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ORIGINAL RESEARCH COMMUNICATION |
1 From the Human Nutrition Laboratory (MBZ, RW, CZ, RB, and RFH) and the Food Process Engineering Laboratory (EW), Swiss Federal Institute of Technology, Zürich, Switzerland, and the Ministry of Health, Rabat, Morocco (NC)
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 hydrogenated palm oil to package potassium iodate, micronized ferric pyrophosphate, and retinyl palmitate into microcapsules (mean particle size: 100 µm). We used the microcapsules to create triple-fortified salt (TFS) with 30 µg I, 2 mg Fe, and 60 µg 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 schoolchildren (n = 157) who had a high prevalence of vitamin A deficiency 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 deficiency 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.
Key Words: Iodine • iron • vitamin A • deficiency • triple fortification • salt • anemia • goiter • children • Morocco
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