Assessment of household use of iodized salt and adequacy of salt iodization: a cross-sectional National Study in Saudi Arabia.

OBJECTIVES: This study was conducted to assess household coverage with iodized salt in Saudi Arabia, and to determine adequacy of salt iodization. METHODS: A school-based cross-sectional study using WHO 30-cluster survey methodology. RESULTS: Analysis of 4242 salt samples using qualitative rapid test kit (RTK) revealed that 68.7% (95% CI 67.3-70.1%) were iodized with significant regional differences (p < 0.001). The highest iodized salt samples came from Makkah (82.3%), Riyadh (81.1%) and Maddinah (76.2%) regions, while the least iodized salt samples came from Hail (31.3%), Baha (53.0%), and Northern Borders (57.5%) regions. The national weighted proportion of households consuming iodizes salt was 69.8% (95% CI 69.4-71.2), which is below the Universal Salt Iodization (USI) goal (≥90% coverage). For validation, a quantitative iodometric titration method was used to analyze 775 representative salt samples screened iodized by RTK; iodine content of ≥15 ppm was found in 95.2% (95% CI 93.9-96.5) of samples with median iodine content 51 ppm (mean 50.4 ± 21.8). More than 70% of the iodized salt samples contained iodine concentration higher than the recommended national level (15-40 ppm). CONCLUSIONS: The study revealed inadequate consumption of iodized salt among Saudi households and explored marked regional heterogeneity. The majority of iodized salt samples contained iodine concentration more than the recommended level. These findings imply the need to launch a public awareness campaign on use of iodized salt. Legislation to ban production and sale of non-iodized salt sale for human consumption might be considered. A well-functioning monitoring system at factory level and surveillance system are crucially needed to ensure proper salt iodization and intake.

A review of some statistics on breastfeeding in Saudi Arabia.

Breastfeeding is the ideal and most natural way of nurturing infants. The importance of breastfeeding has been proved unequivocally, and UNICEF and WHO have issued guidelines to ensure breastfeeding. Saudi Arabia is a country where the legislation is derived from the Quran and Hadiths. The Holy Quran says that the mothers shall give suck to their offspring for two complete years.... The majority of mothers start breastfeeding their infants but soon introduce bottles. The single most common reason cited for the early introduction of bottle feeding is that the breast milk is insufficient. Because of this tendency, many mothers practice mixed feeding. The duration of breastfeeding varies but in general it is done beyond six months, and various factors affect the duration. Researchers have recently started using the WHO recommended key breastfeeding indicators. In a study these key indicators were found to be very low. The authors feel that there is a need to revise the media campaign for promoting breastfeeding utilizing the instructions and guidance from the Holy Quran and Hadiths.