The Ministry of Health and Population is planning to send an expert team to India to study the iodisation process of the salt to be imported to Nepal.

Officials say that the decision about determining the upper limit for iodine content in salt will be taken as per the report and recommendations of the experts' team following their India visit.

“We are planning to send an expert team to India to check the salt iodisation process,” said Lila Bikram Thapa, chief of the nutrition section at the Family Welfare Division of the Department of Health Services. “Along with health experts, specialists from the Department of Food Technology and Quality Control and the United Nations Children’s Fund will be in the team.”

Iodine is a mineral found naturally in seafood and plants that grow in areas near the seas. In places where iodine is naturally rare, it needs to be artificially introduced into the diet via fortified food products.

The Salt Trading Corporation, the agency responsible for importing and distributing salt in Nepal, fortifies iodine at 50 ppm (parts per million) per kilogramme of salt, which is higher than the recommended dosage. The World Health Organization, however, recommends iodine concentration at 15 to 40 ppm per kilogramme.

Officials said the higher iodine level was mandated for Nepal in the 1990s under the assumption that transport and storage times were longer at the time as salt had to be carried on the backs of men and animals and some amount of iodine would dissipate by the time the salt reached markets, mainly in the remote parts of the country. However, now with roads reaching almost all corners of the country, the transport time has significantly gone down, so there is no need for such a high level of iodine in salt, according to doctors.

Officials suspect that high iodine content in the salt sold in Nepal could be among the reasons for the high prevalence of several non-communicable diseases, including thyroid disorders in the country.

Earlier, at high-level meet comprising representatives from the World Health Organisation Nepal office, UNICEF, officials from various government ministries including the Ministry of Agriculture and Livestock Development, the Department of Food Technology and Quality Control, and researchers from Tribhuvan University had agreed on a proposal to set an upper limit for the iodine in salt.

However, no official decision has been taken so far to lower the iodine content in salt.

In 1993, Nepal mandated that salt be fortified with iodine to prevent health problems caused by iodine deficiency, as salt is both cheap and used round the year.

Lack of iodine in the diet can lead to hypothyroidism, where the thyroid glands produce too little thyroxine, leading to the development of goitres.

Several other studies—including the 2016 Nepal National Micronutrient Status Survey jointly carried out by the World Health Organization, UNICEF, the US-based Centres for Disease Control and Prevention, and the Ministry of Health and Population—have found that Nepalis consume excessive amounts of iodine, which resulted in high prevalence of hyperthyroidism.

The survey shows, more than two-thirds—68 percent—of the population across the country is consuming iodine in excess of the recommended levels.

According to Non-communicable Disease Risk Factors: Steps Survey-2019, 5.6 percent of adults (6.5 percent of women and 4.6 percent of men) reported adding salt often or always to food right before or while eating.

Additionally, 19.5 percent of adults (18.1 percent of the women and 21.1 percent of men) reported consuming processed foods that are high in salt often or always.

Doctors say excessive salt intake has not only increased the problem of thyroid disorders, it is also attributed to be a key risk factor for hypertension, which is a major cause of premature deaths worldwide.

A change in dietary patterns and increased consumption of processed foods (including packaged soups), resulted in an increased prevalence of non-communicable diseases such as hypertension, and cardiovascular diseases, according to doctors.

The UN health agency recommends less than two grams of sodium or five grams of salt per day for adults to reduce blood pressure, and cut the risks of cardiovascular diseases and stroke. It also recommends policies to reduce salt intake, including food product reformation, establishing a supportive environment in public institutions, organising communications and mass media campaigns, and front-of-pack labelling to prevent and control non-communicable diseases.