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Double fortified salt at crossroads.

B Sivakumar1, K Madhavan Nair

  • 1Division of Biophysics, National Institute of Nutrition (ICMR), Jamai Osmania, Hyderabad, India. dr_sivakumarb@yahoo.com

Indian Journal of Pediatrics
|August 14, 2002
PubMed
Summary

Double fortified salt (DFS) using iron and iodine is a promising food-based approach to combat widespread deficiencies. While effective for urinary iodine and anemia prevention, significant hemoglobin increases require formulation improvements.

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Area of Science:

  • Public Health Nutrition
  • Micronutrient Interventions
  • Food Fortification

Background:

  • Iron Deficiency Anemia (IDA) and Iodine Deficiency Disorders (IDD) are significant public health issues, often co-occurring.
  • The National Institute of Nutrition (NIN) developed double fortified salt (DFS) with iron and iodine as a food-based strategy.
  • Alternative DFS formulations, including NIN, Nutrisalt, and Micronutrient Initiative (MI), exist, differing in stabilization methods.

Purpose of the Study:

  • To evaluate the stability, bioavailability, acceptability, safety, and community impact of DFS.
  • To assess the feasibility of factory production and community implementation of DFS.
  • To review the effectiveness of different DFS formulations in addressing IDA and IDD.

Main Methods:

  • Extensive studies by NIN on DFS properties and community impact.
  • Stability, acceptability, and impact studies on MI salt.
  • Review of available reports on Nutrisalt stability.

Main Results:

  • DFS strategy is sound, showing good impact on urinary iodine excretion and anemia prevention.
  • Significant hemoglobin increases were not consistently demonstrated, as DFS provides maintenance, not therapeutic, iron levels.
  • Complex study designs and confounding variables affected the interpretation of hemoglobin status.

Conclusions:

  • The double fortification of salt with iron and iodine is a viable strategy for public health.
  • Improvements in DFS formulation are needed to enhance stability and bioavailability.
  • DFS holds potential to significantly reduce iron and iodine deficiencies in vulnerable populations.

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