciences, Faculty of Health and Behavioural Sciences, University of Wollongong, Wollongong, New South Wales, Australia. karenc@uow.edu.au
authors.forename: Karen E
authors.initials: KE
authors.lastname: Charlton
authors.forename: Pieter L
authors.initials: PL
authors.lastname: Jooste
authors.forename: Krisela
authors.initials: K
authors.lastname: Steyn
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Ghosh
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000009:adverse effects; D004039:Diet, Sodium-Restricted / Q000009:adverse effects; D005260:Female; D005527:Food, Fortified; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000188:drug therapy / Q000517:prevention & control / Q000652:urine; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency* / Q000652:urine; D008297:Male; D037141:Mandatory Programs; D008875:Middle Aged; D009752:Nutritional Status; D012964:Sodium / Q000652:urine; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D013019:South Africa; D014504:Urban Health; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine; D012964:Sodium