Folic acid fortification through existing fortified foods: iodized salt and vitamin A-fortified sugar

Background. Folic acid fortification of cereal-grain products has markedly improved folate status and reduced the risks of neural tube defects and other chronic diseases in the populations participating in fortification programs. To more broadly extend its benefit to affected populations in developing countries, it would seem logical to incorporate folic acid fortification into existing or planned programs to minimize the incremental cost of this intervention. Objective. To examine the feasibility of providing folic acid through ongoing programs for salt iodization and vitamin A fortification of sugar. Methods. Folic acid was added to iodized salt and vitamin A-fortified sugar by various methods direct blending as a powder, spraying onto the carriers as aqueous solution or suspension, or blending as a micro-encapsulated premix. The multiple fortified samples were subjected to a prolonged storage stability test, and the retentions of the added micronutrients were followed. Results. Folic acid was generally stable when incorporated into Guatemalan iodized salt and vitamin A-fortified sugar. Even in the presence of encapsulated ferrous fumarate as an iron fortificant, samples retained > 80% in salt and similar to 70% in sugar samples respectively, after 9 months of storage at 40 degrees C and 60% relative humidity. The addition of folic acid as a dry premix made by extrusion was most effective in retaining both folic acid and the other added micronutrients. Conclusions. The fortification method had a pronounced impact on the stability of both folic acid and the other added micronutrients. Proper encapsulation may be required to ensure the stability of multiple fortified foods.