Can Double Fortification of Salt with Iron and Iodine Reduce Anemia, Iron Deficiency Anemia, Iron Deficiency, Iodine Deficiency, and Functional Outcomes? Evidence of Efficacy, Effectiveness, and Safety

Journal of Nutrition

Volumn 151, Issue , 2021, Pages 15S-28S

  Larson, Leila M ^a   Cyriac, Shruthi ^b   Djimeu, Eric W ^c   Mduduzi N N Mbuya, ^c   Neufeld, Lynnette M ^c  

^a UNIVERSITY OF SOUTH CAROLINA   (United States)

^b EMORY UNIVERSITY   (United States)

^c GLOBAL ALLIANCE FOR IMPROVED NUTRITION   (Switzerland)

Author keywords

anemia; cognition; double fortified salt; hemoglobin; iron; review; work productivity

Indexed keywords

FERRITIN; HEMOGLOBIN; IODINE; IRON; SODIUM CHLORIDE; IODIZED SALT;

ANEMIA; ARTICLE; COGNITION; DRUG EFFICACY; DRUG SAFETY; ENZYME LINKED IMMUNOSORBENT ASSAY; FEMALE; HEMOGLOBIN DETERMINATION; HUMAN; IODINE DEFICIENCY; IRON DEFICIENCY; IRON DEFICIENCY ANEMIA; MALE; META ANALYSIS; MORBIDITY; NUTRITIONAL STATUS; OUTCOME ASSESSMENT; PREVALENCE; PRODUCTIVITY; PROGRAM EFFECTIVENESS; SYSTEMATIC REVIEW; ADMINISTRATION AND DOSAGE; DRUG THERAPY; EVALUATION STUDY; FORTIFIED FOOD; HEALTH STATUS; IRON INTAKE; SALT INTAKE;

ANEMIA; ANEMIA, IRON-DEFICIENCY; COGNITION; EFFICIENCY; EVALUATION STUDIES AS TOPIC; FOOD, FORTIFIED; HEALTH STATUS; HUMANS; IODINE; IRON; IRON, DIETARY; MORBIDITY; NUTRITIONAL STATUS; SODIUM CHLORIDE, DIETARY;

EID: 85101489559     PISSN: 00223166     EISSN: 15416100     Source Type: Journal    
DOI: 10.1093/jn/nxaa192     Document Type: Article

References (53)

1. Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Pena-Rosas JP, Bhutta ZA, Ezzati M. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. The Lancet Global Health 2013;1:e16-25.
2. International Institute for Population Sciences I. National Family Health Survey (NFHS-4), 2015-16: India. IIPS Mumbai; 2017.
3. Petry N, Olofin I, Hurrell RF, Boy E, Wirth JP, Moursi M, Donahue Angel M, Rohner F. The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: a systematic analysis of national surveys. Nutrients 2016;8:693.
4. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001;107:1381-6.
5. Asobayire FS, Adou P, Davidsson L, Cook JD, Hurrell RF. Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Cote d'Ivoire. Am J Clin Nutr 2001;74:776-82.
6. Brotanek JM, Gosz J, Weitzman M, Flores G. Iron deficiency in early childhood in the United States: risk factors and racial/ethnic disparities. Pediatrics 2007;120:568-75.
7. Das JK, Salam RA, Kumar R, Bhutta ZA. Micronutrient fortification of food and its impact on woman and child health: a systematic review. Syst Rev 2013;2:67.
8. Pasricha SR, Hayes E, Kalumba K, Biggs BA. Effect of daily iron supplementation on health in children aged 4-23 months: a systematic review and meta-analysis of randomised controlled trials. The Lancet Global Health 2013;1:e77.
9. De-Regil LM, Suchdev PS, Vist GE, Walleser S, Pena-Rosas JP. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (review). Evid-Based Child Health 2013;8:112-201.
10. Paganini D, Zimmermann MB. The effects of iron fortification and supplementation on the gut microbiome and diarrhea in infants and children: a review. Am J Clin Nutr 2017;106:1688S-93S.
11. Veenemans J, Milligan P, Prentice AM, Schouten LR, Inja N, van der Heijden AC, de Boer LC, Jansen EJ, Koopmans AE, Enthoven WT. Effect of supplementation with zinc and other micronutrients on malaria in Tanzanian children: a randomised trial. PLoS Med 2011;8:e1001125.
12. Esan MO, van Hensbroek MB, Nkhoma E, Musicha C, White SA, ter Kuile FO, Phiri KS. Iron supplementation in HIV-infected Malawian children with anemia: a double-blind, randomized, controlled trial. Clin Infect Dis 2013;57:1626-34.
13. Keats EC, Neufeld LM, Garrett GS, Mbuya MNN, Bhutta ZA. Improved micronutrient status and health outcomes in low- and middle income countries following large-scale fortification: evidence from a systematic review and meta-analysis. Am J Clin Nutr 2019;109:1696-708.
14. Ramirez-Luzuriaga MJ, Larson LM, Mannar V, Martorell R. Impact of double-fortified salt with iron and iodine on hemoglobin, anemia, and iron deficiency anemia: a systematic review andmeta-analysis. Adv Nutr 2018;9:207-18.
15. Baxter J, Zlotkin S. Compendium of evidence on double fortified salt. 2014; Toronto, Ontario (Canada), Micronutrient Initiative Centre for Global Child Health.
16. Vatandoust A, Mannar MV, Diosady LL. Organoleptic effects of salt fortification with iron and iodine (DFS): a review. J Nutr 2020.
17. Jackson N, Waters E. Criteria for the systematic review of health promotion and public health interventions. Health Promot Int 2005;20:367-74.
18. Hozo SP, Djulbegovic B, Hozo I. Estimating themean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 2005;5:13.
19. Viechtbauer W. Conducting meta-analyses in R with the metafor package. Stat Softw 2010;36:1-48.
20. Andersson M, Thankachan P, Muthayya S, Goud RB, Kurpad AV, Hurrell RF, Zimmermann MB. Dual fortification of salt with iodine and iron: a randomized, double-blind, controlled trial of micronized ferric pyrophosphate and encapsulated ferrous fumarate in southern India. Am J Clin Nutr 2008;88:1378-87.
21. Tumilowicz A, Schnefke CH, Neufeld LM, Pelto GH. Toward a better understanding of adherence to micronutrient powders: generating theories to guide program design and evaluation based on a review of published results. Curr Dev Nutr 2017;1:e001123.
22. Rawat R, Nguyen PH, Ali D, Saha K, Alayon S, Kim SS, Ruel M, Menon P. Learning how programs achieve their impact: embedding theorydriven process evaluation and other program learning mechanisms in Alive & Thrive. Food Nutr Bull 2013;34:S212-S25.
23. Gerber AS, Green DP, Nickerson D. Testing for publication bias in political science. Polit Anal 2001;9:385-92.
24. Gerber AS, Malhotra N, Dowling CM, Doherty D. Publication bias in two political behavior literatures. Am Polit Res 2010;38:591-613.
25. Sivakumar B, Brahmam GN, Madhavan Nair K, Ranganathan S, Vishnuvardhan Rao M, Vijayaraghavan K, Krishnaswamy K. Prospects of fortification of salt with iron and iodine. Br J Nutr 2001;85 Suppl 2:S167-73.
26. Wenger MJ, Murray-Kolb LE, Nevins JE, Venkatramanan S, Reinhart GA, Wesley A, Haas JD. Consumption of a double-fortified salt affects perceptual, attentional, and mnemonic functioning in women in a randomized controlled trial in India. J Nutr 2017;147:2297-308.
27. Reddy KJ, Nair S. Double fortified salt and deworming-game changers in the battle against iodine and iron malnutrition in Indian school children. Indian J Comm Health 2014;26:175-82.
