Double Fortification Research Articles

Predicting the Stability of Double Fortified Salt by Determining the Coating Quality of the Encapsulated Iron Premix

The technology to simultaneously fortify salt with iron and iodine was developed in Canada and transferred and scaled up in India. The double fortified salt has reached more than 60 million consumers so far. Double fortification of salt is a cost-effective and reliable means of improving iron and iodine deficiencies at a population level. However, high-quality iron premix is essential for the stability of iodine and the program’s success. Therefore, we developed a reliable and cost-effective method for premix coating quality evaluation in the field, especially in low-income settings. The integrity and chemical composition of the coating and exposure of iron at the surface (∼10 μm deep) were determined using scanning electron microscopy and energy-dispersive X-ray spectroscopy to predict the stability of the fortified salt. The phenanthroline colour dropper test was used to test the quality of the double fortified salt by reaction with ferrous iron present on the premix surface. Five iron premix samples were compared. Based on the iron release, coating composition, and the reaction with phenanthroline, Premix-3, and its corresponding DFS, obtained from a local shop in India had the lowest quality among all samples tested. The results of the dropper test corresponded with the analysis using sophisticated analytical tools, confirming it as a simple, reliable, and cost-effective test for iron premix coating quality and integrity. This simple test would be crucial for a successful double fortification program, especially in low-income countries, in predicting iron premix quality, a critical determinant of iodine stability during storage, distribution, and retail. These study results can help governments and NGOs to establish quality standards for iron premix used for salt fortification programs.

Optimization of the color masking and coating unit operations for microencapsulating ferrous fumarate for double fortification of salt

A new coating formulation was developed to eliminate the factor that caused black spots on the iron premix surface, used for making Double Fortified Salt. The formulation is a suspension of titanium dioxide in soy stearin, prepared with ethanol and dichloromethane and applied with a glass sprayer and pan coater. 0–20% w/w titanium dioxide was suspended in 10% w/w soy stearin/hydroxypropyl methylcellulose. Coating with a suspension of 15% w/w TiO2 in 10% w/w soy stearin ensured that all the TiO2 adheres to the premix surface, giving no chance for the recycling of iron contaminated TiO2, which caused the black spot. The new coating formulation ensured that over 90% iodine in Double Fortified Salt was retained after 6 months at 45 °C, 60–70% RH. The whiteness of the premix (L* = 86.4) matched the Double Fortified Salt whiteness (L* = 86.8). Thus, making the new coating method as effective as the previous in desirable characteristics. More so, the new coating method simplifies the existing method by merging the previous color masking, and double coating steps into one step.

Temporal Relation between Double Fortification of Wheat Flour with Iron and Folic Acid, and Markers and Prevalence of Anemia in Children.

Fortification of wheat flour with iron and folic acid became mandatory in Ivory Coast in 2007. The purpose of this study was to determine the time trend relation between mandatory double fortification of wheat flour with iron and folic acid and markers and prevalence of anemia by comparing the data between pre- and post-fortification periods in Ivory Coast children. Data were derived from the pediatric unit of the University Hospital of Treichville, Abidjan, Ivory Coast. Medical records of 467 children from 5 to 14 years old were analyzed from the years 2004 through 2010. Periods from 1 January 2004 to 31 December 2006 and 1 January 2008 to 31 December 2010 were considered as pre- and post-fortification periods, respectively. Data on hemoglobin, hematocrit, red blood cell count (RBC), mean corpuscular volume (MCV), and anemia between pre- and post-fortification periods were compared. There were no significant differences in hemoglobin, hematocrit, RBC, and prevalence of anemia between pre- and post-fortification periods. However, MCV in post-fortification period was significantly higher compared to pre-fortification period in all subjects (77.6 fL vs. 76.8 fL; p = 0.02) and in young girls (79.1 fL vs. 75.2 fL; p = 0.01). Lack of significant differences in anemia and in markers of anemia between pre- and post-fortification periods need further investigation in children of Ivory Coast.

