Mary Poppins sang a “spoonful of sugar helps the medicine go down” but a teaspoon of iodised salt could help the future of human brainpower.

Salt is the key to a smarter nation – but it has to be iodised, says a leading health expert.

“It’s not about increasing salt intake, it’s about making the switch to iodised salt,” says Professor Cres Eastman.

The renowned endocrinologist, vice-chairman of International Council of Iodine Deficiency and professor of medicine at the University of Sydney is very concerned pregnant women are putting their unborn babies at risk of brain defects because they don’t have enough iodine in their diet.

Iodine is a naturally occurring element essential for the healthy development of the brain and iodine deficiency is the world’s leading cause of mental retardation in children.

Children whose mothers didn’t consume enough iodine during their pregnancy can suffer irreversible brain damage, learning difficulties, lower IQ, hearing impairment and other neurological problems.

The World Health Organisation (WHO) says iodine deficiency can cut 10 to 15 points from a child’s IQ.

Alarmingly, research shows more than half of pregnant Australian women and almost half of all school-aged children are iodine deficient.

A growing child needs around 100 micrograms of iodine each day and adults 150 micrograms, however during pregnancy the daily requirement is almost doubled.

Eastman, who has been at the forefront of the push to put iodised salt on Australian dinner tables for the past decade, believes the most cost-effective way to increase the nation’s iodine intake is to replace ordinary salt with iodised salt in processed food.

But he says industry and government have been slow to respond to concerns of a growing epidemic.

Strong opposition has come from the Australian Food and Grocery Council (AFGC), which says the costs of product reformulation and production systems are the major barriers to change.

“Mandating the use of iodised salt across the entire food supply would incur significant costs to the food and grocery manufacturing industry in changes to product reformulation,” said a spokesman for the council.

“… in some cases it may require changes in production systems due to the potential technological impacts of iodised salt.”

But Eastman says industry arguments of increased costs are unfounded as the World Bank has called iodine supplements the most cost-effective health intervention on the planet.

“The extra cost is inconsequential as the United Nations estimates the cost of adding iodine to salt to be roughly 10 cents per person per year,” he says.

The Australian government is aware of the iodised salt issue, and since 2009 iodised salt has been added to most bread.

Eastman says this just isn’t good enough as a pregnant woman would have to eat more than eight slices of bread each day to meet her daily iodine needs.

“It’s a weak fix,” he says.

“This response is completely inadequate as it won’t improve iodine in pregnant or breastfeeding women, neonates or infants – so those who are most at risk won’t be getting any benefit.”

Regulatory body, Food Standards Australia and New Zealand (FSANZ) agrees bread fortification alone will not address the issue.

“The mandatory addition of iodised salt to bread provides enough iodine for most people. However, it will not meet the increased requirements of many pregnant and breastfeeding women,” says FSANZ spokeswoman Lorraine Belanger.

FSANZ echoes Eastman’s concerns, saying there is potential some pregnant or breastfeeding women may feel they will receive enough iodine simply from eating bread and will not seek further supplementation.

Although Australia’s iodine deficiency crisis has been identified by the WHO, Dr Eastman says the government has not run a single public health campaign to educate Australians to consume more iodine.

The Federal Health Department acknowledged the importance of adequate nutrients including iodine for pregnant and breastfeeding women but said it had no plans for a public health campaign.

“The government seems to think it’s done enough by pushing industry to add iodised salt to bread, but this is a half-baked solution,” Eastman says.

Research by Monash University experts published in the Medical Journal of Australia has already shown that bread fortification hasn’t helped improve iodine levels in pregnant women and recommended that iodised salt be used in all processed food, not just bread products.

The results of a national study examining whether iodised bread is making any difference to other target groups will be available by the end of the year, Eastman says.

“At this stage the jury is out on whether or not this intervention has had a sufficiently good effect in correcting the deficiency in children and indigenous.”

~AAP 2011

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