title: Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial.
abstract: OBJECTIVE
  In many developing countries, children are at high risk for both goiter and anemia. Iron (Fe) deficiency adversely effects thyroid metabolism and reduces efficacy of iodine prophylaxis in areas of endemic goiter. The study aim was to determine if co-fortification of iodized salt with Fe would improve efficacy of the iodine in goitrous children with a high prevalence of anemia.
  
  
  METHODS
  In a 9-month, randomized, double-blind trial, 6-15 year-old children (n=377) were given iodized salt (25 microg iodine/g salt) or dual-fortified salt with iodine (25 microg iodine/g salt) and Fe (1 mg Fe/g salt, as ferrous sulfate microencapsulated with partially hydrogenated vegetable oil).
  
  
  RESULTS
  In the dual-fortified salt group, hemoglobin and Fe status improved significantly compared with the iodized salt group (P<0.05). At 40 weeks, the mean decrease in thyroid volume measured by ultrasound in the dual-fortified salt group (-38%) was twice that of the iodized salt group (-18%) (P<0.01). Compared with the iodized salt group, serum thyroxine was significantly increased (P<0.05) and the prevalence of hypothyroidism and goiter decreased (P<0.01) in the dual-fortified salt group.
  
  
  CONCLUSIONS
  Addition of encapsulated Fe to iodized salt improves the efficacy of iodine in goitrous children with a high prevalence of anemia.
authors.affiliation: The Human Nutrition Laboratory, Swiss Federal Institute of Technology, Seestrasse 72/PO Box 474, CH-8803 Rüschlikon, Switzerland. michael.zimmermann@ilw.agrl.ethz.ch
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
authors.forename: Christophe
authors.initials: C
authors.lastname: Zeder
authors.forename: Nourredine
authors.initials: N
authors.lastname: Chaouki
authors.forename: Toni
authors.initials: T
authors.lastname: Torresani
authors.forename: Amina
authors.initials: A
authors.lastname: Saad
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hurrell
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000150:complications*; D002214:Capsules; D002648:Child; D004311:Double-Blind Method; D004338:Drug Combinations; D004357:Drug Synergism; D005260:Female; D006042:Goiter / Q000150:complications* / Q000188:drug therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007455:Iodine / Q000627:therapeutic use*; D007501:Iron / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D000090463:Iron Deficiencies; D008297:Male; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use*; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000187:drug effects; D013974:Thyroxine / Q000097:blood; D014463:Ultrasonography
chemical_list: D002214:Capsules; D004338:Drug Combinations; D006454:Hemoglobins; D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine; D007501:Iron; D013974:Thyroxine