Improving the lives of millions through new double fortification of salt technology

Abstract

Micronutrient deficiencies (including iodine and iron deficiency) is a global health problem affecting one third of the world's population. Salt is an ideal carrier for food fortification as it is universally consumed at equal rates, independently of economic status, and it is industrially processed. Addressing iron and iodine deficiencies together is a challenge, due to interaction between iodine and iron, negating the effect of added iodine. This paper explains the development of an improved microencapsulation‐based technology to produce iron premix, which, when added to iodized salt, is stable and organoleptically indistinguishable. Ferrous fumarate was extruded, followed by cutting, sieving to achieve a size of 300–710 μm (salt grain size). Agglomerated extrudates were microencapsulated (5% hydroxypropyl methylcellulose and 5% soy stearin) to form iron premix. Microencapsulation ensures that the added micronutrients are stable without interaction or degradation. Double Fortified Salt is formed by blending iron premix with iodized salt (1:200 ratio). This technology was transferred to India for industrial scale‐up. The public distribution system was utilized to establish and monitor an efficient distribution network for DFS in a transparent manner. The scale‐up process was initially demonstrated in the state of Uttar Pradesh, following its success two more Indian states have started distribution of DFS. At present, the DFS with iron and iodine is reaching 60 million people in India. This important health intervention technology through food fortification has the potential to be scaled globally to ensure a world free from iron deficiency anemia.

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

“…Several countries have considered the adoption of DFS as part of social safety net programs targeted to vulnerable populations in which the marginal cost of DFS can be subsidized by the government. DFS with iodine and iron is currently estimated to be reaching 60 million people in India through this approach [54]. In addition to DFS with iodine and iron, other combinations have been considered, including DFS with iodine and folic acid [55].…”

“…The current premix available for DFS requires that the raw salt used is of high quality, both in terms of purity and moisture content, characteristics which can be satisfied by only a small minority of the edible salt supply, especially difficult for the salt that is available to small and medium-scale salt producers. Various technologies to address these issues have been developed, such as the use of stabilizers, and encapsulation of iron and/or iodine [54,56]. Programmatically, there is a marginal cost associated with DFS and MFS, resulting in concomitant price increases for a commodity which has limited price elasticity.…”

A case study on the scaling-up of double fortified salt through the public distribution system of a food security program in Uttar Pradesh, India: experiences, challenges, and achievements

“…This provides stability to the iron premix and prevents unwarranted reactions with the iodine or other contaminants present on the surface of the salt particles. 19 The technology for the encapsulated ferrous fumarate iron premix was developed at UofT and transferred free of cost to JVS Foods, a private premix manufacturer in India, enabling local production of encapsulated DFS in India. The construction of a full-scale commercial premix plant at JVS Foods was supported with funding from the IDRC, Global Affairs Canada (through the Canadian International Food Security Research Fund -CIFSRF), and Tata Trusts.…”

Integrating nutrition outcomes into agriculture development for impact at scale: Highlights from the Canadian International Food Security Research Fund

“…The authors of the five papers demonstrate how a range of nutrition‐sensitive interventions, including home gardens and enhanced homestead food production, cropping improvements and diversification, and food fortification can be scaled up to contribute to the improvement of diets and nutritional outcomes in women and children. The papers provide evidence from efficacy (Michaux et al, ) and effectiveness (Angeles‐Agdeppa, Monville‐Oro, Gonsalves, & Capanzana, ) studies, to assessments of technologies to optimise value‐added processing (Durairaj, Gurumurthy, Nachimuthu, Muniappan, & Balasubramanian, ) and cost effectiveness of interventions (Walters, Ndau, Saleh, Mosha, & Horton, ), to a report of bringing a proven intervention to scale (Diosady, Mannar, & Krishnaswamy, ). These interventions aim to improve nutrition through a number of direct and indirect pathways, outlined in a simplified programme impact pathway adapted from Masset, Haddad, Cornelius, and Isaza‐Castro (; Figure ).…”

“…Finally, in the fifth paper, Improving the lives of millions through new double fortification of salt technology , Diosady et al () describe a complex journey from research consisting of efficacy and effectiveness studies, value chain development towards a cost‐effective solution and its scale up. They review their work spanning over 20 years towards a solution to address the persistent problem of iron deficiency in India, building on the success of salt iodization.…”