Impact of use of iron fortified iodised salt beyond 12 months on haemoglobin levels

Abstract

Background: Use of iron fortified iodised salt (IS) for 12 months, resulted in improvement in haemoglobin (Hb) in women, children and men. There is no published data on impact of DFS use beyond 12 months on Hb levels. Methods: A community based open randomised study to assess impact of use of DFS on Hb was discontinued after 12 months due to COVID 19 related lockdown. These families used IS for six months during lockdown; they were willing to continue using the salt provided for further one year. These families were re-randomized into three groups and given the assigned salt for further 12 months and Hb, ferritin and C-reactive protein (CRP) were estimated at 12 months. Results: Improvement in the mean Hb was 0.5 g/dl in women who had used IS earlier and DFS under second randomisation and 0.3 g/dl in those who had used DFS under first and second randomisation. Mean Hb at 30 months was higher in those who had used DFS for 24 months as compared to those who had used IS for 18 months and DFS for 12 months. The deterioration in mean Hb following discontinuation of DFS for 6 and 18 months was small. Conclusions: DFS use for the second year resulted in a further increase in Hb in those who had used DFS earlier. The relatively small deterioration in mean Hb following discontinuation of DFS might at least be in part due to the impact of nutrition and health education and access to health and nutrition services.