330 Salt Can Deliver Folic Acid to Prevent Spina Bifida

INTRODUCTION: Thirty years after folic acid (FA) was shown to be effective in reducing spina bifida and anencephaly (SBA) prevalence, only 25% of such births are prevented globally. A public health intervention of adding FA to iodized salt can potentially increase blood folate levels in women of reproductive age and prevent SBA. METHODS: All households in four rural Indian villages agreed to consume FA-fortified iodized salt (study salt) in a pre- and post-intervention study. Pre- and post-intervention serum folate levels were analyzed from 83 eligible participants. A pre- and post-intervention study was done after consumption of approximately 300 mcg of FA daily using double fortified salt (FA + Iodine). We assessed the differences in median serum folate concentrations at baseline and 4 months. RESULTS: The median serum folate concentration increased from 14.6 nmol/L at baseline to 54.4 nmol/L at end of study. Two-tailed Wilcoxon Signed Rank Test showed the difference to be highly significant (p-value = 1.8 × 10-14). The villagers found the salt acceptable in color, taste and cooking properties. No untoward effects related to the study salt were noted. CONCLUSIONS: FA-fortified iodized salt rapidly increases serum folate concentrations in women of reproductive age. This intervention can accelerate birth defects prevention in countries using iodized salt where uniform FA fortification of cereal grains is not feasible.