Iodized salt makes a difference

Iodized salt makes a difference

Tantri Yuliandini, The Jakarta Post, Jakarta

"Consuming iodized salt will help me become a university
graduate, if not I will get goiter," said Ingka Fitra Sunar, 10,
from Bone, South Sulawesi eloquently.

Ingka was one of seven elementary school children from seven
provinces across Indonesia who won a drawing contest on iodized
salt organized by the United Nations Children's Fund (Unicef).

His prize-winning picture, a watercolor painting showing new
graduates in black robes and mortarboards on one side, and what
appears to be a farmer with a goitrous neck on the other, had a
quality that not many elementary school students could produce.

Other winners also produced more or less the same themes --
that iodized salt will make people smarter and eating non-iodized
salt will produce goiter.

"Salt is produced from seawater, and when combined with iodine
produces iodized salt," another winner, Andrea Tyas Sari Putri
from Surakarta, Central Java, explained. Despite drawing sacks of
salt stacked on a beach, the 11-year-old does not know how it
could be obtained from saltwater.

"We are continually educating children on the benefits of
iodized salt, and the winners of this competition were chosen in
part because of their knowledge of the matter," said Ati Muchtar
Sjarief, Unicef's communication officer, during a recent ceremony
announcing the competition's winners.

The program to erase iodine deficiency in Indonesia began
prior to independence, but Unicef's involvement only started in
the 1970s, she said.

Winners of the competition received a scholarship of Rp 5
million each, a three-day tour package in Jakarta and a Unicef
trophy.

Iodine deficiency is known as the single most common cause of
preventable mental retardation and brain damage. It decreases the
chances of a child's survival, causes goiter and impairs growth
and development.

"Most people only look at gondok (goiter) as the effect of
iodine deficiency, now that they don't see it anymore they think
it's not a problem. But most of the damage you can't see
immediately," Unicef project officer for nutrition Ernest
Schoffelen said, explaining that 90 percent of damage from iodine
deficiency could not be seen.

Iodine deficiency in pregnant women, for example, causes
miscarriage and stillbirth, while children with iodine deficiency
disorder (IDD) can grow up stunted, apathetic, mentally retarded,
and incapable of normal movements, speech, or hearing.

The International Council for the Control of Iodine Deficiency
Disorders (ICCIDD) predicts some 2.2 billion people, or 38
percent of the world's population, live in areas with iodine
deficiency and are at risk of experiencing complications caused
by the deficiency.

"Some regions in Indonesia risk these complications, such as
West Nusa Tenggara, East Nusa Tenggara, Sulawesi, Aceh, and
Maluku. And even in Java there are pockets that don't get enough
iodine," Schoffelen said.

Only 65 percent of Indonesian people consume enough iodine, 15
percent of people do not get enough, while the other 20 percent
do not get iodine at all, he said.

Iodine is a chemical element that can be found in fairly
constant amounts in seawater, but its distribution over land and
fresh water is uneven.

It is an essential part of the chemical structure of thyroid
hormones, which are released into the bloodstream and carried to
target organs, particularly the liver, kidneys, muscles, heart,
and developing brain. The body needs proper levels of thyroid
hormones to work well.

Most of the iodine we consume comes from food and drink, Ati
said, with seafood being a good source because the ocean contains
considerable iodine.

Other sources include freshwater fish, vegetables and meat,
depending on the amount of iodine it is produced in, which may
not be adequate if they are grown in iodine deficient areas.

"Jakartans are OK because they get enough variety of foods,
but other areas in Indonesia do not have enough sources of food,"
Ati said, adding that most processed food also contains iodized
salt.

Iodized salt is special produced, and except for a few
isolated cases, edible salt does not naturally contain iodine,
Schoffelen said, explaining that iodine is added deliberately to
salt as one of the most efficient ways of improving iodine
nutrition.

He recommended the consumption of about 10 grams of iodized
salt per day. About 30 milligrams of iodine is contained in a
kilogram of table salt.

"The problem arises because raw salt that is locally produced
is often leaked into the market without being properly processed
with iodine," Schoffelen said, adding that in the meantime about
50 percent of the country's raw salt supplies are imported from
India, Australia and Jordan, and are not well controlled.

"If control of imported salt in improved and there is
enforcement of the law and a committed government, the problem of
iodine deficiency would easily be solved," he said.

Before 1995, less than 50 percent of the population consumed
iodized salt which increased to 65 percent in 1996, but this
figure remains stagnant until present because of a lack of
commitment, Schoffelen explained.

Unicef monitors iodine deficiency in seven provinces in
Indonesia, namely Banten, West Java, Central Java, East Java,
West Nusa Tenggara, East Nusa Tenggara and South Sulawesi.