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Physician: Be careful of the salt you use

Salt – it’s one of the oldest and most widely used seasonings. Saltiness is also one of the five basic tastes we experience, along with sweetness, sourness, bitterness and umami – and we all need some salt in our diets, but one physician is warning Bahamians to be careful about the type of salt they consume and to always opt for the simplest salt they can get – one without iodine.

Iodine is a trace mineral commonly found in seafood, dairy products, grains and eggs. It is also combined with table salt to help prevent iodine deficiency.

A person’s thyroid gland uses iodine to produce thyroid hormones, which aid in tissue repair, regulates metabolism and promotes proper growth and development.

Iodine deficiency may also cause serious issues in children and pregnant women. Low levels of iodine can cause brain damage and severe problems with mental development in children, and may also be associated with a higher risk of miscarriages and stillbirth.

According to Dr. Cyprian Strachan, people living in The Bahamas, as well as those living where they can get adequate amounts of seafood and sea breeze, should avoid iodized salt. The doctor said consumption of a balanced diet that includes other sources of iodine, such as seafood, means they’re probably getting enough iodine in their diet through their food source alone.

“There is such a thing as too much iodine,” said Strachan. “And in some people their thyroids would shut down or speed up, depending on genetics. So, some people would get thyroid disease and heart disease and all the rest, and some people their thyroid slows down and they start to gain weight, start to have irregular periods, and they get pressure and sugar and cholesterol. So, you have to have a balance of iodine.”

While many people worldwide are at an increased risk of iodine deficiency, he said that is not the case for Bahamians, and his recommendation is to not use a salt if the label states that it contains iodine, a necessary nutrient. He acquiesces that iodine is a necessary nutrient, but extra intake isn’t necessary in countries where they’re surrounded by salt water and they have easy access to seafood.

“We should avoid the salt with iodine because we already have seafood and sea breeze,” said the doctor.

Deficiencies in micronutrients like iodine are prevalent in regions where iodized salt is uncommon, or there are low levels of iodine in the soil – a condition commonly found in areas such as Africa, Asia, Latin America and parts of Europe.

Prior to the 1920s, endemic iodine deficiency was prevalent in the United States’ Great Lakes, Appalachians, and Northwestern regions, a geographic area known as the “goiter belt” where 26 percent to 70 percent of children had clinically apparent goiter – an abnormal enlargement of the thyroid gland, which can cause a cough and make it difficult to swallow or breathe.

The most common cause of goiters worldwide is a lack of iodine in the diet.

After World War I, Strachan said medical officials started to note that the grade point averages of children were low, and realized that the mothers did not get enough vitamins and minerals, including enough iodine to make a child properly.

“Central USA in the region of Michigan is where they were doing a lot of research on it [as well as] certain parts of Africa where they just don’t have enough sea breeze and seafood; Central China, Central India, Russia had issues, [as well as] some countries like Sweden that are landlocked. Everywhere where you got away from the coastline there were problems. The cheapest way was to just put a little iodine in the salt rather than get them a piece of seafood,” he said.

The discovery of iodine was made during the early part of the 19th century.

David Marine, a U.S. physician in Ohio, and his colleagues initiated an iodine program in over 2,100 schoolgirls in 1917, and over the next few years, he and colleagues published a series of papers reporting a significantly decreased frequency of goiter in children treated with iodine, compared to children who did not receive iodine supplementation.

In 1922, David Cowie, chairman of the Pediatrics Department at the University of Michigan, proposed at a Michigan State Medical Society thyroid symposium that the U.S. adopt salt iodization to eliminate simple goiter.

In the U.S. iodized salt first became available on grocery store shelves in Michigan on May 1, 1924.

The fortification of salt with iodine is an effective, inexpensive, and stable route of ensuring adequate iodine intake.

Approximately 120 countries, including Canada and some parts of Mexico, have adopted mandatory iodization of all food-grade salt.

But according to Strachan, with the introduction of iodized salt, when certain governments went back to check if people were getting healthier, they found that the people who had access to seafood and sea breeze actually got sick with high blood pressure, diabetes and miscarriages.

“They used to blame salt as the cause for high blood pressure, but modern discussions and investigations have found that salt is not the biggest problem that we have and you need a certain amount of salt. If you get too wild with it and cut out the salt then people get sick, but the iodized salt is a different thing. Iodized salt was introduced as a cheap way of getting iodine to mothers and people who were not able to make children properly. They kept studying it to see if that was the cause of high blood pressure, or one of the causes, and they can’t confidently say that salt was killing people,” he said.

The WHO states that most people consume too much salt – on average nine to 12 grams per day, or around twice the recommended maximum level of intake. The organization says salt intake of less than five grams (just under a teaspoon) per day for adults helps to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart attack. And that reducing salt intake has been identified as one of the most cost-effective measures countries can take to improve population health outcomes. For children aged two to 15, the recommended maximum intake of salt for adults should be adjusted downward, based on their energy requirements relative to those of adults.

With so many salts to sift through – table salt, kosher salt, sea salt, Fleur de sel, sel gris (gray salt), pink salt, Himalayan black salt, Hawaiian alaea red salt, Hawaiian black lava salt, Cyprus black lava salt, truffle salt, to other regional sea salts which can make the list seem almost endless, Strachan’s advice is to always opt for the simplest salt.

“They have these salts with colors, but that’s because they have these tiny impurities in them. When I say impurities it just has other minerals in it – a little bit of volcanic dust in it, or a little bit of extra iron that adds to the flavor. Even iodized salt tastes different than regular salt – it tastes saltier. The simplest form of salt we should get is plain salt – no iodine. The box should not say this contains iodine, a necessary nutrient,” said the doctor.

Shavaughn Moss

Lifestyles Editor at The Nassau Guardian
Shavaughn Mossjoined The Nassau Guardianas a sports reporter in 1989. She was later promoted to sports editor.Shavaughn covered every major athletic championship from the CARIFTA to Central American and Caribbean Championships through to World Championships and Olympics.
Shavaughn was appointed as the Lifestyles Editor a few years later.

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