• she/her

healthcare bureaucrat in philly, v adhd, orthodox jew, ect ect, im love my wife



I've been getting into Food Science youtube and this video on the history / present state of iodine fortification / deficit in America chiefly but also the world in general is just, so cool

Basic context is that iodine is what ones thyroid uses to produce the hormone that the body uses to regulate how the energy produced from food is allocated / used. If one has severe deficiency they develop chiefly what is called a goiter (the thyroid swells producing a visible swelling of the neck as well as chronic coughing / swallowing problems). Over enough time there is also a notable drop in brain function. The real issue however is that even mild iodine deficiency in pregnant people leads to congenital iodine deficiency which had the antiquated name of "cretinism" (yes that's where the word cretin comes from!). The result of this are, well, what one thinks of when they hear the word "cretin". It's uh very brutal

Okay so now some earth science. This rarely was a problem until modernity as most civilizations either clustered around the coasts (where they got it from fish or from the iodine that leached into the soil) or lived on places that previously had been ocean beds (as that is what makes good soil, and that soil is rich in iodine). In modernity though you could have thriving sedentary cities that had neither ocean access or rich farmlands. As such people now lived in places with a dearth of iodine

Now onto the history. In the US there was "the goiter belt", the north of the country had just massive amounts of iodine deficiency. They knew the cause but nobody did anything about it which shouldn't be shocking but is, countless people for generations being hit by diminished mental capacity and physical impairments needlessly. I digress.

This was seen as just a regional quirk of the area, a just normal result of the poors not having the means to eat fish shipped in on ice beds from the coasts. That remained true until WWI when the army hit headlines with the fact that they just straight up could not recruit enough soldiers from places like Minnesota due to just soooo many people either having necks that could not fit into the uniforms or having congenital deficit leading to them not being able to pass the competency exams

Now it was a national security issue! What if there was an invasion of the US and nobody to defend it? What if the issue spread? What a massive loss of opportunity! Companies started voulunterally adding iodine to salt (following the Swiss who started a handful of years prior), regulation followed suit. There was a huge zeitgeist push to make sure you were getting enough iodine especially while pregnant.

And the cool thing is that WWII offered an extremely rare ability to test this intervention. The same draft was called just a generation apart. As such the sample size was the same, the screening tools/metrics were the same, everything was the same except one generation was at risk of deficiency and the other was not.

It worked! Goiters and congenital iodine deficiency were basically eradicated. That's so fucking sick!!! That rules!!! The same results have been seen abroad as the capacity to fortify foods spreads to other nations.

But now a days very very few meals that Americans eat are cooked at home, and restaurants very rarely use fortified salt. What's more people, like me, who still cook as much as one did in ye olden times do so because of a love a cooking, and in foodie spaces fortified salt has become blase. Everyone knows you want fancy irregularly shaped salt, a different kind for each kind of dish, nobody wants uniform cubes of salt.

Luckily we have not seen a rise in goiters. The tools used in the dairy industry just happen to be cleaned by iodine filled sanitizing products, and cows are fed iodine because kinda hard to make a ton of milk if your thyroid is fucked. More people eat dairy or fish regularly so make out alright.

But much of our produce is grown in what was the goiter belt, and even a mild deficiency of iodine leads to a drop in IQ. Whatsmore congenital deficiency is not really visibly noticeable in its mild forms, still impactful but you have to screen for it. This could be a silent and growing public health crises as many people cannot having dairy, don't like fish, and aren't cooking on their own / with iodinized salt.

Anyways yeah it's a neat story! And a reminder that so so so much work has gone into building the life we all live now. Also a reminder to eat iodine salt jkalfjdak; study after study has shown that people cannot tell its presence via taste stop acting like it alters taste.


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