Triple fortification of salt with microcapsules of iodine, iron, and vitamin A1–3

Background: In many developing countries, children are at high risk of goiter, vitamin A deficiency, and iron deficiency anemia. Objective: We aimed to develop a stable, efficacious salt fortified with iodine, iron, and vitamin A. Design: A novel spray-cooling technique was used with hydroge-nated palm oil to package potassium iodate, micronized ferric py-rophosphate, and retinyl palmitate into microcapsules (mean particle size: 100 m). We used the microcapsules to create triple-fortified salt (TFS) with 30 g I, 2 mg Fe, and 60 g vitamin A/g salt. After storage trials, we compared the efficacy of TFS with that of iodized salt in a 10-mo, randomized, double-blind trial in goitrous school-children (n 157) who had a high prevalence of vitamin A defi-ciency and iron deficiency anemia. Results: After storage for 6 mo, losses of iodine and vitamin A from the TFS were 12–15%, and color was stable. In the TFS group, mean hemoglobin increased by 15 g/L at 10 mo (P 0.01), iron status indexes and body iron stores improved significantly (P 0.05), and mean serum retinol, retinol-binding protein, and the ratio of retinol-binding protein to prealbumin increased significantly (P 0.01). At 10 mo, prevalences of vitamin A deficiency and iron de-ficiency anemia were significantly lower in the TFS group than in the iodized salt group (P 0.001). Conclusion: Newly developed microcapsules containing iodine, iron, and vitamin A are highly stable when added to local African salt. TFS was efficacious in reducing the prevalence of iron, iodine, and vitamin A deficiencies in school-age children. Am J Cli