Godbole Ujwala, Basantani Mahesh, Yadav Subhash, Godbole Nachiket, Khandpur Sukhanshi, Godbole Madan, Raza Sana, Mbuya Mduduzi N N, Neufeld Lynnette M
Institute of Bioscience and Technology, Shri Ramswaroop Memorial University, Barabanki, Uttar Pradesh, India.
Department of Endocrinology, Molecular Medicine, and Biotechnology, UP-USI Coalition, Sanjay Gandhi Postgraduate Institute campus, Lucknow, India.
Curr Dev Nutr. 2021 Mar 30;5(4):nzab028. doi: 10.1093/cdn/nzab028. eCollection 2021 Apr.
Double-fortified salt (DFS) with iron and iodine has been demonstrated to be efficacious but questions of unintended effects on the gains in salt iodization remain. The main cross-sectional study based on the use of DFS over 1 y showed a reduction in iron deficiency risk. Whether the programs and the levels of added iron can adversely affect iodine status is yet to be established.
We hypothesized that the addition of iron to iodized salt can adversely affect iodine status in women of reproductive age (WRA).
A cross-sectional substudy was conducted in 4 matched-pair adjacent districts of rural Uttar Pradesh, India, in 2019. Under the public distribution system (PDS), DFS was available for 1 y through Fair Price Shops, in the 2 DFS supply districts (DFS-SDs). In these districts, iodized salt was also available in the market. In the 2 compared DFS nonsupply districts (DFS-NSDs), only iodized salt was available. In the substudy, participants included WRA (= 1624) residing in rural areas of the selected districts. Iodine content in urine and salt samples was measured in each of the groups.
Significantly fewer women from the DFS-SDs had median urinary iodine concentration values indicative of moderate to mild iodine deficiency compared with the women from the DFS-NSDs. The salt purchase pattern and iodine content revealed that significantly fewer (21.99%) households in the DFS-SDs were purchasing inadequately iodized crystal salt, compared with 36.04% households in the DFS-NSDs.
The data reject the working hypothesis and suggest a beneficial effect of the DFS program on the iodine status in WRA, thereby supporting a recommendation of DFS supply through the PDS.
铁碘双强化盐（DFS）已被证明是有效的，但对碘盐加碘增加量的意外影响问题依然存在。基于使用DFS超过1年的主要横断面研究显示缺铁风险有所降低。添加铁的方案和水平是否会对碘营养状况产生不利影响尚待确定。
我们假设在碘盐中添加铁会对育龄妇女（WRA）的碘营养状况产生不利影响。
2019年，在印度北方邦农村地区4个匹配的相邻地区进行了一项横断面子研究。在公共分配系统（PDS）下，DFS通过平价商店在2个DFS供应区（DFS-SDs）供应了1年。在这些地区，市场上也有碘盐供应。在2个对比的DFS非供应区（DFS-NSDs），只有碘盐供应。在子研究中，参与者包括居住在选定地区农村的育龄妇女（=1624人）。对每组的尿液和盐样中的碘含量进行了测量。
与来自DFS-NSDs的妇女相比，来自DFS-SDs的妇女中，尿碘浓度中位数表明中度至轻度碘缺乏的人数明显较少。盐的购买模式和碘含量显示，DFS-SDs中购买碘含量不足的晶体盐的家庭明显较少（21.99%），而DFS-NSDs中的这一比例为36.04%。
数据否定了工作假设，表明DFS方案对育龄妇女的碘营养状况有有益影响，从而支持通过PDS供应DFS的建议。