28. Rhee JY. The effect of iron deficiency on worker productivity: evidence from a field experiment in India. Ithaca (NY): Cornell University; 2012.
29. Rajagopalan S, Vinodkumar M. Effects of salt fortified with iron and iodine on the haemoglobin levels and productivity of tea pickers. Food Nutr Bull 2000;21:323-9.
30. Krämer M, Kumar S, Vollmer S. Improving children's health and cognition: evidence from school-based nutrition intervention in India. Courant Research Centre: Poverty, Equity and Growth-Discussion Papers; 2018.
31. Banerjee A, Barnhardt S, Duflo E. Can iron-fortified salt control anemia? Evidence from two experiments in rural Bihar. J Dev Econ 2018;133:127-46.
32. Nair S, Goswami R, Rajan MGR, Thakkar V. Impact of double fortified salt on iron and iodine deficient school children (6 to 12 years) of rural Vadodara. J Public Health Epidemiol 2013;5:370-3.
33. Nair S, Bandyopadhyay S, Skaria L. Impact assessment on DFS supplementation post NHE on nutrient intake of critically anemic pregnant mothers in a tribal set up of Gujarat. Indian J Comm Health 2014;26:170-4.
34. Nadiger H, Krishnamachari K, Naidu AN, Rao BN, Srikantia S. The use of common salt (sodium chloride) fortified with iron to control anaemia: results of a preliminary study. Br J Nutr 1980;43:45-51.
35. Use of common salt fortified with iron in the control and prevention of anemia-a collaborative study. Report of the Working Group on fortification of salt with iron. Am J Clin Nutr 1982;35:1442-51.
36. Habicht JP, Pelto GH. From biological to program efficacy: promoting dialogue among the research, policy, and program communities. Adv Nutr 2014;5:27-34.
37. Moorthy D, Rowe L. Evaluation of global experiences in large scale double fortified salt (DFS) programs. J Nutr 2021;151(Suppl 2):38S-46S.
38. Cyriac S, Mbuya M, Khurana K, Martorell R, Neufeld L. Double Fortified Salt (DFS) Program in Uttar Pradesh, India: lessons from the implementation of a salt fortification intervention in a nutritionally insecure region (P10-098-19). Oxford University Press; 2019.
39. Shield A, Ansari MT. Review of experience of the production of salt fortified with iron and iodine. J Nutr 2021;151(Suppl 2): 29S-37S.
40. Mannar MV, Dunn JT. Salt iodization for the elimination of iodine deficiency. NL: ICCIDD; 1995.
41. Namaste SM, Aaron GJ, Varadhan R, Peerson JM, Suchdev PS. Methodologic approach for the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Am J Clin Nutr 2017;106:333S-47S.
42. Asibey-Berko E, Zlotkin SH, Yeung GS, Nti-Nimako W, Ahunu B, Kyei-Faried S, Johnston JL, Tondeur MC, Mannar V. Dual fortification of salt with iron and iodine in women and children in rural Ghana. East Afr Med J 2007;84:473-80.
43. Nti-Nimako W. The efficacy of double-fortified salt in reducing iodine deficiency and anemia. University of Ghana; 1998.
44. Jayatissa R, Fernando D, Gunathilaka M. Effectiveness of salt fortified with iron and iodine to improve iron status in a community settings in Sri Lanka: Department of Nutrition, Medical Research Institute. In collaboration with Micronutrient Initiatives, India; ICCIDD, Sri Lanka; 2012.
45. Haas JD, Rahn M, Venkatramanan S, Marquis GS, Wenger MJ, Murray-Kolb LE, Wesley AS, Reinhart GA. Double-fortified salt is efficacious in improving indicators of iron deficiency in female Indian tea pickers. J Nutr 2014;144:957-64.
46. Bathla S, Grover K. Impact of double fortified salt (DFS) supplementation on the nutritional profile: anaemic adolescent girls. Chem Sci Rev Lett 2017;6:1630-7.
47. Reddy K, Nair S. Double fortified salt: an effective measure to control micronutrient deficiencies in Indian pregnant women. Int J Community Med Public Health 2017;3:679-86.
48. Vinodkumar M, Rajagopalan S, Bhagwat I, Singh S, Parmar BS, Mishra OP, Upadhyay SS, Bhalia N, Deshpande SR. A multicenter community study on the efficacy of double-fortified salt. Food Nutr Bull 2007;28:100-8.
49. Zimmermann MB, Zeder C, Chaouki N, Saad A, Torresani T, Hurrell RF. Dual fortification of salt with iodine and microencapsulated iron: a randomized, double-blind, controlled trial in Moroccan schoolchildren. Am J Clin Nutr 2003;77:425-32.
50. Zimmermann MB, Zeder C, Chaouki N, Torresani T, Saad A, Hurrell RF. Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial. Eur J Endocrinol 2002;147:747-53.
51. Zimmermann MB, Wegmueller R, Zeder C, Chaouki N, Rohner F, Saïssi M, Torresani T, Hurrell RF. Dual fortification of salt with iodine and micronized ferric pyrophosphate: a randomized, doubleblind, controlled trial. Am J Clin Nutr 2004;80:952-9.
52. Wegmüller R, Camara F, Zimmermann MB, Adou P, Hurrell RF. Salt dual-fortified with iodine and micronized ground ferric pyrophosphate affects iron status but not hemoglobin in children in Cote d'Ivoire. J Nutr 2006;136:1814-20.
53. Kaur SJ. Effect of consumption of double fortified salt on iron and iodine status of young women. Ludhiana: Punjab Agricultural University; 2000.