SynthesisThe Journal of nutrition2021
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.
Synthesis in The Journal of nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Fortification of condiments and seasonings with iron for preventing anaemia and improving health.The Cochrane database of systematic reviews · 2023Pooled it
- Fortification of salt with iron and iodine versus fortification of salt with iodine alone for improving iron and iodine status.The Cochrane database of systematic reviews · 2022Pooled it
- A Randomized Crossover Trial of Acceptability of Quadruple-Fortified Salt in Women and their Households in Southern India.The Journal of nutrition · 2025Trial
- Modeling the Contribution of Multiple Micronutrient Fortification of Salt to Daily Nutrient Intake Among the Ethiopian Population.Current developments in nutrition · 2024Article
- Review of intervention products for use in the prevention and control of anemia.Annals of the New York Academy of Sciences · 2023Review
- Dietary Approaches to Iron Deficiency Prevention in Childhood-A Critical Public Health Issue.Nutrients · 2022Review
- The Role of Multiply-Fortified Table Salt and Bouillon in Food Systems Transformation.Nutrients · 2022Article
- A Novel Expert System for Diagnosis of Iron Deficiency Anemia.Computational and mathematical methods in medicine · 2022Article
- Making programmes worth their salt: Assessing the context, fidelity and outcomes of implementation of the double fortified salt programme in Uttar Pradesh, India.Maternal & child nutrition · 2022Article
- Influence of Iron Addition (Alone or with Calcium) to Elements Biofortification and Antioxidants inPlants (Basel, Switzerland) · 2021Article
- The Impact of Double-Fortified Salt Delivered Through the Public Distribution System on Iodine Status in Women of Reproductive Age in Rural India.Current developments in nutrition · 2021Article
- Key Considerations for Policymakers-Iodized Salt as a Vehicle for Iron Fortification: Current Evidence, Challenges, and Knowledge Gaps.The Journal of nutrition · 2021Article
- The Potential of Iodine and Iron Double-Fortified Salt Compared with Iron-Fortified Staple Foods to Increase Population Iron Status.The Journal of nutrition · 2021Review
- Evaluation of Global Experiences in Large-Scale Double-Fortified Salt Programs.The Journal of nutrition · 2021Review
- The Double-Fortified Salt (Iodized Salt with Iron) Consultation: A Process for Developing Evidence-Based Considerations for Countries.The Journal of nutrition · 2021Article
- High Coverage and Low Utilization of the Double Fortified Salt Program in Uttar Pradesh, India: Implications for Program Implementation and Evaluation.Current developments in nutrition · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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