The Ministry of Health and Population said that a decision on whether to lower the iodine content in salt will be taken only after a micronutrient status survey, which will start in May next year.

The nationwide survey to be carried out after 10 years, with the financial support of USAID and technical support of the US Centers for Disease Control and Prevention, will be completed in 2026.

“The decision to lower the iodine content in salt will be taken only after assessing the level of iodine in the urine of children and pregnant women,” said Lila Bikram Thapa, chief of the Nutrition Section of the Family Welfare Division under the Department of Health Services. “We hope the new report of the micronutrient survey will help us make appropriate decisions.”

Iodine is a mineral found naturally in seafood and plants that grow in areas near the sea. 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 kilogram of salt, which is higher than the recommended dosage. The World Health Organisation, however, recommends iodine concentration at 15 to 40 ppm per kg.

Only 40 ppm of iodine per kilogramme of salt is fortified for India, as it is assumed that the Indian population does not need as much iodine as the Nepali people, since they also get iodine content from foods produced near the ocean.

Health experts in Nepal have blamed the excessive amounts of iodine content in salt for the rise in non-communicable diseases, including hypothyroidism.

Several studies—including the 2016 Nepal National Micronutrient Status Survey jointly carried out by the World Health Organisation, UNICEF, the US-based Centres for Disease Control and Prevention, and the Ministry of Health and Population—found that Nepalis consume excessive amounts of iodine, which has resulted in high prevalence of hyperthyroidism, a condition when the thyroid gland does not produce enough thyroid hormones.

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

According to the Non-communicable Disease Risk Factors: Steps Survey-2019, 5.6 percent of the 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 the adults (18.1 percent of the women and 21.1 percent of men) reported consuming processed foods that are often or always high in salt.

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

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

Earlier, the government had sent a team of experts to salt factories in India’s Gujarat state to study the iodine fortification process and the possibility of lowering the iodine content in salt. The expert team furnished its report, but the concerned authorities could not decide on the reduction of iodine level in salt.

“We have decided to wait further until the report of the planned survey comes,” said Thapa. “The report will help us analyse what changes have happened in the last 10 years and make appropriate decisions.”

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.

Officials said the higher iodine level was mandated for Nepal under the assumption that transport and storage times were longer at the time as the 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, with roads reaching almost all corners of the country, transportation time has significantly decreased, so there is no need for such a high level of iodine in salt, say doctors.

The World Health Organisation 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.