Guetterman Heather M, Rajagopalan Kripa, Fox Allison M, Johnson Christina B, Fothergill Amy, George Nisha, Krisher Jesse T, Haas Jere D, Mehta Saurabh, Williams Jennifer L, Crider Krista S, Finkelstein Julia L
Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States.
Arogyavaram Medical Center, Andhra Pradesh, India.
J Nutr. 2025 Jan;155(1):322-337. doi: 10.1016/j.tjnut.2024.10.037. Epub 2024 Oct 26.
Double-fortified salt (DFS; iron, iodine) improved iron status in randomized trials and was incorporated into India's social safety net programs, suggesting opportunities to address other micronutrient deficiencies.
To evaluate the acceptability of quadruple-fortified salt (QFS; iron, iodine, folic acid, and vitamin B) in women and their households, using a randomized crossover trial design and triangle tests.
Women 18-49 y (n = 77) and their households were randomly assigned to receive QFS or DFS in a randomized crossover design over a 3-wk period (week 1: QFS/DFS, week 2: iodized salt, week 3: DFS/QFS). Each week, participants completed a 9-point hedonic questionnaire (1 = dislike extremely to 9 = like extremely) to evaluate 5 sensory domains (color, odor, taste, texture, and overall acceptability) of the intervention, and the remaining salt was weighed using a digital scale. Triangle tests were conducted among women to evaluate sensory discrimination of salt consumed in rice dishes prepared using standardized recipes. Mixed models were used to examine hedonic ratings and salt use; salt type, sequence, and period were included as fixed effects, and household was included as a random effect. Binomial tests were used to evaluate sensory discrimination of salt type in triangle tests.
Mean hedonic ratings for most of the 5 sensory domains were ≥7 (like moderately) and did not differ by salt type [overall acceptability mean (SD): QFS: 7.8 (0.7) compared with DFS: 7.7 (1.2); P = 0.68]. Household salt use (weighed) did not differ by salt type. During the 3-wk intervention period, weighed salt use and hedonic ratings significantly increased, indicating a period effect independent of salt type or sequence. In triangle tests, rice samples prepared with QFS, DFS, or iodized salt were not distinguishable.
Acceptability of QFS was high, based on individual hedonic ratings and weighed household salt use. Rice dishes prepared with DFS, QFS, and iodized salt were not distinguishable. Findings informed the design of a randomized trial of QFS in this population. This trial was registered at clinicaltrials.gov as NCT03853304 and CTRI/2024/04/066208.
在随机试验中，双重强化盐（DFS；铁、碘）改善了铁营养状况，并被纳入印度的社会安全网计划，这表明有机会解决其他微量营养素缺乏问题。
采用随机交叉试验设计和三角试验，评估四重强化盐（QFS；铁、碘、叶酸和维生素B）在女性及其家庭中的可接受性。
18至49岁的女性（n = 77）及其家庭被随机分配，在为期3周的时间内接受QFS或DFS，采用随机交叉设计（第1周：QFS/DFS，第2周：碘盐，第3周：DFS/QFS）。每周，参与者完成一份9分的享乐主义问卷（1 = 极其不喜欢至9 = 极其喜欢），以评估干预措施的5个感官领域（颜色、气味、味道、质地和总体可接受性），并使用数字秤称量剩余的盐。在女性中进行三角试验，以评估使用标准化食谱烹制的米饭菜肴中所食用盐的感官辨别力。使用混合模型来检验享乐主义评分和盐的使用情况；盐的类型、顺序和时间段作为固定效应纳入，家庭作为随机效应纳入。二项式检验用于评估三角试验中盐类型的感官辨别力。
5个感官领域中大多数的平均享乐主义评分≥7（中等喜欢），且不因盐的类型而异[总体可接受性平均值（标准差）：QFS：7.8（0.7），DFS：7.7（1.2）；P = 0.68]。家庭盐的使用量（称重）不因盐的类型而异。在3周的干预期内，称重的盐使用量和享乐主义评分显著增加，表明存在独立于盐的类型或顺序的时间段效应。在三角试验中，用QFS、DFS或碘盐烹制的米饭样本无法区分。
基于个体享乐主义评分和家庭盐的称重使用量，QFS的可接受性较高。用DFS、QFS和碘盐烹制的米饭菜肴无法区分。研究结果为该人群中QFS的随机试验设计提供了依据。该试验在clinicaltrials.gov上注册为NCT03853304，在CTRI上注册为CTRI/2024/04/066208。
