Improving the lives of millions through new double fortification of salt technology

Abstract

Micronutrient deficiencies (including iodine and iron deficiency) is a global health problem affecting one third of the world's population. Salt is an ideal carrier for food fortification as it is universally consumed at equal rates, independently of economic status, and it is industrially processed. Addressing iron and iodine deficiencies together is a challenge, due to interaction between iodine and iron, negating the effect of added iodine. This paper explains the development of an improved microencapsulation-based technology to produce iron premix, which, when added to iodized salt, is stable and organoleptically indistinguishable. Ferrous fumarate was extruded, followed by cutting, sieving to achieve a size of 300-710 μm (salt grain size). Agglomerated extrudates were microencapsulated (5% hydroxypropyl methylcellulose and 5% soy stearin) to form iron premix. Microencapsulation ensures that the added micronutrients are stable without interaction or degradation. Double Fortified Salt is formed by blending iron premix with iodized salt (1:200 ratio). This technology was transferred to India for industrial scale-up. The public distribution system was utilized to establish and monitor an efficient distribution network for DFS in a transparent manner. The scale-up process was initially demonstrated in the state of Uttar Pradesh, following its success two more Indian states have started distribution of DFS. At present, the DFS with iron and iodine is reaching 60 million people in India. This important health intervention technology through food fortification has the potential to be scaled globally to ensure a world free from iron deficiency anemia.

Keywords: anemia; fortification; iodine; iron; maternal death; microencapsulation; salt.

Figure 1

Process flow diagram for Double Fortified Salt technology

Figure 2

Product development stages in Double Fortified Salt

Figure 3

Iodine retention (%) in Double Fortified Salt samples stored at 25°C at RT, 35°C at 60–70% RH, 45°C at 60–70% RH after 6 months(Footnote: (a) India 2015 pilot batch coated with 10% hydroxypropyl methyl cellulose (HPMC); (b) lab 2016 batch coated with 10% soy stearin; (c) lab 2016 batch coated with 5% HPMC and 5% SS; (d) India 2016 batch coated with 5% HPMC and 5% SS)

Figure 4

Journey of Double Fortified Salt: timeline

Figure 5

Double Fortified Salt program implementation strategy framework in Uttar Pradesh, India(Footnote: UP: Uttar Pradesh, India; PDS: public distribution system; FPS: Fair Price Shops; UPFCS: Uttar Pradesh Food & Civil Supplies Department; FSDA: Food Safety and Drug Administration]

Figure 6

Double Fortified Salt program activities for scale‐up