Nutrition and health status of women using iron fortified iodised salt

Background: Globally nearly 2 billion persons of all age, sex, and physiological groups are anaemic. Sustained use of iron fortified iodised salt (Double fortified salt DFS), improves haemoglobin and reduces the prevalence of anaemia without requiring dietary modification or iron supplementation. Since large-scale food fortification programmes provide fortified foods to the general population without prior screening or individual monitoring, it is essential to document the safety of long-term DFS use.in general population Methods: A community-based open randomized study is being conducted among low middle-income families in South West Delhi, India, to assess the long-term impact of DFS use. Nutritional status, blood pressure, micronutrient profile, lipid profile, and liver, kidney and thyroid function tests were assessed in 919 women at enrolment and in 391 women who continued to use the allocated salt for six months and provided blood samples both at enrolment and after six months of use of the salt. Results: At enrolment, prevalence of under-nutrition was low (<5%), two-thirds of the women were overweight or obese and nearly three-quarters had abdominal adiposity. Hypertension was present in 7.8% of women. More than 80% had vitamin D deficiency, 47.1% had iron deficiency, 26.4% had vitamin B12 deficiency and 12.0% had folate deficiency. Although the prevalence of elevated total cholesterol and LDL cholesterol was low, low HDL cholesterol and elevated triglyceride and VLDL concentrations were common. More than 95% of women had normal liver, kidney and thyroid function tests. At enrolment, the profile of all women and the subset of women who provided blood samples at 0 and 6 months was similar. Comparison of paired observations showed that there were no significant changes in body weight, body mass index, blood pressure or prevalence of hypertension after six months of use of either DFS or iodised salt (IS). Small changes were observed in some biomarkers of micronutrients, lipid profile; the magnitude of these changes was small and unlikely to be of clinical or public health significance. There were no changes in liver, kidney or thyroid function after six months use of either DFS or IS. Conclusions: Use of DFS by apparently healthy women for six months was not associated with any changes in nutritional status, blood pressure, micronutrient profile, lipid profile, or liver, kidney and thyroid function which were of clinical or public health significance. These findings suggest that DFS can be safely used in food fortification programmes aimed at improving iron intake and haemoglobin status.