Double-fortified salt reduces anemia, benefit:cost ratio is modestly favorable

Iron deficiency is very widespread, with adverse consequences for health and cognition. Iron supplementation is not popular for long-term use, and cereal fortification is not feasible where milling occurs locally. Double-fortified salt (DFS: using both iron and iodine) is an alternative. The study undertakes a literature survey to find the effect of DFS on hemoglobin, and then uses a previous algorithm to make calculations for India. The benefit:cost ratio was estimated as 2.4:1 if only the benefits to children and women were included, and between 4:1 and 5:1 if anemia levels for men also decreased. This is just a little lower than the median ratio estimated for iron fortification of cereal staples (6.7:1), for home fortification for children less than two (37:1), and for biofortification - breeding for high iron - of cereals (high, but no exact figure available). Double-fortified salt is therefore a good alternative for improving iron status in populations where fortification of other staple foods does not achieve desired coverage. (C) 2011 Elsevier Ltd. All rights reserved.