India is the country with the world's largest population of newborns who are unprotected by iodized salt from the mental impairment caused by Iodine Deficiency Disorders. At the India-International Salt Summit 2010, I was invited to share my views on whether there is any conflict between government advocacy of salt reduction and its pursuit of universal salt iodization.

Short answer: no conflict at all. As I told the international delegates (pdf 75.57 kB) :

Two public health challenges inhere in dietary salt, both with major public health implications. First, conclusive research, broad experience and consensus organizational endorsement support fortification of salt with potassium iodate or potassium iodide to protect against Iodine Deficiency Disorders. Second, inconsistent research, ineffective experience, yet broad endorsements have mired implementation of advisories for population salt intake reduction intended to improve human cardiovascular health outcomes.

I noted a series of efforts by salt reduction activists questioning whether portraying salt as a public health benefactor and the fact that the issue has been dismissed whenever it has been raised, adding:

Let’s hope this is the end of this false “debate.” We need to unite and put our energies into achieving universal salt iodization. We cannot be distracted by those who would blame their lack of success reducing dietary salt on our achievements in advancing salt iodization.

If salt reductionists want to argue in favor of reducing overall salt intakes, we should make them offer evidence, not excuses. We should remind them that while the hypothesized benefits of salt reduction may fuel contentious debate, there is global consensus that salt iodization is the most cost-effective and sustainable strategy to prevent iodine deficiency disorders. It is imperative that we promote iodized salt to help every expectant mother enjoy optimal iodine nutrition and every child be born protected from iodine deficiency. Optimal iodine nutrition will protect the entire population from the loss of intellectual and physical resources through this easily preventable cause of mental retardation.