Should you have iodised salt? Is having rock salt better for heart health?

Like many health-conscious people, Anu Ahuja was concerned about the damaging consequences of excess salt on hypertension and heart health. So, she substituted her table salt. “I do not use it in my cooking anymore. Instead, I have switched over to rock salt or sea salt, which are rich in minerals and bring other health benefits, like keeping BP in check. My family has had iodised salt all their lives. So, I do not think we need it anymore,” says she.
Ahuja is a classic case of how influencer-dominated conversations in social media and the glut of unfiltered information may actually drive you to making eating choices that may not agree with your body. “The common make that everybody makes is to believe that iodine is the culprit. It is high levels of sodium that one must avoid. And sodium is present in all kinds of salt. None of these natural salts have iodine and solely depending on them could make you iodine-deficient. Iodine is an important nutrient that is needed the thyroid glands to produce certain hormones. If you are not getting adequate quantities of it, you can get an enlarged thyroid gland or goitre and an abnormally low level of thyroid hormones, which is known as hypothyroidism,” says nutrition and author Kavita Devgan who has worked with the FSSAI on fortified salts. “Why do you think the government chose common salt to fortify with iodine when they could do so with other foods? Because it is a primary kitchen staple that people cannot do without and it could address deficiencies person-to-person. In fact, the iodine-fortified salt is one of the biggest nutrition success stories in India, affordable and universal at the same time. People may argue that they have had enough iodised salt all their lives and can now supplement it from other sources. That’s a fallacy. First, everybody in this country is not privileged enough to have iodine-sufficiency from alternate sources. Second, you have to be concerned about the next generation that needs to grow healthy,” she reasons.

Problem is not iodine but sodium
As Devgan says, “Only a small portion of sodium or salt is used in cooking. You have to watch out for adding raw salt to food. About 70 per cent of sodium consumed is from processed and restaurant foods. That choice is ours to make.” Salt intake in India is about 11 g per day, exceeding the WHO’s recommended maximum intake of 5 g per day. Indians consume nine per cent more salt than the global average — 10.06 gm. “That’s where diet modification comes in. That demands more attention,” she adds.
How does excess sodium affect your heart? Extra sodium adds water into your blood vessels, increasing the total blood volume, leading to bloating and weight gain. This courses through your blood vessels, increasing blood pressure. Over time, high blood pressure may weaken the blood vessel and speed up plaque build-up.
Should we have iodised salt on a daily basis?
“Yes, otherwise we cannot meet our iodine requirements on a daily basis. It’s difficult to meet the desired iodine intake without iodised salt as foods vary on the iodine content depending on the soil quality in which they are grown. Everybody doesn’t live near the sea or grows food on iodine-rich land. The most common dietary sources of iodine are seaweed, fish and dairy products. Inland areas have fewer natural sources of iodine. These are factors that selective information gathering doesn’t take into account,” says Dr Priyanka Rohatgi, Chief Nutrition, Indraprastha Apollo Hospitals, New Delhi.

Since I have grown up on iodised salt, can I do without it altogether and switch over to natural salts?
“Table salt contains 2360 milligrams of sodium per teaspoon, whereas a teaspoon of Himalayan pink salt contains 1680 milligrams of sodium — a reduction of about one-third. We can’t do away with iodised salt. Adults need 140 micrograms (μg) of iodine a day. Most people should be able to get all the iodine they need eating a varied and balanced diet with iodised salt,” adds Dr Rohatgi. “Besides, pregnant mothers, who need about 220 micrograms, cannot afford to give birth to children with iodine deficiency. The thyroid hormone is essential for the development of the brain and nervous system in the foetus. Deficits can lead to mental retardation, dwarfism, hearing loss and other problems in the child later,” advises Devgan.
What are other sources of iodine?
Iodine is found mainly in animal protein foods and sea vegetables, and to a lesser extent in fortified foods like breads, cereals and milk. You would find them in seaweed (nori, kelp, kombu, wakame) fish, shellfish (cod, canned tuna, oysters, shrimp), dairy (milk, cheese, yogurt), eggs, meat and chicken. “But remember there are vegetarians, vegans and people who have not grown up with these foods. Suggesting an alternative iodine diet does nothing if the sodium intake in your food, be it through salt or other food sources, is high,” cautions Dr Rohatgi.