Skip to main content
NUTRITION 2025 Main banner

Global Nutrition (Oral Session 1)

(OR01-01-25) Encapsulated Ferrous Fumarate Double Fortified Salt Improves Iron Status and Reduces Iron Deficiency Anemia in Women of Reproductive Age in Madhya Pradesh, India

Saturday, May 31, 2025
10:00 AM – 10:12 AM ET
Location: S220 E-G
Emerging Leaders in Nutrition Science Poster Competition Student Interest Group (SIG) Three-Minute Thesis (3MT) Competition
Objectives: This study examined the effect of introducing encapsulated ferrous fumarate double fortified salt (EFF-DFS) at the community level on iron status and the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in women of reproductive age (WRA).  

Methods: The study was conducted across 10 districts in Madhya Pradesh, India, covering urban, rural and tribal areas and representing a wide geographic and demographic spectrum. A total of 10,467 women, 15-49 years, were sampled. A quasi-experimental design was utilized wherein pre- and post-intervention measurements were taken to analyze the effects of introducing EFF-DFS (five intervention districts) compared to no EFF-DFS (five comparison districts). The baseline evaluation was conducted shortly after the introduction of EFF-DFS in 2018, and the endline evaluation was carried out in 2021. Primary outcomes were the prevalence of anemia, ID, and IDA based on hemoglobin and serum ferritin levels. Secondary outcomes included acceptance and usage of EFF-DFS, assessed via household surveys and product purchase records.

Results: Anemia prevalence was high (60.7%) in WRA, with much of it due to factors other than ID. A differential change occurred in the prevalence of anemia (intervention: 65% to 60.9%; comparison: 58.1% to 58.7%; –0.045; CI: -0.08, -0.01) and IDA (intervention: 13% to 7%; comparison: 17% to 16%; –0.03; CI: -0.06, -0.01) between women in the intervention vs comparison districts, resulting in not only a decrease in prevalence of anemia but also a significant shift from more severe to less severe forms of anemia in those who received DFS versus those who did not, suggesting the propitious effect of DFS on people who are already at risk. Acceptance of EFF-DFS increased over time, and purchase and consumption of EFF-DFS were associated with a lower risk of ID and IDA.

Conclusions: EFF-DFS, introduced at the community level, is an effective approach for improving iron status in WRA. The high prevalence of non-iron deficiency anemia and ways to treat it in this population should be further explored.

Funding Sources: The Government of Canada through Global Affairs Canada and Bill and Melinda Gates Foundation.