Women's perceptions relating to the introduction of mandatory iodine fortification in Australia

Aim: In Australia, the mandatory fortification of salt used in bread with iodine has recently been approved by the regulatory authorities (Food Standards Australia New Zealand). Apart from thiamine fortification of bread that has been in place since 1991, no other mandatory fortification programs exist in the country. The aim of the present study was to explore women's understanding of mandatory fortification as a public health strategy and their opinions regarding its appropriateness for addressing the re-emergence of iodine deficiency. Methods: Four focus group discussions with 20 women of child-bearing age, recruited from Wollongong in New South Wales. Results: Women had little knowledge about the role of iodine in the diet and were unaware that iodine deficiency was a public health issue in Australia. Mandatory fortification was viewed with concern, especially regarding the possible risk of toxicity. Clear labelling of fortified foods, in conjunction with education initiatives to accompany the pending iodine fortification program, were considered by the research participants to be essential in order to address these concerns. Conclusion: Women in the present study expect an authority, either a government body or health professionals, to take responsibility in making proactive decisions for the health of the population. When accompanied by transparent processes that include widespread consultation with consumers and clear explanations for the process, mandatory fortification is considered acceptable as an appropriate and effective strategy for ameliorating iodine deficiency.