Effect of QFS on the Microbiome in Indian Women
The objective of this study was to determine whether quintuply-fortified salt (QFS) alters the gut microbiome of non-pregnant WRA (NPWRA) after 12 months. A double-blind, randomized, controlled community-based trial was conducted among 998 NPWRA (18-49 years) in Punjab, India. Eligible participants were randomized to receive 1) QFS with iron as encapsulated ferrous fumarate, zinc, vitamin B12, folic acid, and iodine (eFF-QFS); 2) QFS with the same micronutrients, but iron as encapsulated ferric pyrophosphate plus ethylenediaminetetraacetic acid (eFePP-QFS); or 3) standard iodized salt. Stool samples were collected from a subsample of NPWRA (n= 186) at baseline and 12 months and subjected to 16S rRNA gene sequencing. Outcomes included intervention effects on alpha diversity (Shannon index and abundance-based estimator (ACE) index) assessed via linear mixed regression models, Bray-Curtis dissimilarity (beta diversity) compared via permutational multivariate analysis of variance (PERMANOVA), and relative abundance of abundance of Enterobacteriaceae, Lactobacillus, and Bifidobacterium, Prevotella or Streptococcus modeled using zero-inflated negative binomial mixed regression.