Impact of Double-Fortified Salt with Iron and Iodine on Hemoglobin, Anemia, and Iron Deficiency Anemia: A Systematic Review and Meta-Analysis

Advances in Nutrition
María J Ramírez-LuzuriagaReynaldo Martorell

Abstract

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 stud...Continue Reading

References

May 9, 2000·The American Journal of Clinical Nutrition·L H Allen
Feb 13, 2001·The Journal of Nutrition·B J BrabinD Pelletier
Feb 13, 2001·The Journal of Nutrition·S J Oppenheimer
Feb 13, 2001·The Journal of Nutrition·B J BrabinF Verhoeff
Apr 2, 2002·The Journal of Nutrition·Joseph M Hunt
Apr 2, 2002·The Journal of Nutrition·Frederick Trowbridge, Reynaldo Martorell
Jul 4, 2002·Food and Nutrition Bulletin·L L DiosadyM G Venkatesh Mannar
Aug 14, 2002·Indian Journal of Pediatrics·B Sivakumar, K Madhavan Nair
Jan 24, 2003·The American Journal of Clinical Nutrition·Michael B ZimmermannRichard F Hurrell
Sep 28, 2004·The American Journal of Clinical Nutrition·Michael B ZimmermannRichard F Hurrell
Dec 1, 2004·The Journal of Nutrition·Rita WegmüllerRichard F Hurrell
Sep 20, 2005·Health Promotion International·N JacksonUNKNOWN Guidelines for Systematic Reviews in Health Promotion and Public Health Taskforce
Aug 28, 2007·Food and Nutrition Bulletin·Malavika VinodkumarShailesh R Deshpande
Aug 28, 2007·Food and Nutrition Bulletin·Srinivasaiyengar RanganathanBhattriprolu Sivakumar
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherUNKNOWN PRISMA Group
May 26, 2010·Food and Nutrition Bulletin·Yao Olive LiAnnie S Wesley
Aug 5, 2011·Lancet·Yarlini BalarajanS V Subramanian
Jan 4, 2013·Nutrition Reviews·Chang Cao, Kimberly O O'Brien
Mar 17, 2016·Advances in Nutrition·Parminder S SuchdevUNKNOWN BRINDA Working Group
Feb 6, 2017·The Lancet. Diabetes & Endocrinology·Eduardo A PretellMichael B Zimmermann

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Citations

Jun 25, 2019·Annals of the New York Academy of Sciences·Lynnette M NeufeldKenneth H Brown
Nov 15, 2020·International Journal of Environmental Research and Public Health·Rimma KorobitsynaYngvar Thomassen
Sep 27, 2021·The Cochrane Database of Systematic Reviews·Katharina da Silva LopesErika Ota

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