An evaluation of salt intake and iodine nutrition in a rural and urban area of the Cote d'Ivoire

Objective: To evaluate the habitual salt intake of individuals living in th e Cote d'Ivoire, and to monitor the iodine nutrition of adults, schoolchild ren and pregnant women one year after implementation of a universal salt io disation programme. Design:A three day weighed food records with estimation of food intake from a shared bowl based on changes on body weight, determination of sodium and iodine concentrations in 24 h (24 hi urine samples from adults, and determ ination of urinary iodine in spot urines from schoolchildren and pregnant w omen. Setting: A large coastal city (Abidjan) and a cluster of inland villages in the northern savannah region of the Cote d'Ivoire. Subjects: For the food records: 188 subjects (children and adults) in the n orthern villages; for the 24 h urine collections: 52 adults in Abidjan and 51 adults in the northern villages, for the spot urine collections: 110 chi ldren and 72 pregnant women in Abidjan and 104 children and 66 pregnant wom en in the north. Main results: From the food sun ey data in the north, the total mean salt i ntake (s.d.) of all age groups and the adults was estimated to be 5.7 g/d ( +/- 3.0), and 6.8 g/d ( +/- 3.2), respectively. In the 24 h urine samples from adults, the mean sodium excretion was 2.9 g/d (+/- 1.9) in the north a nd 3.0 g/d ( +/- 1.3) in Abidjan, corresponding to an intake of 7.3-7.5 g/d of sodium chloride. In the north the median 24 h urinary iodine excretion in adults was 163 mu g/d, and the median urinary iodine in spot urines from children and pregnant women was 263 mu g/l and 133 mu g/l, respectively. I n contrast, in Abidjan the median 24 h urinary iodine was 442 mu g/d, with 400, of the subjects excreting > 500 mu g/d, and the median urinary iodine in spat urines from children and pregnant women was 488 mu g/L and 363 mu g /l, respectively. Nearly half of the children in Abidjan and 32% of the pre gnant women were excreting > 500 mu g/l. Conclusion: Based on the estimates of salt intake in this study, an optimal iodine level for salt (at the point of consumption) would he 30 ppm. There fore the current goals for the iodised salt programme-30-50 ppm iodine-appe ar to be appropriate. However. in adults, children and pregnant women from Abidjan, high urinary iodine levels-levels potentially associated with incr eased risk of iodine-induced hyperthyroidism-are common. These results sugg est an urgent need for improved monitoring and surveillance of the current salt iodisation programme in the Cote d'Ivoire.