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Randomized Controlled Trial
. 2017 Dec;147(12):2297-2308.
doi: 10.3945/jn.117.251587. Epub 2017 Oct 11.

Consumption of a Double-Fortified Salt Affects Perceptual, Attentional, and Mnemonic Functioning in Women in a Randomized Controlled Trial in India

Michael J Wenger  1   2 , Laura E Murray-Kolb  3 , Julie Eh Nevins  2 , Sudha Venkatramanan  2   4 , Gregory A Reinhart  5 , Annie Wesley  6 , Jere D Haas  2
Affiliations
Randomized Controlled Trial

Consumption of a Double-Fortified Salt Affects Perceptual, Attentional, and Mnemonic Functioning in Women in a Randomized Controlled Trial in India

Michael J Wenger et al. J Nutr. 2017 Dec.

Abstract

Background: Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory.Objective: The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function.Methods: Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants (n = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18-55 y.Results: Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly (P < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function.Conclusion: DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.

Keywords: cognition; fortification; iron deficiency; memory; nutritional neuroscience; perception.

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Conflict of interest statement

Author disclosures: MJW, LEM-K, JEHN, SV, and JDH, no conflicts of interest. GAR was previously affiliated with the Mathile Institute, which provided funding for this work. AW is associated with Nutrition International (formerly Micronutrient Initiative), which provided support for the study.

Figures

FIGURE 1
FIGURE 1
Study design and sample selection. Hemocue (Radiometer America, Inc.). Hb, hemoglobin; CN, control group; DFS, double-fortified salt group; sFt, serum ferritin.
FIGURE 2
FIGURE 2
Examples of the stimuli used in each of the 5 tasks (a–e). Dimensions are given in degrees of visual angle, assuming an unconstrained viewing distance of 70 cm. ANT, attentional network task; CFE, composite face effect task; CRT, cued recognition task; CTH, contrast threshold task; SRT, simple reaction time task; TTH, temporal threshold task.
See this image and copyright information in PMC

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