01 August 2012

The expat life is a never ceasing adventure. Yesterday I finally found iodised salt, a quest I have been on for nearly two years.

I arrived in August 2010 and after jet-lag wore off (took two weeks, wowsa!) I inventoried Paul's home for the basics, condiments included. Ah, after I got over the shock of being expected to cook with seasonings that had expired in the last century (no, really, he had spices labelled as having expired in 1998 and 1999-one bottle in '97), one afternoon after a walk through town I then got the extremely unpleasant shock of finding out the milk here isn't Vitamin D fortified (neither is the bread). But the capper is that table salt (hell, any salt) here is not routinely iodised. I was really-really-really shocked.

How does a modern country with the best healthcare system in the world not fortify it's milk and bread with Vitamin D, and not routinely iodise it's bloody salt?!

Please do not misunderstand, dear readers, I really do love the UK, but WTH??!! Life expectancies here in the UK are lower than in the US and now I understand. I understand why it seems as though 1 in 3 people seen on the streets have some sort of physical or mental handicap. No duh, they're all deficient in two essential nutrients, inexpensive and easily added to common food stuffs. Vitamin D and iodine.

But they don't add those two inexpensive and easily added nutrients, and the healthcare burden is incredible.

Multiple sclerosis (MS) is very common in Scotland, the northernmost areas have exceptionally high rates of the killer. It has been suspected that Vitamin D deficiency contributes or even causes MS and some medical authorities have been urging bread and milk producers to fortify with it. Other medical authorities have shrugged, so to get adequate Vitamin D into us I have to serve out a pill to each of us. Daily. For the rest of our lives.

Incidence rates of goiter, cretinism, mental retardation and several other conditions known to be caused or exacerbated by iodine deficiency are abnormally high here, so high that it is common to see iodine deficiency handicapped people every time one goes out and about. 70% of tested Brits in 2011 showed iodine deficiency.

Yet to get iodised salt here I have to:

A-drive nearly 200 miles round trip to buy an 80p canister of Cerebos at the nearest Waitrose grocery.

B-order a £20 case of Morton salt PLUS pay £30 shipping-yes, that's right, I can buy a case of good old American Morton's Iodized Salt for £20 on Amazon.co.uk who will then have it shipped from the USA to my home in NorthEast Scotland at the cost of £30. S'rlsy. Sigh.

C-Search the Internet, find a post on an expat forum I ordinarily wouldn't touch with a barge pole stating that SOMETIMES (but not always) Lidl and Aldi carry iodised salt. Why? Because a few years back the Germans caught on to the financial burden of iodine deficiency in their population and started iodising their salt and fortifying their bread. (Side note-they now also toss in Vitamin D to milk and bread)

And yesterday Lidl had a case of iodised salt. And the manager promised me they would continue to carry it as their German owners had taken the decision to carry permanently. I bought a box, no sense buying more than I can store. I do have to watch my salt intake so a box of salt will last us quite a while.

Which might explain my fever to find a reliable, reasonably priced source for the stuff. I can't take in much more than 2g of salt a day (the recommended daily allowance in the UK is an astonishing 6g per day, that is flippin' mind-boggling, I think maybe they are trying to kill off the population?). Now, if I use iodised salt I can meet my recommended daily allowance of salt, and get the daily allowance of iodine (150mcg) at the same time.

It took me nearly a year to figure out how to read the labels on food here to figure out daily sodium intake because they don't list it in milligrams here if they list it at all, and then they list it as salt so I had TWO conversions to make. It took me forever to figure out I need to keep the intake at 2g of salt a day, it really did.

Whew, being an expat is such an adventure in so many small ways.

Paul had NEVER got the proper daily recommended Vitamin D in his life because even though he was and is an outdoorsy fellow, the sun so rarely shines here in Scotland that nearly ALL Scots have some level of Vitamin D deficiency. I wasn't surprised he showed to be 'somewhat deficient'. Sorry, you either are or are not. He was.

I grew up in Southern California, and even after leaving there at age 18 I have spent most of my life out of doors in strong sunlight, really it's a wonder I haven't developed skin cancer. And I grew up drinking fortified milk and eating fortified bread. Vitamin D wasn't one of my big worries. I didn't register as deficient but we tested early on and it's possible I was coasting on a lifetime of sunshine and fortification.

So I hit the 'Net to do some research. Right about the same time I was saying to Paul 'I don't get this, you guys have the highest MS rates in the world, highest goiter, cretinism and other iodine deficiencies related health problems and yet you don't...' the BBC News announced that the results were in-not fortifying milk and bread was causing severe deficiencies...

They still haven't caught on to the iodised salt thing and it's frankly scaring the hell out of me. I walk down the streets here seeing physically and mentally handicapped people I know damn well are that way because they are suffering Vitamin D and iodine deficiencies. For feck sake, so many people in this town have rickets it's a common sight to see them walking around, yet Paul didn't even know what it was.

No, really. We were out to the shops, and I noticed a number of people with the peculiar rickets gait. I said to Paul 'Wow, lot of rickets around here, are people so poor they can't afford milk and bread?!' He didn't know what I was talking about, had never heard of rickets even though in a Twilight Zone feeling half hour walk around town we'd seen several people walking around with that rolling-hitching gait so profoundly recognisable as rickets that once you know what it is, you never forget what it looks like. So I explained it to him, that rickets were a disease of malnutrition, that anyone with access to milk and bread wouldn't have rickets...

This was early on and was nearly a deal-breaker, no guy wants to think his girlfriend is dissin' the town.

It took an hour on the 'Net to convince Paul that rickets are directly relatable to Vitamin D deficiency; MS, Type1 diabetes, and several other chronic, debilitating, and life threatening conditions are as well, and that those several goiter sufferers we'd seen were suffering from iodine deficiency.

Seriously, 1 in five according to my count that day. Excuse me, I went my whole fifty plus years in the US having seen goiter maybe twice total, and here I saw so many people with goiter in ONE DAY that I gave up counting.

Right, so from the laptop to the kitchen...I reached into the fridge to show him the milk label-WTH??!

I looked at the bread label, and that's when I realised I might be in trouble. But I looked at the salt canister and that's when I knew I was in trouble.

Milk and bread-no fortification. Salt-no idodising.

People like to call the UK the nanny state but until they routinely fortify milk and bread, and iodise table salt, I am going to think this is more of a 'kill off your general population' state. It is absolutely mid-boggling to me that the government bangs on about austerity and rationing NHS healthcare when they have the simplest solution to a huge lot of the chronic illness and disability yet refuse to implement it!

Really shocking to me that I had to search for nearly two years for a reliable source of iodised salt, and that I have to remember to serve a daily supplement of Vitamin D for the rest of my life.

I don't have any trouble finding Vitamin D supplements, it's now sold in Boots and all of the grocery stores. But I had one hell of a time finding a reliable source of iodised salt. In a civilised Union so cock-sure of it's superiority to the US, I found that troubling.

The expat adventure.

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