India has reinstated a ban on non-iodized salt in the country as of this past May of 2005. There seems to be enough evidence presented by both sides of this debate suggesting that the ban – and advocacy against it – may be politically driven and not just based on data.

Government of India Notification No. GSR 340 ( E) reads
" No person shall sell or offer or expose for sale or have in his premises for the purpose of sale the common salt for direct human consumption unless the same is iodised".
The Notification becomes law on 15-8-2005.

The government lifted the ban on non-iodized salt in 2000. Some states continued to impose the ban over the past five years, but now, a recent Supreme Court ruling and a nationwide study showed a drop in the consumption of iodine from 49 percent and caused lawmakers to reevaluate their decision.

On one hand, researchers argue that Iodine Deficiency Disorders (IDD) can lead to brain damage and poor brain development as well as goiter, cretrinism, defects in speech and hearing, psycho-motor defects, loss of IQ points and also is a leading cause of mental impairment.

Based on this, and on studies that claim that there has been a significant growth in IDD, the government has decided to reinstate the ban.

However, numerous researchers and civic society groups are livid about this ruling. Many argue that such a ruling is a result of pressure from a few large production houses such as the Tatas and Hindustan Lever to monopolize salt production in the country and take production away from the hands of small communities and local industries. They argue that such research is actually inconsistent with other studies.

According to R.P. Singh, an endocrinologist attached to the two-billion dollar super-speciality Apollo Hospital here, diets in urban areas are already rich in iodine and there is little need for supplements in cities.

In fact, Singh says many of his patients suffer from hyper-thyroidism only because of excess iodide in their diets. "The iodates loses oxygen molecules and transform into iodides through mishandling, poor storage and exposure to the sun on transportation."

Singh says it is remarkable that while hyper-thyroidism and associated hormonal problems such as hirsuits in women and enlargement of breast in men are on the rise in the cities, it is unheard of in the rural areas of the Indian plains.

Iodine is volatile and rapidly degenerates and evaporates when subjected to small rises in temperature and completely disappears on cooking. "This makes it useless for people who really need it especially those who live in the sub-Himalayan hill tracts," Singh says.

Singh and his colleagues are now demanding that the government find some medium other than table salt to get iodine to people who live in iodine-deficiency belts. "At least people should be able to choose between iodised and uniodised salt," he said.

There are a number of reasons why such a ban does not make any sense. It is ridiculous to enforce a dietary regimen on 97.5% of the population because 2.5 % of the population suffers from cretinism owing to iodine deficiency. Instead, a more effective method would be based on increased awareness of dietary considerations. Milling and polishing of rice and other grains removes their iodine content. Cereals, millets, pulses, dals, leafy vegetables, roots and spices, jaggery, nuts, fruits, milk and milk products, eggs, fish and even tap water contain iodine in its natural, absorbable form. Government agencies and NGOs need to advocate a healthy, balanced diet and clean drinking water.

In fact, a large section of the population in India tends to have hyperthyroidism. Since Indian food includes items like pickles and preserves which have a very high salt content, it is quite likely that even those with normal thyroid functioning can be pushed into the hyperthyroid category with compulsory usage of iodised salt. Also, each individual has his / her own capacity to absorb/ not absorb iodine. Thus, a law that prohibits non-iodized salt is actually dangerous.

Another major matter for concern is that manufacturers in India use Potassium Iodate instead of Potassium Iodide to iodise common salt. Potassium Iodate is toxic and has not been approved in the USA. Studies in Australia have shown a high incidence of thyrotoxicosis with Potassium Iodate.

Iodised salt is not mandatory in most of the world including USA, UK, Australia, Switzerland, Mauritius, or Turkey, for example. In fact, Tasmania and Holland had heavy increases in thyrotoxicosis when iodised salt was introduced and they actually discontinued it.

It is our right as consumers to decide whether we want to use it or not. Both should be available in the market and properly labelled to show the contents. Infact, Iodised salt should carry a compulsory warning in Bold Lettering that “Usage of Iodised Salt could lead to Thyrotoxicosis.”

Clearly, research presents us with contradictions that make it impossible to clearly conclude that iodized salt is necessary for the entire population or even that it is safe for the entire population. Under these circumstances, the best approach is increased awareness and testing and for ensuring that both kinds of salt are available and can be used based on the needs of the individual.

With the ban coming into effect from 15th August 2005, it is important to convey to our elected representatives that the citizens of India should hold the right to choose whether iodized salt is good for them.
The Prime Minister of India, New Delhi (Fax) : 011 -23016857 / 23019817,
(Ph) : 011- 23012312
The President of India, New Delhi (Fax) : 011 - 23017290 / 23017824 / 23019545 / 7290
(Ph) : 23015321, (e-mail) :presidentofindia@rb.nic.in
The Secretary, The Ministry of Health and Family Welfare - (Fax) : 011 – 23061648, (Ph) : 23018514 / 23061661, (e-mail) : hfm@alpha.nic.in

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