Randomized Trial of Quadruple Fortified Salt for Anemia and Birth Defects Prevention in Southern India

Julia Finkelstein, ScD, MPH, Cornell University (Funded 2018)

Neural tube closure defects (NTDs) are among the most common and severe adverse pregnancy outcomes in the United States and globally. Women of reproductive age are a high-risk population for anemia and micronutrient deficiencies, and there is increasing evidence of the role of periconceptional nutritional status in the risk of birth defects and other common pregnancy complications. However, there is little representative population-level data from Southern India, where the burden of micronutrient deficiencies and birth defects is among the highest in the world. Salt fortification is a promising strategy to prevent anemia and multiple micronutrient deficiencies, as it utilizes a widely consumed and affordable food and existing production and distribution systems. We propose to conduct the first randomized efficacy trial of quadruple-fortified salt (QFS) – i.e., vitamin 812, folic acid, iron, and iodine. If proven to be efficacious, QFS could represent a low-cost and sustainable strategy to target anemia and micronutrient deficiencies and improve the health of vulnerable populations including women and young children. This project will conduct the first randomized efficacy trial of quadruple-fortified salt (QFS) – i.e., vitamin 812, folic acid, iron, and iodine. If proven to be efficacious, QFS could represent a low-cost and sustainable strategy to target micronutrient deficiencies and improve the health of vulnerable populations including women and young children.