Improving the Iron Status of School Children Through a School Noon Meal Programme with Meals Prepared Using a Multiple Micronutrient-Fortified Salt in Tamil Nadu, India.

BACKGROUND AND OBJECTIVES:To improve the iron status of school children through noon meals prepared using a multiple micronutrient-fortified salt.METHODS AND STUDY DESIGN:Children from a randomly selected school who consumed (intervention) and did not consume (reference) a noon meal prepared using a multiple micronutrient- fortified salt were studied over 1 year. A pre-post-test design for children aged 5-17years in reference (n=100) and intervention (n=128) groups was used. Levels of serum ferritin, soluble transferrin receptor (sTfR), alpha glycoprotein (AGP), and C-reactive protein (CRP) were assessed at baseline and at 1 year. In a subsample, urinary iodine was assessed.RESULTS:sTfR decreased in the intervention group (-0.80 mg/L) but increased in the reference group (0.47 mg/L) at 1 year (p=0.0001).Body iron stores (BIS) increased in the intervention group (0.09 mg/kg body weight) and decreased (-0.58 mg/kg body weight) in the reference group at 1 year (p=0.028).These findings indicate an increase in iron deficiency in the reference group and a decrease in the intervention group. However, no changes in serum ferritin and urinary iodine were observed in either group or between groups.CONCLUSIONS:Iron status can be improved in schoolchildren in Tamil Nadu by increasing the amount of micronutrients in the fortified salt used for preparing noon-time school meals.