Pastoralists, Mongolia. Image courtesy of Esther Schelling, Swiss TPH.
One of a series of blogs written by CABI editors for One Health Day on November 3rd 2016
It's always nice to meet up with a CABI author at a conference especially when they are giving a talk around a theme dear to CABI‘s heart, namely “One Health”: the concept of working across the interface of animal, plant, human and environment to achieve health & development which is sustainable and fair. CABI has been gathering, managing and generating research information across all these sectors since 1912. We know “its all connected”.
The conference was the RSTMH biennial meeting [Cambridge UK, Sept 12-16th, 2016], and the author in question, Esther Schelling, co-editor of CABI’s book One Health: The Theory and Practice of Integrated Health Approaches . To read a free e-chapter, use this link.
In One Health beyond early detection and control of zoonoses Esther talked about her long-time project with nomadic pastoralists in Chad and a rift valley fever (RVF) control project in Kenya. She drew attention to the need for:
- more interdisciplinary studies to include an evaluation of One Health working
- involvement of social scientists
- engagement of key stakeholders
And tellingly she provided a cost-benefit analysis to society of controlling zoonoses when the disease is in its animal host before it infects human beings.
Those cost-benefit analyses made a deep impression on the delegates, many of whom were involved in zoonotic neglected tropical diseases. Perhaps for the first time they were appreciating the added benefits and synergies that a transdisciplinary approach between science, society, humanities and medicine could bring.
IN my March
2013 blog “Eat
less salt but make sure it contains iodine!”, I described the problems of addressing iodine–deficiency
diseases in Pakistan and the worrying
rise in iodine deficiency in the UK,
linked to a shift in eating patterns
away from dairy and oily fish, our traditional sources of iodine. Whereas, other developed countries had relied
on introducing a national supply of iodised salt, we had got away without it.
But even countries using iodised salt, now had to watch out, as salt–reduction campaigns to tackle rising cardiovascular
diseases, were allowing iodine-deficiency to reoccur albeit at a low-level (as
compared to the high level of iodine deficiency found in developing countries)
NOW there is further support for re-emerging iodine deficiency
in the UK: this time a study on pregnant
women published in the Lancet. They have identified changes in the IQ of primary-school
children born to mothers with low-level iodine deficiency: IQ goes down 3 points & reading age is
reduced. For more information, read the BBC article Iodine deficiency 'may lower
UK children's IQ and the Lancet
Need I say more? In the March blog, which featured
on Global Health Knowledge Base
and CABI-Handpicked & carefully
sorted , I covered the spectrum of iodine-deficiency diseases which can
occur in children born to mothers with iodine-poor diets, leaving the children with permanent physical
& mental intelligence problems.
Daily it seems, the case is being made to consider introducing iodised
salt into the UK and to advise would-be
pregnant mothers not only to ensure folic acid is in their diet but also
adequate iodine ( BUT not through
seaweed supplements). Pregnant mothers who rely on organic milk should be aware that this contains less iodine than usual and they will need to increase iodine intake to compensate.
WE do indeed “have a new challenge to addressing
iodine deficiency in both developing and developed countries”.
Salt has been used for thousands of years to flavor
& preserve food BUT reliance on fast food, biscuits and tinned goods, with
their hidden salt content, has created for us a high salt diet and with it an
alarming rise in cardiovascular disease.
Reducing our salt intake, by working
with food industry and educating the public (World Salt Awareness Week), should
counter this disease epidemic. BUT take this too far, and could an old
disease re-emerge? I speak of iodine deficiency in the diet, which can cause abortion,
stillbirth, goitres, mental retardation & birth defects: iodized salt
WHO recommend universal salt
iodization for developing countries as a simple, safe and cost-effective
measure to address iodine deficiency, and many developed countries follow this
Image: Amanda Mills, USDA.
People afraid of salt so a disease re-emerges or is unaddressed?
If we ever needed
a reminder of the importance of iodized salt & public attitudes to health, you
only had to read “salt
rumors add to health crisis in pakistan” (Washington Post).
A fuller discussion of these issues can be found in the March issue of Global Health Knowledge Base, along with the latest research on iodine
deficiency and salt iodisation.
blogger, Henry Ko, health services researcher with SingHealth,
Singapore, provides a personal commentary on issues raised by Mark
Bitterman's book on salt: “Salted: A manifesto on the world’s most
mineral, with recipes”.
healthcare researcher with both professional and recreational interests in
food, nutrition, and cooking, I was drawn to a book I casually found whilst
scanning a bookstore shelf in the cooking section called “Salted: A manifesto
on the world’s most essential mineral, with recipes”. The writer is ‘selmelier’, Mark Bitterman.
Image: Mark Bitterman
For a book in
the cookbook section, I found it highly enlightening and detailed, almost like
a scientific textbook on salt. Make no mistake, this is not a regular cookbook.
It is a book with three sections that (1) highlights human’s history with salt,
especially the production of salt and culinary traditions of using salt, (2)
has a section on identifying all the many different types and features of
artisanal salts, and finally (3) a section with recipes for cooking and using
salt for food (e.g. seasoning, curing).
What I learnt
about the salt industry really opened my eyes. Some of the
points highlighted in the book and by skeptics of the salt industry in the
public, match – that there appears to be an agenda by big industry to sell iodised salt.
You can read the full article by Henry Ko in the March issue of Global Health Knowledge Base, along with the latest research on
iodine deficiency and salt iodisation.
Also relevant to the debate is "Salt, could it be implicated in autoimmunity?"(CABI's Nutrition and Food Sciences),
reporting on two animal studies in Nature two weeks ago.