Peer-reviewed article
Effects of Quintuply-Fortified Salt on the Micronutrient Status of Children 12 to 59 Months of Age in Punjab, India: Results from a Randomized, Community-Based, Household Trial.
Long JM, Goh YE, Duggal M, Das R, Manger MS et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether salt fortified with five micronutrients (zinc, vitamin B-12, folic acid, iodine, and iron) improved the nutritional status of young children in Punjab, India compared to regular iodized salt. Over 470 children aged 12 to 59 months were randomly assigned to receive one of three types of salt for 12 months. Children who consumed quintuply-fortified salt showed better vitamin B-12 and folate levels, but no improvements in zinc, iron, or iodine status. The findings suggest fortified salt could help address vitamin B-12 and folate deficiencies in young children.
Key points
- At baseline, 35% of children had anemia and 30% had iron deficiency anemia, with 17% having vitamin B-12 insufficiency
- Children receiving quintuply-fortified salt with ferric pyrophosphate had 16% higher serum vitamin B-12 and 29% higher serum folate at 12 months compared to iodized salt group
- Red blood cell folate concentrations were 21% higher in the fortified salt group at 12 months
- No significant improvements were found in serum zinc, ferritin, hemoglobin, or urinary iodine between fortified and regular iodized salt groups
- Effects were similar between the two types of quintuply-fortified salt tested
Limitations
The study only measured outcomes at three time points over 12 months and was limited to one region (Punjab, India), so findings may not generalize to other populations or longer-term effects. The lack of effect on iron, zinc, and iodine status means the intervention does not fully address all micronutrient deficiencies identified at baseline.
Abstract
Background Micronutrient deficiencies remain prevalent among preschool-aged children (PSC) in India. Quintuply-fortified salt (QFS) is one of many potential interventions to improve micronutrient intake and status at the population level. Objectives To determine the effect of QFS compared with iodized salt (IS) for 12 mo on the micronutrient status of PSC. Methods This was a substudy of a double-blinded, household-randomized, controlled, community-based trial involving nonpregnant females of reproductive age whose households were randomly assigned to receive: 1) QFS with zinc, vitamin B-12, folic acid, iodine, and iron as encapsulated ferrous fumarate (eFF-QFS); 2) QFS with the same micronutrients, but iron as encapsulated ferric pyrophosphate plus ethylenediaminetetraacetic acid (eFePP-QFS); or 3) IS. The micronutrient status of 470 PSC (aged 12-59 mo) residing in these households was assessed at enrollment, 6 mo, and 12 mo. Continuous outcomes were analyzed with linear regression and reported as means or geometric mean ratios, and binary outcomes were analyzed with logistic regression and reported as odds ratios. Results At baseline, the prevalence of anemia, iron deficiency anemia, hypozincemia, vitamin B-12 insufficiency, and folate deficiency was 35%, 30%, 14%, 17%, and 5.5%, respectively. Effects of QFS at 6 and 12 mo were greatest for vitamin B-12 and folate. At 12 mo, the eFePP-QFS group had higher serum vitamin B-12 [geometric mean ratio (GMR) = 1.16, 95% confidence interval (CI) = 1.03, 1.30], serum folate (GMR = 1.29, 95% CI = 1.09, 1.53), and red blood cell folate (GMR = 1.21, 95% CI = 1.05, 1.39) concentrations compared with the IS group. Effects were similar among the 2 QFS groups. There were no significant differences in serum zinc, ferritin, hemoglobin, or urinary iodine between groups at 6 and 12 mo. Conclusions Preschool children consuming QFS for 12 mo demonstrated greater improvements in vitamin B-12 and folate status compared with children consuming IS. QFS may be a useful vehicle to address micronutrient deficiencies, especially vitamin B-12 and folate, in this population.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Provision of quintuply-fortified salt (containing zinc, vitamin B-12, folic acid, iodine, and iron) for 12 months compared to iodized salt
- Population
- 470 preschool children aged 12-59 months in Punjab, India, living in households randomly assigned to salt type
Key finding
Serum vitamin B-12 was 16% higher (GMR = 1.16, 95% CI = 1.03, 1.30) in the ferric pyrophosphate fortified salt group at 12 months