Folic acid-fortified iodised salt and blood folate in Indian women
What it found
In 83 women of reproductive age in rural India, eating salt fortified with folic acid and iodine for 4 months raised median blood folate levels about 3.7 times.
The study was done in people.
What they found
Studies in people
Folate levels rose
The median serum folate went from 14.6 nmol/L at the start to 54.4 nmol/L after 4 months, a 3.7-fold increase. The authors say this difference was highly significant.
Most women improved
More than 90% of the women had higher serum folate at the end of the study. One woman stayed the same, and 6 women had a decrease.
Test ceiling reached
The lab test could only measure folate up to 54.4 nmol/L. At the start, 3 women (3.6%) were at that ceiling; by the end, 48 women (57.8%) were.
Salt well accepted
The women found the study salt acceptable in colour and taste. Four minor health complaints (headache, fever, stomach pain) were judged unrelated to the salt.
Other findings
Salt stayed stable
The study salt kept its iodine and folic acid levels for 8 months when stored at room temperature in the community.
What the authors conclude
“This nonrandomized controlled trial provides novel evidence that folic acid–fortified iodized salt consumption increases serum folate levels among women of reproductive age with the potential to prevent SBA in their offspring.”
Also in their conclusions
- They conclude that using folic acid-fortified iodized salt was associated with increased serum folate concentrations in women of reproductive age.
- They say this novel evidence can inform public health policy to accelerate SBA prevention.
- They suggest that folic acid-fortified iodized salt offers an opportunity for policy makers in India and other countries to consider effective folic acid fortification programs.
How it was done
India has a high number of babies born with spina bifida and anencephaly, and many women do not take folic acid supplements early enough in pregnancy. The authors wanted to see if salt fortified with folic acid and iodine could raise folate levels in women who might become pregnant.
They studied 83 nonpregnant, nonlactating women aged 20 to 44 in 4 rural villages in Southern India. The women used double-fortified salt (folic acid plus iodine) exclusively for 4 months, aiming for about 300 µg of folic acid a day, and gave blood samples before and after.
What it can’t tell you
- The study did not have a control group that used salt without folic acid, so it cannot prove that the salt alone caused the folate increase.
- The findings come from 4 villages and 83 women, so they may not apply to all women in India or elsewhere.
- The study did not measure whether the women had fewer babies with spina bifida or anencephaly.
Who paid
- Conflicts
- Conflict of Interest Disclosures: None reported.
- Authors work at
- University of Central Florida College of Medicine, Orlando; King George Hospital at Andhra Medical College, India; Rangaraya Medical College, India
The paper
- Title
- Folic Acid-Fortified Iodized Salt and Serum Folate Levels in Reproductive-Aged Women of Rural India: A Nonrandomized Controlled Trial
- Type
- Clinical trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Pattisapu JV, Manda VV, Kottakki MNR, et al (2024). Folic Acid-Fortified Iodized Salt and Serum Folate Levels in Reproductive-Aged Women of Rural India: A Nonrandomized Controlled Trial. JAMA network open. doi:10.1001/jamanetworkopen.2024.1777Free full textPubMed 38457177DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error