Israel Mandates Iodine Fortification in Table Salt to Combat Deficiencies

Israel's Ministry of Health is preparing to implement regulations requiring the addition of iodine to table salt, a move that comes a decade after surveys revealed widespread iodine deficiency. Previous studies indicated that approximately 60% of school-aged children and 85% of pregnant women suffered from insufficient iodine levels. National biological monitoring data from 2020-2021 confirmed this persistent issue, showing no significant improvement in the population's iodine status over the past five years.

Following international guidelines from the World Health Organization and the UN Food and Agriculture Organization, iodizing salt is a proven method to prevent and correct iodine deficiency disorders, crucial for proper physical and cognitive development, especially in vulnerable groups like pregnant women, fetuses, infants, and children. Addressing this deficiency promptly can significantly mitigate or prevent its adverse health consequences.

In Israel, about 15% of daily salt intake comes from salt added during cooking or at the table, with the majority originating from processed foods. The new regulations will mandate that table salt sold in household packaging, which constitutes about 90% of home salt purchases and is price-controlled, be fortified with iodine. The Ministry has set a fortification level of 30 mg of iodine per kilogram of salt, expected to provide about 45 micrograms of iodine daily, representing roughly 30% of the recommended daily intake. This conservative dosage is based on current scientific knowledge.

The effectiveness of this fortification program will be monitored through ongoing population surveillance to assess its impact and adjust iodine levels if necessary. Historically, it was believed that Israel's coastal location provided sufficient iodine through diet and water, but this notion proved incorrect. Modern Israeli diets do not heavily rely on iodine-rich seafood, and much of the food supply is imported. Furthermore, the increased reliance on desalinated water, which contains very low iodine levels, has further reduced dietary iodine intake from this source.

Research from the United States has demonstrated that adequate iodine exposure during pregnancy leads to significant long-term benefits for children, including an approximately 11% increase in income in adulthood in areas with severe iodine deficiency, along with higher labor force participation and full-time employment rates. Food industry sources suggest that as long as the iodine addition range set by the Ministry is broad, consumer prices should not change significantly, as current basic paper packaging is sufficient. However, a narrow range might necessitate more expensive, airtight packaging.