Prospects of fortification of salt with iron and iodine

Abstract

Fortification of salt with iron has been developed by the National Institute of Nutrition (NIN) as a strategy for the control of iron deficiency anaemia (IDA) in India, similar to iodization of salt for control of iodine deficiency disorders (IDD). Stability of the iron fortified salt (IFS), its bioavailability and organoleptic evaluation of food items containing the IFS have been demonstrated. Acceptability and effectiveness of the IFS in school children and in multicentric community trials have been demonstrated. With the introduction of universal iodization of salt as a national policy in 1988, NIN has developed a formulation for double fortification (DFS) of salt with iodine and iron. The stability of the nutrients under laboratory conditions along with their bioavailability were found to be good but varying with the quality of salt used. The DFS has been evaluated in controlled trials in tribal communities and in residential school children. The findings of these studies are discussed. Overall, in these trials, DFS effectively controlled iodine deficiency but a clear impact on reducing anaemia was not demonstrated. In residential schoolchildren, increased urinary excretion of iodine as well as reduced anaemia were observed. The quality of salt has been found to be an important determinant of the stability of iodine in DFS. Further evaluation of this potentially important intervention is in progress.Iron and iodine fortified salt: Double fortified salt: Impact of haemoglobin: Urinary iodine

Symposium on “Food Technology for Better Nutrition”

“…When the difference between mean scores allotted was tested, the results showed that there was no difference in the organoleptic properties of a variety of foods between DFS (4.1 to 5.0) and unfortified salt (4.0 to 4.9); there were no changes in color, appearance, taste, and odor of the foods (Ranganathan and others 1996). DFS was well accepted in day‐to‐day cooking, and there were no complaints regarding the quality of the foods prepared with it (Brahmam and others 1994, 2000; Sivakumar and others 2001).…”

“…NIN‐DFS was distributed to households periodically in 1‐kg pouches in the community study in tribal areas of the East Godavari district of AP, while it was supplied in 50‐kg sacs to the residential schools in Hyderabad for over 2 y in each study (Brahmam and others 1994, 2000; Sivakumar and others 2001).…”

Impact of delivering iron-fortified salt through a school feeding program on child health, education, and cognition: Evidence from a randomized controlled trial in rural India

“…Laboratory studies show good stability of the iron and iodine content of the NIN formula of DFS. In a few small-scale experimental studies, where regular consumption was closely monitored, acceptability and effectiveness in increasing hemoglobin levels were also tested (Sivakumar, et al 2001, Nairl, et al 2013, Haas, et al 2014. Most of these studies found good acceptability and increases in hemoglobin levels at least for subgroups.…”

Double fortified salt: an effective measure to control micronutrient deficiencies in Indian pregnant women

“…In India, the only data available on NIN-DFS supplementation amongst pregnant women revealed no difference in hemoglobin levels between experimental and control group after 2 years of supplementation in tribal villages of Andhra Pradesh, though there was a significant rise in Hb concentration (0.8g/dl) in experimental group (p<0.01). 25 This population was on rice based diet. However, in our study a significant difference was observed between both the groups at the end.…”