• A nonrandomized controlled trial was conducted in four rural villages in southern India from July to November 2022.

• Nonpregnant, nonlactating women aged 18-45 years were enrolled and participants consumed the study salt (folate-fortified iodized) exclusively, and serum folate concentrations were measured at baseline and post-intervention.

• The results of the study are as follows:

1. Serum folate levels increased significantly post-intervention (median: 14.6 nmol/L to 54.4 nmol/L, P < .001).

2. Over 90% of participants experienced higher folate levels.

3. Study salt remained stable for eight months, maintaining iodine and folate content.

4. The study showed a 3.7-fold increase in serum folate with 300 µg folic acid daily from fortified iodized salt.

5. Folic acid fortification of iodized salt can prevent spina bifida and anencephaly by improving folate levels.

• Some of the strengths of this study were that it was conducted in remote villages that had minimal external influences and that there was a high adherence and participant retention.

• Few of the limitations of the study included a small sample size and a lack of control group. 

• Also, the study tested a single dose formulation of folic acid without exploring other various concentrations.

• The authors concluded that folic acid–fortified iodised salt presents a viable strategy for enhancing folate levels and preventing neural tube defects in high-risk populations.

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