Synbiotic Fermented Milk with Double Fortification (Fe-Zn) as a Strategy to Address Stunting: A Randomized Controlled Trial among Children under Five in Yogyakarta, Indonesia

Stunting is one of the public health problems that has yet to be solved in Indonesia. This study developed synbiotic fermented milk with iron and zinc fortification that was then tested in a clinical setting. The product was made from skimmed milk and fructooligosaccharides (FOS) and fermented with Lactobacillus plantarum. A sample of 94 stunted children under five years old were randomly assigned to intervention or control groups. The intervention group received double-fortified synbiotic milk, while the control group drank non-fortified milk. After three months, the number of normal children in both groups, according to weight- or height-for-age z-score category, was found to be increasing. However, the difference between the two groups was not significant (p > 0.05). The study suggests that fermented milk may have a good effect on child growth. Further research is needed to deepen the potency of synbiotic fermented milk for stunted children.

Quadruple fortification of salt for the delivery of iron, iodine, folic acid, and vitamin B12 to vulnerable populations.

A process for simultaneous delivery of iron, iodine, folic acid, and vitamin B12 through salt as a potential and holistic approach to ameliorate anaemia and reduce maternal and infant mortality is presented. Two approaches for adding folic acid and B12 to salt during double fortification with iron and iodine were investigated. Attempts to add both micronutrients through the iodine spray solution were unsuccessful. Hence, folic acid was added through a stabilized iodine solution, and B12 was added through the iron premix. Four approaches used to incorporate B12 into the iron premix were investigated: (1) co-extruding B12 with iron, (2) spraying B12 on the surface of the iron extrudate, (3) adding B12 to the colour masking agent, and (4) adding B12 to the outer coating. Of these approaches, coextrusion (1) was the best, based on the ease of production and stability of fortificants. The salt formulated with the solid iron-B12 premix and sprayed iodine and folic acid solution contained 1000 ppm iron, 50 ppm iodine, 25 ppm folic acid, and 0.25 ppm B12. Over 98% of B12, 93% folic acid, and 94% iodine were retained after 6-month storage in the best formulation. This technology can simultaneously deliver iron, iodine, folic acid, and vitamin B12 in a safe and stable salt enabling public health measures for improved health at a minimal additional cost.

Review of Experience of the Production of Salt Fortified with Iron and Iodine

The double fortification of salt with iodine and iron has been proposed as a method for the mass prevention of iron deficiency anemia. This article reports on the technical and financial aspects of the production of such double fortified salt (DFS) based on the experiences of current and past producers. It draws contrasts with the established process of fortifying salt solely with iodine particularly examining the cost and complexity of the processes involved. Based on these factors it questions the commercial viability of existing DFS formulations and thus their sustainability as vehicles for the widespread distribution of iron outside a subsidized environment. It makes suggestions for the future development of DFS particularly relating to the development of less expensive iron formulations suitable for use with lower quality salts and identifies key technical and economic areas to be taken into account when considering the production of DFS.

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

BackgroundAnemia, iron deficiency, and iodine deficiency are problems of important public health concern in many parts of the world, with consequences for the health, development, and work capacity of populations. Several countries are beginning to implement double fortified salt (DFS) programs to simultaneously address iodine and iron deficiencies. ObjectiveOur objective was to summarize the evidence for efficacy and effectiveness of DFS on the full range of status and functional outcomes and across different implementation and evaluation designs essential to successful interventions. MethodsWe conducted a systematic review and meta-analysis of published and gray literature examining the effects of DFS on nutritional status, cognition, work productivity, development, and morbidity of all population groups. We searched for articles in Medline, Embase, CINAHL, Cochrane Central Register, and ProQuest for randomized trials, quasi-randomized trials, and program effectiveness evaluations. ResultsA total of 22 studies (N individuals = 52,758) were included. Efficacy studies indicated a significant overall positive effect on hemoglobin concentration [standardized mean difference (95% CI): 0.33 (0.18, 0.48)], ferritin [0.42 (0.08, 0.76)], anemia [risk ratio (95% CI): 0.80 (0.70, 0.92)], and iron deficiency anemia [0.36 (0.24, 0.55)]. Effects on urinary iodine concentration were not significantly different between DFS and iodized salt. The impact on functional outcomes was mixed. Only 2 effectiveness studies were identified. They reported programmatic challenges including low coverage, suboptimal DFS quality, and storage constraints. ConclusionsGiven the biological benefits of DFS across several populations in efficacy research, additional evaluations of robust DFS programs delivered at scale, which consider effective implementation and measure appropriate biomarkers, are needed.

