Impact of the use of iron-fortified iodized salt on hemoglobin levels: a community based open randomized trial

Abstract

Background: In India prevalence of iron deficiency and anemia is high across all age, sex and physiological groups because of inadequate iron intake and poor bioavailability of iron from habitual Indian diets. Research studies in school-age children have shown that use of iron-fortified iodized salt (DFS) resulted in small improvement in Hb level; there are very few studies reporting impact of DFS use in women and men. Methods: A community-based open three arm randomised study was carried out to assess the impact of DFS use on Hb in women, men and children. The control group received iodised salt and two intervention groups received two formulations of DFS. Results: Socio-demographic and nutrition profile of the families, mean Hb, ferritin and C reactive protein levels of women, men and children at enrolment were comparable in all three groups. The DFS use for 12 months resulted in improvement in mean Hb in children (0.8 gm/dl) women (0.4 gm/dl) and men (0.3 gm/dl). Improvement in Hb was higher in anemic women, men and children. There was no change in mean Hb in non-anemic persons. There was a small improvement in ferritin in women who have low ferritin but no change in ferritin in women and men with normal ferritin. Conclusions: DFS may be a safe, feasible, affordable, and sustainable method for improving the iron intake and Hb status and accelerating India’s progress towards the SDG goal of 50% reduction in prevalence of anemia.