A Brief History of Salt and Public Health



As budding health professionals, many of us know that iodine is a trace mineral essential for proper thyroid function. This function, however, was not public knowledge until fairly recently.

Iodine deficiency can result in cretinism, mental retardation, and goiter. In the early 1900’s, populations living in inland areas became especially susceptible to goiter, as they had little access to iodine-rich foods from the oceans. These parts of the United States became known as The Goiter Belt, and spanned over most of the north and central states. As these occurrences of goiter became more prevalent, scientists began linking iodine with the treatment, and soon the prevention, of this illness.

Armed with this new knowledge, doctors and scientists set about  finding a vehicle for the efficient delivery of this necessary element to the masses. In cooperation with public health services, salt companies began adding iodine to their product and offering it at the same price as regular salt to Americans in the 1920’s. This availability lead to a steep decline in cases of endemic goiter.

This innovative collaboration of public health, medicine, science, and industry was an excellent example of the positive power of public health. Not only did goiter begin to diminish, but Americans noticed an increase in IQ and decreased numbers of babies being born with mental handicaps. The target populations were given an accessible preventative treatment to some very undesirable conditions at no extra cost. The entire operation of salt ionization enjoyed worldwide success in areas with these health disparities, granted they had the available funding and development.

While all of these things were counted as successes to many national health systems in the 20th century, some drastic changes began to appear more and more in the way Americans ate. The arrival of processed and convenience foods was a revolutionary breakthrough in the preservation and availability of goods. This mid-century innovation employs many techniques to produce products, but many foods are processed with sodium. As more knowledge about the health ramifications of excess sodium intake surfaced, Americans have been encouraged to cut back on their sodium intake. Since many of the foods we are already eating contained sodium, many people simply cut back on the iodized table salt. People have also begun to embrace a culture of artisan health. Many folks prefer to use sea salt, or any of its various fancy cousins, e.g. Himalayan pink salt and Fleur de Sel.  This all sounds like fair compensation, but the problem is this: the sodium used in processed foods does not contain iodine, and sea salts contain some trace minerals, including iodine, but not nearly enough to fulfill daily requirements.

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Fortunately, with all of the advancements in food systems today, iodized salt is not the only resource for people living inland and hoping to maintain healthy thyroid function. The importance of educating people on proper iodine intake, however, may now become more essential in coming years. Successful health systems must remain current with population trends in nutrition, and ensure that the people know what they may be lacking. Hundreds of Americans have relied on the safety net of fortified foods from our public health systems to retain proper nutrient levels, and these kinds of food trends that stray from tradition are often completely unpredictable. This is where a knowledge of generational diversity is important, as many people in younger generations have begun to make different choices and foods, some of these fortifications may become obsolete.

While I have faith that we will likely avoid the appearance of a modern Goiter Belt,  I am interested to see what kinds of things we will see on the nutritional horizon in the future of public health and food trends.