Optimization of Unit Operations for Microencapsulating Ferrous Fumarate During Scale-Up of Double Fortification of Salt with Iron and Iodine

Abstract Objectives This study evaluates factors responsible for the floating of iron premix in double fortified salt (DFS), which initially affected the large-scale implementation of the salt fortification program in India, and provides solutions to the scale-up of the technology. Materials and Methods To mitigate this time-sensitive scale-up challenge. First, the iron premix samples were obtained from the industrial scale-up pilot studies in India, evaluated for the impact of the amount of coating material (5 per cent, 7.5 per cent, and 10 per cent (in weight)), type of formulation (soy stearin, SEPIFILM and hydroxypropyl methylcellulose), amount of titanium dioxide (25-35 per cent (in weight)) used for color masking; Second, we studied the effect of change in the composition of the coating, from 10 per cent (in weight) soy stearin to a double coat with 5 per cent (in weight) hydroxypropyl methylcellulose and 5 per cent soy stearin or 10 per cent soy stearin and 1 per cent (in weight) lecithin mixture, on particle density, floating or sinking property of the iron premix, and on the stability of iodine in the DFS. Results It was observed that the hydrophobic nature and the amount of soy stearin used for coating caused the floating issue. The double coating with 5 per cent hydroxypropyl methylcellulose and 5 per cent soy stearin was preferred because lecithin in soy stearin enhanced the moisture-aided adverse interaction between iron and iodine. Shelf-life storage studies proved over 80 per cent iodine retention after 12 months of storage in the DFS formulated with iron premix double-coated with hydroxypropyl methylcellulose and soy stearin. Conclusion This proffered solution enabled the full implementation of the double fortification program in India.

Modeling shows high potential of folic acid-fortified salt to accelerate global prevention of major neural tube defects.

We estimated the global proportion of folic acid-preventable spina bifida and anencephaly (FAP SBA) potentially prevented through mandatory double fortification of iodized salt with folic acid. Using United Nations Children's Fund (UNICEF) and Global Fortification Data Exchange (GFDx) data sets, we modeled country-specific number of FAP SBA cases prevented annually using (a) current coverage of the salt in households worldwide and (b) expected daily amount of folic acid intake from folic acid-fortified iodized salt. Our evidence-based modeling strategy assumed mandatory folic acid fortification of salt at 20 ppm, and that at 200 μg/day intake of folic acid through fortified salt, should achieve 100% prevention of all FAP SBA in countries. One hundred countries that have data on percent of households consuming iodized salt globally were examined; 55 of them have ≥80% households consuming iodized salt. Our model estimated approximately 180,000 cases of FAP SBA could be prevented in these 100 countries through folic acid-fortified iodized salt, and 150,000 of them would be in countries where ≥80% households consuming iodized salt that can be potentially fortified with folic acid. Salt fortification with folic acid could contribute to the prevention of about 65% global FAP SBA cases annually. Our evidence-based model shows that there is high potential to prevent FAP SBA using folic acid-fortified iodized salt. Prevention will reach countries where there is a limited reach of centrally processed folic acid-fortified wheat or maize flour. If this intervention is made feasible by the salt industry, it can accelerate the prevention of FAP SBA significantly.

Modeling Shows High Potential of Folic Acid Fortified Salt to Accelerate Global Prevention of Major Neural Tube Defects

Background: We estimated the global proportion of folic acid-preventable spina bifida and anencephaly (FAP SBA) potentially prevented through mandatory double fortification of iodized salt with folic acid. Methods: Using UNICEF and Global Fortification Data Exchange (GFDx) datasets, we modelled country-specific number of FAP SBA cases prevented annually using: 1) current coverage of the salt in households worldwide; and 2) expected daily amount of folic acid intake from folic acid fortified-iodized salt. Our evidence-based modeling strategy assumed mandatory folic acid fortification of salt at 20 ppm, and that at 200 μg/day intake of folic acid through fortified salt, should achieve 100% prevention of all FAP SBA in countries. Findings: One hundred countries that have data on percent of households consuming iodized salt globally were examined; 65 of them have ≥80% households consuming iodized salt. Our model estimated approximately 180,000 cases of FAP SBA could be prevented in these 100 countries through folic acid fortified-iodized salt, and 150,000 of them would be in countries where ≥80% households consuming iodized salt that can be potentially fortified with folic acid. Salt fortification with folic acid could contribute to the prevention of about 65% global FAP SBA cases annually. Interpretation: Our evidence-based model shows that there is high potential to prevent FAP SBA using folic acid-fortified iodized salt. Prevention will reach countries where there is a limited reach of centrally-processed folic acid-fortified wheat or maize flour. If this intervention is made feasible by the salt industry, it can accelerate the prevention of FAP SBA significantly. Funding Statement: No funding was received to conduct any aspect of this study Declaration of Interests: The authors have no financial relationships relevant to this article to disclose. Dr. Godfrey P. Oakley Jr. is a co-inventor (while at CDC, compensation is under the regulations of CDC) of a patent that covers adding folic acid to contraceptive pills, and he has been a consultant to Ortho McNeil on this issue.

