International Journal of Environmental Research and Public Health · 6 authors, 2 centres
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This study reviewed 1,026 recipes from 102 issues of the top eight highest-circulation magazines in the US and found that while 48% of recipes listed salt as an ingredient, none specified iodized salt. This is concerning because iodine deficiency is re-emerging among US women of reproductive age, and iodized salt is a key dietary source of iodine. The authors recommend that magazine editors call for iodized salt in recipes to help prevent iodine deficiency in vulnerable populations.
**Background:** Iodine deficiency is a re-emerging public health problem in the United States, particularly among women of reproductive age (WRA). Median urinary iodine concentrations in pregnant women in the US have been reported at 129 μg/L, below the WHO cutoff of 150 μg/L for sufficiency. Salt iodization is voluntary in the US, and only about 53% of salt sold at retail is iodized. Magazines have over 200 million readers annually in the US and are a common source of recipes and nutritional information, with 84% of affluent women reporting reading print magazines. Despite this, no prior studies have examined whether magazine recipes specify iodized salt.
**Methods:** The top ten US magazines by circulation (as of June 2021, per the Alliance for Audited Media) were identified. Two magazines (Allrecipes and WebMD Magazine) were unavailable and excluded. The remaining eight magazines were accessed online through Emory University Library and local libraries in Atlanta. For each magazine, the 12 most recent issues were reviewed; if an issue contained no recipes, an additional issue was reviewed. Nine issues were excluded due to unavailability. A total of 102 issues (dates ranging from December 2019/January 2020 to November 2021) were analyzed. For each recipe, researchers recorded the magazine, issue date, recipe name, whether salt was listed as an ingredient, and the type of salt specified. Two researchers independently scored each recipe for reliability.
**Key Results:** Among the 102 issues reviewed, 74 contained recipes. A total of 1,026 recipes were identified. Salt was listed as an ingredient in 493 recipes (48.0%). None of these 493 salt-containing recipes specified 'iodized salt' as the type of salt. Fourteen different types of salt were identified across recipes. Approximately 52% of salt-containing recipes did not specify a salt type. Kosher salt was the most commonly specified type (41.09% of salt-containing recipes). Taste of Home listed the most salt types (n=10), followed by Better Homes and Gardens (n=7). The 218 recipes from Cosmopolitan and Good Housekeeping did not specify salt type at all. Vanity Fair had no recipes in any of its 13 reviewed issues.
**Clinical Implications:** The absence of iodized salt recommendations in nearly 500 salt-containing recipes from high-circulation US magazines represents a missed opportunity to address declining iodine status among WRA. Given that iodized salt is a primary dietary source of iodine in the US and that iodine deficiency can cause goiter, hypothyroidism, and impaired neurodevelopment in offspring, promoting iodized salt in widely-consumed recipes could help prevent the re-emergence of iodine deficiency. The authors recommend that magazine editors specifically call for iodized salt in recipes and include notes emphasizing the benefits of iodized salt use. They note that efforts to increase iodized salt consumption are compatible with sodium reduction strategies, as iodine levels in salt can be adjusted accordingly.