F&N Bulletin Vol 23 No 1b - United Nations University

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88 4. Sternin M, Sternin J, Marsh D. Scaling up a poverty alleviation and nutrition program in Viet Nam. In: Marchione T, ed. Scaling up, scaling down: capacities for overcoming malnutrition in developing countries. Amsterdam: Gordon and Breach, 1999:97–111 5. Save the Children. Towards new applications of the “positive deviance” approach in Save the Children’s programs: report of a planning meeting. Washington, DC: Save the Children, August 3, 2000. 6. Subcommittee on Nutrition. Low birthweight: report based on the international low birthweight symposium and workshop held on 14–17 June 1999 at the International Center for Diarrheal Disease Research in M. Ahrari et al. Dhaka, Bangladesh. SCN Nutrition Policy Paper No. 18. Geneva: United Nations Administrative Committee on Coordination/Subcommittee on Nutrition, 2000. 7. World Health Organization. Maternal anthropometry and pregnancy outcomes. Bull WHO 1995;73(suppl). Geneva: World Health Organization, 1995. 8. National Research Center, Community Medicine Department. Incidence and risk factors of low birthweight in Al-Minia Governorate, Egypt. Dokki, Egypt: National Research Center, 1997. 9. Pecoud A, Donzel P, Schelling JL. Effects of foodstuffs on the absorption of zinc sulfate. Clin Pharmacol Ther 1975;17:469–73.
Difference in goiter rates between regular and occasional users of iodized salt in Mongolia Chieri Yamada and Dalphjabin Oyunchimeg Editorial introduction This paper was accepted for publication not only for its positive findings but also for a negative observation. On the positive side, it is of interest there was no difference in goiter and urinary iodine excretion between families that regularly used iodated salt and those that used it only half of the time. The former constituted 20% of the families and the latter 30%. The possibility must be recognized that the five groups differed in other factors in addition to iodated salt consumption. Ultrasound examination is not needed to determine iodine-deficiency disorder status when urinary iodine excretion is available. However, since it was used in this study, it would have been desirable to determine the relative size of the goiters and not just their presence or absence. On the negative side is the observation that the consumption of iodated salt was limited by a price that was three to seven more than noniodated salt. When salt was first fortified with potassium iodate in Guatemala in 1956, iodated salt was being sold in the United States at the same price as noniodated salt. When it was ascertained that the cost of iodizing salt with potassium iodate in Guatemala was so small per kilogram that it did not justify an increase in the retail cost of salt, the decree requiring universal iodation of salt for human consumption so specified. Potassium iodate was used for the first time instead of potassium iodide because studies of the Institute of Nutrition of Central America and Panama (INCAP) demonstrated that its iodine was equally available [1] and that it could be added with only a small loss, even under unprotected tropical conditions [2]. This meant that there was no need to dry and refine it and sell it in moisture-proof packages or to increase the price. Chieri Yamada is affiliated with the Department of Nursing, School of Health Sciences, Hirosaki University, Hirosaki, Japan. Dalphjabin Oyunchimeg is affiliated with the Department of Public Health, Ministry of Health, in Ulaanbaatar, Mongolia Mention of the names of firms and commercial products does not imply endorsement by the United Nations University. Today the water-insoluble potassium iodate is the basis for salt iodation in developing countries, since the quality and packaging of the salt are unimportant to its correction of iodine deficiency. Salt with iodine should not cost the consumer significantly more than salt without iodine, but there are complicating circumstances. In Mongolia refined iodated salt must reach rural areas through a geographically difficult supply chain, and it cannot be expected to be sold at the same price as crude local salt. Nevertheless, there is no justification for the huge price differential observed by the authors. This violates the human rights of the population and is unacceptable. There should be no economic obstacle to substituting iodated salt for noniodated salt. There is clearly a need for any agency that promotes the national iodation of salt in countries to ensure it is not made a pretext for price-gouging of those most in need. Unfortunately, governments sometimes do not recognize the importance of having salt with iodine available at the lowest possible cost and impose valueadded taxes and other taxes on it, as is currently the case in Mongolia. Locally gathered salt can be cheaper, therefore, because producers do not pay these taxes. The recent initiative by the Asian Development Bank and UNICEF to promote the universal iodation of salt in the countries of Central Asia and Mongolia calls for the removal of all tariff barriers to the production and sale of iodated salt. This has been accepted as a requirement for financial support by all of the participating countries, and when implemented, should improve the prospects for affordable salt in Mongolia. Remarkably, soon after this editorial was first drafted, the same authors submitted a Letter to the Editor (page 108) that provides an excellent response to it. Recognizing that a high price for iodated salt was inhibiting its use, particularly in rural areas, they initiated a pilot study using a simple method of adding potassium iodate to the local crude salt at the village and family level in three villages. The resulting salt sold for a price similar to that for noniodized salt. It is clear that this approach is labor intensive, and, as they note, it would require a strong communication and education program. For these Food and Nutrition Bulletin, vol. 23, no. 1 © 2002, The United Nations University. 89
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Contents Review articles Nuclear an
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Special Article Nuclear and isotopi
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Nuclear and isotopic techniques 5 T
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Nuclear and isotopic techniques 7 T
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Nuclear and isotopic techniques the
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Palm oil: A healthful and cost-effe
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Palm oil will be less absorbed and
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Palm oil oil at the present time is
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Palm oil crystal forms for the requ
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Nutritional status of urban primary
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F&N Bulletin Vol 23 No 1b - United Nations University

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