Improving the lives of millions through new double fortification of salt technology.

Micronutrient deficiencies (including iodine and iron deficiency) is a global health problem affecting one third of the world's population. Salt is an ideal carrier for food fortification as it is universally consumed at equal rates, independently of economic status, and it is industrially processed. Addressing iron and iodine deficiencies together is a challenge, due to interaction between iodine and iron, negating the effect of added iodine. This paper explains the development of an improved microencapsulation‐based technology to produce iron premix, which, when added to iodized salt, is stable and organoleptically indistinguishable. Ferrous fumarate was extruded, followed by cutting, sieving to achieve a size of 300–710 μm (salt grain size). Agglomerated extrudates were microencapsulated (5% hydroxypropyl methylcellulose and 5% soy stearin) to form iron premix. Microencapsulation ensures that the added micronutrients are stable without interaction or degradation. Double Fortified Salt is formed by blending iron premix with iodized salt (1:200 ratio). This technology was transferred to India for industrial scale‐up. The public distribution system was utilized to establish and monitor an efficient distribution network for DFS in a transparent manner. The scale‐up process was initially demonstrated in the state of Uttar Pradesh, following its success two more Indian states have started distribution of DFS. At present, the DFS with iron and iodine is reaching 60 million people in India. This important health intervention technology through food fortification has the potential to be scaled globally to ensure a world free from iron deficiency anemia.

Double Fortified Salt in India: Coverage, Efficacy and Way Forward

Iron deficiency remains the world’s most widespread nutritional disorder and India is one of the countries very worst afflicted. India has successfully reduced the burden of iodine-deficiency disorders through mandatory iodization of salt for more than 20 years. This has resulted in a significant decrease in the prevalence of iodine deficiency diseases. Building on the success with iodization, double fortification of salt with iodine and iron is gaining ground and can be integrated with established iodization processes. DFS contemplates the creation and distribution of a powerful innovative product with demonstrated health effects, building on existing distribution platforms for salt through public distribution channels targeted to some of the most impoverished populations in the country at minimal expense and without requiring changes in cultural habits and compliance. Two formulations have been approved by Food Safety and Standard Authority of India (FSSAI) with iron either in the form of encapsulated ferrous fumarate or ferrous sulphate. A meta-analysis showed that DFS increased hemoglobin concentrations significantly. This intervention as part of a broader anemia strategy has the potential to effect large-scale anemia reduction across populations in India on a permanent and economically self-sustaining basis.

Double fortification of salt with folic acid and iodine

Salt fortification is an effective strategy to reduce micronutrient deficiency in developing countries because salt is consumed universally and at constant levels irrespective of socioeconomic status. The demonstrated efficacy of salt iodization resulted in a major international program to achieve universal salt iodization. To address the widespread deficiency in folic acid, the objective of this research was to develop a stable formulation of salt fortified with both folic acid and iodine. The fortification process will use a single solution that will be sprayed onto salt using existing salt iodization equipment and infrastructure. Optimal salt formulations were prepared by spraying a pH 9 carbonate buffer solution containing 1%–3% (weight per volume) iodine, as potassium iodate, and 1%–2% (weight per volume) folic acid. After fortification, the optimal formulations prepared using refined salt, retained >80% of the folic acid and >90% of the iodine after 12 months of storage at ambient conditions.

