Double fortified salt and deworming”- game changers in the battle against iodine and iron malnutrition in Indian school children

Abstract

Background Controlling malnutrition among school children has been a priority issue of current nutrition strategies in India. However, meeting majority of the MDGs by controlling micronutrient deficiencies among school children demands attention and intense efforts by the country. Various state governments have implemented different strategies in school health programs, but the results are not very promising. Thus as an universal strategy, double fortified salt (DFS) can be implemented as a measure to combat deficiencies of two micronutrients. Aims and Objectives to assess impact of NIN-DFS supplementation on micronutrient status (iron and iodine) of rural school children with deworming and NHE. Methods and materials School children (N=947) (6-15 years) from rural villages of Vadodara, Gujarat were randomly selected and were assigned into 4 case control groups using DFS and deworming as intervention strategies. Results After 9 months of intervention, median UIC improved significantly (p<0.001) in both the groups and the prevalence of iodine deficiency decreased significantly (p<0.001). Mean Hb improved (+0.60 g/dl) significantly (p<0.001) among supplemented group (DFS+DW) compared to decrease (-0.54 g/dl) among control group (DW). IQ/cognition scores also improved significantly among experimental groups (p<0.01, Memory and draw-a-man test scores) compared to control groups. However, NHE provided to the parents of the school children, helped to meet major proportion of RDA of the children. The micronutrient status of the children was observed to improve significantly, who were benefited by multiple approaches. Conclusion DFS production and consumption should be promoted as universal strategy at policy level and multiple strategies should be used to benefit the targeted population in simple and most effective manner.