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by tstrimple
1484 days ago
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There was also a problem with populations lacking enough iodine in their diet that was addressed with food additives, specifically iodized salt which had a major health benefit across the nation. These types of solutions work. It's a continual source of frustration when systemic issues are dismissed simply as matters of "personal responsibility". > The U.S. was historically iodine deficient prior to the early 1920s, particularly in the goiter belt region of the Great Lakes, Appalachians, and the northwestern area of the country, due to the effects of natural atmospheric processes. Following the successful implementation of salt iodization program in Switzerland, the introduction of iodized table salt in the U.S. during the 1920s significantly improved its iodine nutritional status. However, although recent national studies demonstrate that the general population is overall iodine sufficient, salt iodization in the U.S. is not universal, and certain subsets of the population, including pregnant and lactating women and their offspring, may be at risk for mild to moderate iodine deficiency. As such, a public health approach by the American Thyroid Association and the Endocrine Society advocate U.S. women to take a supplement containing 150 µg iodine/day beginning preconception. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509517/ |
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That paper was published in 2012. In 2014 (my wife's first pregnancy) no major pregnancy supplement included iodine, and my wife's doctor said it was unnecessary. The only supplement I could find without an outrageous amount of iodine while still being quasi-reputable was a Whole Foods-branded, 225mcg kelp-based pill. (Not USP or similarly certified, but I figured/hoped a large, brick & mortar retailer like Whole Foods would perform some vetting of their supplier and reliability of the product.) Circa 2015-2017 major pregnancy supplement makers, like Nature Made (USP certified, sold at Walgreens, hospitals, etc), quietly added iodine.
The problem with the older conventional wisdom is/was that eating habits have changed: 1) people began eating processed foods and restaurant foods (especially fast food), most of which do not used iodized salt; 2) home cooks, especially those following TV cooking shows, began using kosher salt, which is not iodized; and 3) the medical community was admonishing everybody to consume less salt, so people were less inclined to use table salt. These are also compounded by the fact that the most commonly eaten vegetables, e.g. soy and those from the Brassicaceae family (broccoli, kale, cabbage, etc), are goitrogenic.
Another major and far more important food supplement is niacin. Widespread supplementation of cereal grains began in the mid 20th century. More recently (1990s in the U.S.) folate was made a mandatory supplement in cereal grains. The difference between these and iodine is that packaged foods, most prepared foods (fast food, restaurants using normal supply chains, etc), and the most commonly used home ingredients still contain these supplements. Whereas outside of pregnancy (i.e. fetal development), inadequate iodine is still (arguably) a creeping problem for children. This is sort of similar to vitamin D--eating habits are changing (e.g. less milk consumption) and we need to find new routes for supplementation to reach people, especially groups most at risk.
On the plus side, in relative terms the iodine "problem" is relatively small and mostly only visible at large population scales. And despite the hype over its importance, I suspect the same is true for vitamin D deficiencies--not nearly as impactful to public health as niacin and folate. But if people keeping selling this idea of food supplementation as somehow adulterating, polluting, and contaminating food, these problems are only going to grow.