Microencapsulation of iron in a reversed enteric coating using spray drying technology for double fortification of salt with iodine and iron

AbstractPrevention of iron deficiency, the most widespread nutritional disorder, can be achieved by salt double fortification; however, iron addition requires the prevention of iron‐iodine interaction. For this purpose, reversed enteric coated iron‐containing microparticles were developed in this study.Microparticles were produced using either of two coating materials: Eudragit EPO and chitosan. Coating material solutions were loaded with increasing amounts of iron and then spray dried. Maximum payloads were established and functionality/morphology of microparticles was assessed. Microparticles were added into iodized salt with different moisture contents and adhesion and stability was measured during storage.Eudragit EPO is unsuitable for iron fortification, as even low payloads prevented solid particles formation. Chitosan was an effective iron coating as good functionality/morphology was achieved with loadings up to 25%. The best particles were spherical (∼10 µm average diameter) and retained the encapsulated iron at pH 7 and released it at pH 1. Chitosan microparticles can be properly attached to the surface of coarse salt when the initial moisture content of salt is 2.4%, and iodine retention after 12 weeks storage was 90% at 25C and 70% at 45C.Chitosan is suitable for producing an iron premix for stable salt double fortified with iodine and iron.Practical ApplicationsDouble fortification of salt with iodine and iron has been proved to be effective in reducing iron deficiency prevalence in India. Current fortification approaches use iron particles developed using an extrusion or fluidized bed agglomeration processes, to match the size and appearance of salt grains.However, in the developing world, the most consumed salt type is coarse salt. This fact imposes the need for developing iron microparticles that can be attached to the surface of coarse salt. Salt requires 2.4% moisture for good attachment. Iron microparticles must be stable in such environment. This can be achievable using reversed enteric coatings for avoiding the interaction of iodine and iron during salt preparation and storage.

Concept of double salt fortification; a tool to curtail micronutrient deficiencies and improve human health status

Fortification of food with micronutrients such as vitamins and minerals is one of the main strategies used to combat micronutrient deficiencies. Fortification in common salt is a fruitful strategy because of the daily consumption of 5-12 g salt per person globally. Therefore double fortification of salt with iodine and iron could be a reasonable approach to prevent both iodine and iron deficiencies. It is reckoned that about two billion people are iodine-deficient worldwide. Iodine deficiency during pregnancy may affect the health status of both mother and fetus and increase infant mortality. Deficiencies of both these micronutrients during childhood affect somatic growth and cognitive and neurological function. Thyroid metabolism is negatively affected by iron deficiency and reduced effectiveness of iodine prophylaxis in areas of endemic goiter. High prevalence of iron deficiency among children may be reduced by the application of effective iodized salt programs. However, ensuring the stability and bioavailability of both iron and iodine as double-fortified salt is difficult. Iodine present in iodide or iodate form in dual-fortified salt is oxidized to free iodine in the presence of ferrous ions and oxygen and consequently loses its characteristics. Moreover, ferrous iron is more bioavailable but is readily oxidized to the less bioavailable ferric form. However, both forms of iron may lead to discoloration of the final product, which can be reduced by providing a physical barrier around the iron. Salt encapsulation is one of the best tools to provide a physical barrier for undesirable reactions and interactions during storage. In this review the concept of dual salt fortification, the impact of fortification on curing various life-threatening maladies, latest assessments of mineral deficiencies and the choice of fortificants are discussed.

Birth defects in India: Hidden truth, need for urgent attention

Birth defects (structural, functional and metabolic disorder present from birth, may be diagnosed later) rising up as an important cause of infant mortality even in developing countries where infant mortality has been reduced to much extent. Seventy percent of birth defects are preventable through the application of various cost effective community genetic services.Indian people are living in the midst of risk factors for birth defects, e.g., universality of marriage, high fertility, large number of unplanned pregnancies, poor coverage of antenatal care, poor maternal nutritional status, high consanguineous marriages rate, and high carrier rate for hemoglobinopathies. India being the second most populous country with a large number infant born annually with birth defects should focus its attention on strategies for control of birth defects. Many population based strategies such as iodization, double fortification of salt, flour fortification with multivitamins, folic acid supplementation, periconceptional care, carrier screening and prenatal screening are some of proven strategies for control of birth defects. Strategies such as iodization of salt in spite of being initiated for a long time in the past do have a very little impact on its consumption (only 50% were using iodized salt). Community genetic services for control of birth defects can be easily flourished and integrated with primary health care in India because of its well established infrastructure and personnel in the field of maternal and child health care. As there is wide variation for infant mortality rate (IMR) in different states in India, so there is a need of deferential approach to implement community genetic services in states those had already achieved national goal of IMR. On the other hand, states those have not achieved the national goal on IMR priority should be given to management of other causes of infant mortality.

