Dismantling the Myths about Salt Iodization
1. Why should the whole population have access to iodized salt? The latest available scientific and practical knowledge indicates that when universal salt iodization is not mandatory, iodine insufficiency occurs. 2. What does iodine insufficiency among the population cause? This depends on the degree of insufficiency which can vary from loss of national intellectual capacity of 10% to 15% when insufficiency is not severe, as is the case with Russia, to endemic goitre and in most severe cases - to cretinism. A book published in 2003 entitled “IQ and the Wealth of Nations, by Richard Lynn and Tatu Vanhanen, found that national IQs are highly correlated with real GDP (Gross Domestic Product) per capita. The book also reports direct relation between national IQs and the growth of per capita GDP from 1950 to 1990. There is an obvious positive relation between mean IQ of the population and economic wealth of the nations. No nation can afford to give up 10% to 15% of its intellect. 3. Does mandatory salt iodization not limit human rights and consumer choice? In accordance with part 3 of the article 55 of Constitution of the Russian Federation, rights and freedoms of a person and a citizen can be limited by federal law only to such extent, when it is essential in terms of safeguarding the fundamentals of the constitution system, morality, health and legitimate interests of other parties, ensuring country’s defense and security of the state. Iodine deficiency is a serious threat to national health and human development and such measures are fully justified. WTO does stimulate free flow of goods but countries having legislations prohibiting sale and trade of non-iodized salt have never been brought to court by another government. Additionally, experience shows that free choice by suppliers of iodized salt could leave out scarcely populated remote areas. Free choice by the population is likely to exclude the poor who, given the option, will normally choose for the slightly cheaper non-iodized salt. Not all consumers may make an informed decision about the type of salt they buy as they may not be aware of the benefits attributed to iodized salt. Therefore, the consumer’s right to adequate iodine nutrition is not ensured. Free choice in this case will most likely exacerbate socio-economic differences already growing in the evolving Russian market economy. 4. What about educating the population to increase demand for iodized salt? The option to achieve universal use of iodized salt through awareness raising (and changing purchasing behavior) will be long, more expensive and not necessarily easy to sustain. It is a well known fact that in the world’s industrialized nations, with their high incomes and advanced communications capacities, efforts to empower people with knowledge about healthier diets have met with only limited success. Specifically these happen to be with the poorest part of the population that most needs to consume iodized salt so as to provide their children with equal opportunities to grow and develop their full physical and mental potential. 5. Is it not true that several developed nations have succeeded in bringing iodine deficiency under control without universal salt iodization? Most European countries have iodized salt available, but in about half its use is only voluntary. Mandatory salt iodization exists in Austria, Denmark, Poland, Czech and Slovak Republics, Bulgaria, Romania, Serbia and other countries of the former Yugoslavia. In some developed countries (UK, Norway, Sweden, USA, Canada) most of iodine comes from meat, poultry and diary products as iodine is an essential component of animal’s fodder. However, growing amount of countries (Italy, Spain and the Netherlands) are considering mandatory iodization of all salt for human consumption. 6. Mandatory salt iodization does not take into account possible deterioration of health of those people who are overly sensitive towards iodine substances. Would USI not deprive them of the right to choose this product based upon medical recommendations. Iodized salt contains extremely small amount of iodine (that are still sufficient to cover daily requirements in this micronutrient). Cases of “over-sensitivity” towards iodine in iodized salt have never being reported. Iodized salt is a safe product and can be consumed by everyone without any medical recommendations, indications and contraindications (WHO, 1993). 7. Is potassium iodate (salt fortificant) not a toxic substance, and therefore dangerous for human consumption? Chlorine is also an extremely toxic substance and it is widely used, in the appropriate dosage, to make water suitable for human consumption. In the minute amount used for salt iodization, potassium iodate has no toxic effects. WHO and FAO consider potassium iodate as “generally safe”. Iodate has been used for decades in many countries without any reported influence on health of population. (ICCIDD Report on Iodate Toxicity, 2001, commissioned by WHO). 8. Does iodized salt not have negative effects on certain foods (pickles among them)? Since 1999 only potassium iodate is used by the salt industry for salt fortification in the Russian Federation. Extensive studies and vast experience show that salt with potassium iodate has no negative effects on foods. In some cases (bread baking) iodated salt is even beneficial for quality of products. 9. Cannot IDD be prevented by iodine supplementation (tablets, food supplements)? Supplementation with iodine tablets makes sense when patient already has endemic goiter. However iodine supplementation is an expensive and inefficient method for the prevention of IDD. The annual price of iodine supplementation amounts to several hundred rubles per person which is totally restrictive to majority of population. Difference in price of iodized versus common salt is only few rubles per person per year and could be easily absorbed by the population. 10. Is iodized salt not significantly more expensive than common salt? Would in this case the salt producers not have a vested interest in promoting mandatory salt iodization. There are different types of salt on the market. Some imported brands of salt are indeed expensive. The origin and package of salt determines the price not the presence of iodine. However, difference in price of quality domestic iodized salt versus non-iodized domestic salt is very low (from several kopeks to 1-2 rubles). On the production level price of iodized salt is only 10-15% higher than common salt (this difference covers price of potassium iodate and iodization process). Salt producers do not gain significant profits producing iodized salt. The profit margin is the same for iodized and non-iodized salt. 11. What effect does the use of iodized salt have on protection of the population in case of nuclear disasters such as Chernobyl? Radioactive iodine is a major radioisotope constituent in nuclear power plants and could leak after nuclear accident. This has already happened after Chernobyl accident. There are 434 commercial nuclear reactors worldwide with the potential for accidents. Even very small amounts of inhaled or ingested radioiodine can do grave damage as it will always concentrate in the thyroid gland. In iodine deficient subjects, this accumulation will be increased causing more damage to the thyroid. Irradiation of the thyroid is a risk factor for development of thyroid cancer. Recent scientific studies showed that iodized salt could improve iodine nutrition and decrease trapping of radioactive iodine thus decreasing risk of thyroid cancer.
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