Quadruple Fortification of Salt with Iodine, Iron, Vitamins B9 and B12 to Reduce Maternal and Neonatal Mortality by Reducing Anemia and Nutritional Deficiency Prevalence (P24-041-19).

Objectives To develop a quadruple fortified salt(QFS) formulation that provides100 + % of RDA for iodine and vitamin B12 and 30-50% of RDA for iron and folic acid in forms that are organoleptically stable, bioavailable and acceptable to consumers. Methods Iodine was sprayed onto salt as an aqueous solution of potassium iodate. Iron was admixed as a solid premix, which was colour masked with TiO2 and encapsulated in soy stearine to provide a water-impervious coating. The iron core was made of ferrous fumarate, which was agglomerated to an average size matching salt grain, i.e., 300-500 µm. Folic acid and vitamin B12 were added either in the iodate spray solution or in the solid iron premix. The premixes and salt were stored at 25, 35 and 45°C at 65% RH for up to a year. The loss of iodine, folic acid and vitamin B12 were monitored. An optimized formulation was tested on the pilot scale at JVS Foods Pvt, Jaipur, India. Results Folic acid can be stabilized in the iodine spray solution, and triple fortified salt containing iodine, folic acid and encapsulated ferrous fumarate retained >90% of both the added iodine and folic acid for 6 months. Stable QFS was made by incorporating vitamin B12 in the solid iron premix at a 1:200 ratio. The process was scaled up to produce some 25 kg of iron and B12premix, sufficient for 5 tons of salt, or 500,000 daily doses of salt. Organoleptic testing of Indian meals produced with quadruple fortified salt were found to be acceptable by a consumer panel at the University of Delhi. Conclusions Stable quadruple fortified salt that can provide up to 50% of RDA of folic acid and iron and 100 + % of RDA of vitamin B12 and iodine has been developed. The product was pilot tested and had high consumer acceptability. The formulation could reduce the incidence of maternal and infant mortality at a cost of less than 20¢/annum. Funding Sources This research was funded by Grand Challenges Canada through the Saving Lives at Birth program, and by the Bill and Melinda Gates Foundation.