Optimisation of polymer coating process for microencapsulating ferrous fumarate for salt double fortification with iodine and iron

An extrusion-based encapsulation process has been developed for making salt grain-sized iron premix for salt fortification. The first step of extrusion agglomeration process has been studied and reported previously. The focus of this study is on the optimisation of the colour-masking and polymer coating steps. Several colour-masking techniques and polymer encapsulants were investigated at various encapsulation levels. Salt samples prepared by blending the resulting iron premixes with iodised salt retained more than 90% of the original iodine and more than 93% of the ferrous iron after 3 months storage at 35°C and 60% relative humidity (RH). Hydrophilic coatings such as hydroxypropyl methyl cellulose (HPMC) offered more protection at the 10% encapsulation level compared to other coating materials studied. All iron premix formulations exhibited high particle density, good bioavailability and acceptable organoleptic properties. The process using the most effective formulations and optimised operation parameters is ready for pilot scale testing and field studies.

Double fortification of sorghum (Sorghum bicolor L. Moench) and finger millet (Eleucine coracana L. Gaertn) flours with iron and zinc

Finger millet and sorghum flours were used as vehicles for double fortification with ferrous fumarate, zinc stearate and EDTA. The iron and zinc salts were added at levels that provided 60mg iron and 50mg zinc per kg of flour. EDTA was added at levels equimolar to the added iron. The double-fortified finger millet and sorghum flours contained bioaccessible zinc contents of 0.83 and 1.63mg/100g, respectively, while the respective bioaccessible iron contents were 2.39 and 2.63mg/100g. The exogenous iron and zinc did not mutually interfere with their bioaccessibility. The shelf-life of the fortified flours was also satisfactory up to a period of 60 days, as indicated by the moisture and free fatty acid contents in the fortified flours. Double fortification of the millet flours did not negatively alter the sensory quality of the products prepared from them. The RDA for iron and zinc of Indian children, women and men can be sufficiently met with approximately 4 dumplings or 9 rotis. The use of such qualitatively and quantitatively rich flours can be promoted through welfare programs to reduce and subsequently eradicate iron and zinc deficiency.

Feasibility and optimization study of using cold-forming extrusion process for agglomerating and microencapsulating ferrous fumarate for salt double fortification with iodine and iron

A microencapsulation-based technology platform has been developed for salt double fortification with iron and iodine, aiming to address two globally prevalent micronutrient deficiencies simultaneously. Specifically, ferrous fumarate was microencapsulated into a form of salt grain-sized premix, and then added into iodised salt. The earlier process involved fluidised-bed agglomeration followed by lipid coating. To improve physico-chemical properties of the iron premix, the use of cold-forming extrusion for agglomerating and microencapsulating ferrous fumarate was investigated and optimized in this study, leading to optimal formulations and operation parameters. Grain flours were suitable for forming an extrudable dough incorporating high percentages of ferrous fumarate. All extruded iron particles, regardless of binders used, were rich in iron and had excellent iron in vitro digestibility. The extruded iron particles formed the basis of the final, microencapsulated iron premixes with desired particle size (300–700 µm), and other physical, chemical, nutritional, and organoleptic properties suitable for salt fortification.

Iodine stability in iodized salt dual fortified with microencapsulated ferrous fumarate made by an extrusion-based encapsulation process

The development of a novel, extrusion-based process for making microencapsulated ferrous fumarate for salt double fortification has been reported earlier. This paper focuses on the results of a one-year storage test, specifically the stability of both iodine and ferrous iron in the double fortified salt (DFS) samples prepared using optimal formulations of the iron premix. The study was devised to test the effectiveness of the encapsulation system in the prevention of interaction between ferrous fumarate and iodine, and preservation of the iodine in iodized salt. The results confirmed that direct iodine–iron interaction occurred in the DFS samples when the iron compound was added without proper coating. However, when an appropriately encapsulated iron premix was used, the interaction could be completely prevented. The extrusion-based process has proven to be an effective approach to producing a stable, bioavailable iron premix, suitable for incorporation into iodized salt for combating iodine and iron deficiencies.