(Spoiler alert- Just because it’s gourmet doesn’t mean it’s better for you)
I love dining out and trying new foods, and I love to cook too. Many of the recipes I find so appealing include the use of gourmet salts (Pink Himalayan, Kosher, Sea salt, sel Gris, and Fleur de sel to name a few). As I pushed aside my $0.79 container of good old Morton’s iodized salt in my cupboard and reached for the pretty pink Himalayan salt, my Obstetrician mind began to turn. Should pregnant women be more cautious about the type of salt they are using? A First World question for sure, but I was curious. I do live in the First World after all, and so do my patients.
Iodine deficiency worldwide affects 2 billion people and is the leading preventable cause of intellectual and developmental disabilities. It’s a sobering fact that 1/3 of the world is at risk for iodine deficiency and the decision by the US in the 1920s to add iodine to every day, run-of-the mill table salt reduced this problem for the vast majority of Americans. Using just ½ tsp of iodized salt per day supplies 150 mcg of iodine; enough to prevent iodine deficiency in the average American, however in pregnancy, the recommendation is for 220mcg daily. If you’re nursing, you need 290mcg of iodine to supply yourself and your newborn, as iodine is transmitted in breast milk; almost double what the average (non-lactating) person needs.
The greatest concern of iodine deficiency in pregnancy is the impact is has on the developing fetal brain. Iodine deficiency in pregnancy translates to a patient with a potential goiter, hypothyroidism, weakness and fatigue and a fetus with stunted fetal growth and brain development.
There are very few good sources of iodine in our diet- one reason why iodine deficiency is so commonplace worldwide. Foods high in iodine include Fish (cod/tuna), seaweed, shrimp, egg yolks, dairy and maybe grains grown in fortified soils. Even so, pregnant women must eat a substantial amount of these in order to reach the recommended 220mcg/ day if they are not using iodized salt in their diet. A brief inquiry into the iodine content of my favorite (non- table salt) salts reveals: Kosher Salt – 0mcg Iodine, Pink Himalayan Salt and Sea Salt- variable (but emphasize that it’s low). Bottom line- the majority of our pregnant and nursing patients need to supplement their diet with iodized salt. Enjoy the occasional “gourmet” salt but make sure iodized salt is in your daily routine.
Testing for iodine deficiency can be done in a number of ways: urine and blood testing are most common. Consider it if you feel you might be deficient or considering pregnancy.