Dataset Information

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

ABSTRACT: 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.

SUBMITTER: Shields A

PROVIDER: S-EPMC7882366 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Shields Alister A Ansari Mohammed Anas MA

The Journal of nutrition 20210201 Suppl 1

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 ...[more]

PMID: 33582782

Similar Datasets

Project description:Double-fortified salt (DFS) containing iron and iodine has been proposed as a feasible and cost-effective alternative for iron fortification in low- and middle-income countries (LMICs). We conducted a systematic review and meta-analysis from randomized and quasi-randomized controlled trials to 1) assess the effect of DFS on biomarkers of iron status and the risk of anemia and iron deficiency anemia (IDA) and 2) evaluate differential effects of DFS by study type (efficacy or effectiveness), population subgroups, iron formulation (ferrous sulfate, ferrous fumarate, and ferric pyrophosphate), iron concentration, duration of intervention, and study quality. A systematic search with the use of MEDLINE, EMBASE, Cochrane, Web of Science, and other sources identified 221 articles. Twelve efficacy and 2 effectiveness studies met prespecified inclusion criteria. All studies were conducted in LMICs: 10 in India, 2 in Morocco, and 1 each in Côte d'Ivoire and Ghana. In efficacy studies, DFS increased hemoglobin concentrations [standardized mean difference (SMD): 0.28; 95% CI: 0.11, 0.44; P < 0.001] and reduced the risk of anemia (RR: 0.59; 95% CI: 0.46, 0.77; P < 0.001) and IDA (RR 0.37; 95% CI: 0.25, 0.54; P < 0.001). In effectiveness studies, the effect size for hemoglobin was smaller but significant (SMD: 0.03; 95% CI: 0.01, 0.05; P < 0.01). Stratified analyses of efficacy studies by population subgroups indicated positive effects of DFS among women and school-age children. For the latter, DFS increased hemoglobin concentrations (SMD: 0.32; 95% CI: 0.03, 0.60; P < 0.05) and reduced the risk of anemia (SMD: 0.48; 95% CI: 0.34, 0.67; P < 0.001) and IDA (SMD: 0.37; 95% CI: 0.25, 0.54; P < 0.001). Hemoglobin concentrations, anemia prevalence and deworming at baseline, sample size, and study duration were not associated with effect sizes. The results indicate that DFS is efficacious in increasing hemoglobin concentrations and reducing the risk of anemia and IDA in LMIC populations. More effectiveness studies are needed.

Project description:Background Data from several efficacy studies and a long-term effectiveness study have encouraged the governments to adopt a policy of providing double-fortified salt (DFS) in the Mid-Day Meal (MDM) programs in government schools across India. These envisaged food security events are likely to boost the manufacturing of DFS in a big way. Thus, it becomes pertinent to come up with a robust monitoring system involving community and field workers for quality checks. It is imperative to equip these field workers with simple testing kits (STKs) capable of qualitative detection of iron and iodine in DFS. As the consumer acceptance of foods is based on several factors including sensory characteristics, performance, convenience, cost, nutrition, and product image, a variety of iron compounds are in use for fortification. However, it becomes challenging to provide a kit that can overcome the chemical masking of iodine detection by iron compounds. Objectives We aimed at (1) the development of a field-friendly STK for quick qualitative assessment of iodine and various forms of iron present in DFS, (2) to check its validity under field conditions. Methods We put in place reagents combined using known chemical reactions and balanced use of oxidants to overcome the problems of encapsulation and to maximize the use, by enabling reagent combination to react with all forms of iron. Results The kit reagents successfully detect iodine as well as three commonly used iron fortificants in DFS. Published field trials confirmed the specificity and sensitivity of the developed kit. The simplicity and use of the kit by a field worker can be seen in the enclosed video. Conclusion The combination of improvised kit reagents allows early detection of iron and iodine in DFS. Iron is detected in a variety of iron-containing fortifications. The provision of diluted H2O2 ensures the presence of oxygen-free radicals that enhances iodine release captured by concentrated KI making iodine detection an easy task.

Project description:BACKGROUND:Bouillon cubes are a potential vehicle for iron fortification. They are currently fortified with ferric pyrophosphate (FePP), which is known to be poorly absorbed. The objective of this study was to assess the iron absorption of Aspergillus oryzae grown in FePP (ASP-p) and compare it with FePP and ferrous sulfate (FeSO4)-fortified bouillon cubes. METHODS:In 2 single-blinded, crossover studies, healthy women with serum ferritin concentrations <40 μg/L were randomly assigned to consume a rice-vegetable meal with iron-fortified chicken bouillon. Subjects in study I (n = 17, 18-26 y) consumed iron from both iron sources as 57FePP and 58ASP-p (intrinsically labeled with 58FePP) with a meal containing 4.2 mg of total iron provided for 3 d. Study II (n = 18, 18-29 y) was similar except that subjects consumed 57FeSO4 and 58ASP-p. Whole-blood stable isotope enrichment after 14 d was used to measure fractional iron absorption. Hemoglobin, hematocrit, serum ferritin, hepcidin, and serum C-reactive protein were analyzed at baseline and at 14 d. A t test was used to compare the mean differences in fractional absorptions within each study and baseline characteristics between studies. RESULTS:Geometric mean (95% CI) fractional iron absorption of FePP [0.94% (0.63%, 1.40%)] was lower than ASP-p [2.20% (1.47%, 3.30%)] (P < 0.0001) in study I. In study II, ASP-p fractional absorption [2.98% (2.03%, 4.38%)] was lower than that of FeSO4 [9.88% (6.70%, 14.59%)] (P < 0.0001). Both ferritin (r = -0.41, P = 0.014) and hepcidin (r = -0.42, P = 0.01) concentrations were inversely correlated with ASP-p iron absorption. Fractional absorption of ASP-p was also positively correlated with FePP (r = 0.92, P < 0.0001) and FeSO4 (r = 0.52, P < 0.02) absorption. CONCLUSIONS:ASP-p-fortified bouillon provided 2.3-fold higher absorbable iron than the currently used FePP. Bouillon fortified with ASP-p may contribute sufficient bioavailable iron to meet the daily iron requirements in young women only if consumed with other iron-fortified staple foods. This trial was registered at clinicaltrials.gov as NCT03586245.

Dataset Information

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

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets