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With a pinch of salt

(China Daily)
Updated: 2009-08-13 07:45

Should, or should not, the country stick to the blanket ban on non-iodized salt?

We do not know. Nor do the individual scientists who have bothered to try to find an answer. So we, like many curious about the truth concerning one of our most essential daily intakes, find it necessary for competent authorities to come up with a convincing answer.

This is no small matter, but one of far-reaching significance for public health.

Ours used to be one of the world's most iodine-deficient countries. So, starting 1994, iodized salt, as the result of a compulsory national strategy, has monopolized the salt market. Given the State monopoly on salt, non-iodized salt has effectively been outlawed and normally is unavailable to the average household.

Yet iodine intake is not something the-more-the-better. As the old adage goes, "too much is as bad as too little." While iodine deficiency is popularly known to cause thyroid diseases, excessive intake, too, can cause problems.

Solid evidence of an explicit link between iodized salt and the recent surge in thyroid ailments is yet to be established. However, the temporal coincidence justifies suspicion of a potential association - more and more epidemic screening programs have pointed to a new peak of thyroid illness outbreak roughly in step with compulsory iodine addition. And, considering the potentially serious public health implications, such suspicion must be examined.

For one, there can be no one-formula-fits-all solution in this case in a country as large as ours. In spite of the overall scope and severity of iodine deficiency in China, the extent varies considerably from region to region. Beijing and the provinces of Hebei, Shanxi, Jiangsu, Anhui, Fujian, Shandong and Henan, for instance, are iodine-rich areas. Compulsory addition of iodine, which has been the case for a long time, means a potentially damaging public health risk in these areas.

Human knowledge of iodine, too, has evolved through the years. During a good part of the 1990s, the World Health Organization insisted that a daily intake of 1,000 micrograms is safe for an adult. In 2001, the WHO lowered that ceiling to 300 micrograms a day. Plus, the geography of iodine deficiency may also have changed as the national diet did.

The more worrisome aspect of the story is that the clause on differentiated treatment in the National Iodine Addition Act has been ignored by government salt suppliers. Which is one more example of good intentions gone awry at the hands of policy executors.

As the people become increasingly concerned about the safety of iodized salt, the authorities have an obligation to provide answers, especially to two critical questions: What is responsible for the recent rise in thyroid diseases? Does iodized salt have a role in it?

(China Daily 08/13/2009 page8)