When Levente Diosady was tasked two decades ago with finding a way to add iron into the diets of people in developing countries and save millions of lives, he took it with a grain of salt — literally.

Diosady, a food engineering professor at the University of Toronto, found a way to add iron to table salt but it took a lot longer than he thought.

"A couple of experiments turned into 20 years of lab work," Diosady told CBC Toronto.

Now, the condiment dubbed "double-fortified salt" is delivering health benefits to more than 24 million people in India's state of Uttar Pradesh, where anemia is particularly rampant.

According to the World Health Organization, iron deficiency anemia is the most widespread nutritional disorder in the world. Poor pregnancy outcome, impaired physical and cognitive development, increased risk of death in children and reduced work productivity in adults are possible consequences. 

Indian women and children

In developing countries every second pregnant woman and about 40 per cent of preschool children are estimated to be anemic, according to the World Health Organization. (Micronutrient Initiative)

The Uttar Pradesh state government is spending more than $40 million to purchase the salt and make it available to low income consumers.  

Tata Trusts, India's largest charitable foundation, and the Bill and Melinda Gates Foundation have also become recent backers.

When Diosady's research team first started, they were producing 100 grams at a time in the lab.The salt is now being manufactured in India and the first order from Uttar Pradesh for the month of January 2017 alone is for 6,000 tonnes.

India iron deficiency

According to the World Health Organization, iron deficiency anemia is aggravated by worm infections, malaria and other infectious diseases such as HIV and tuberculosis. (Micronutrient Initiative)

Saving lives with salt

More than 50 per cent of women in India are iron deficient, and there are more than 200,000 maternal deaths each year, Diosady explained.

"When they have blood loss during child birth, it becomes fatal," he said.

He added more than one million children die in India each year due to nutrient-related deficiencies.

Diosady began testing the efficacy of his creation during a pilot project in 2004 in the Indian state of Tamil Nadu, where the government supplies impoverished school children with one hot meal each day.

Regular salt was replaced with double-fortified salt in the lunches of more than three million children, 85 per cent of whom were anemic.

"In eight months, we cured a million kids from anemia," Diosady said. "At the end, only 50 per cent were anemic."

Double fortified salt

It took years for the research team at the University of Toronto to make iron-fortified salt look and taste like normal table salt. (Laura DaSilva/CBC )

Affordability is key

The project was run in conjunction with the Ottawa-based non-profit Micronutrient Initiative, which is mandated to give vulnerable populations around the world access to the nutrients they need to survive and thrive.

The organizations. vice president of programs and technical services, Mark Fryars, said there was a ripple effect in the children. "It also helped them do things like concentrate better in school."

He said research is being done now on how to bring the cost of double-fortified salt down.

"It's got to fit in with markets and affordability," he said. "How can you make this work, not just for a village, but for a million villages?"

U of T fortified salt

University of Toronto engineering students Kiruba Krishnaswamy (left) and Saheh Sinichi are researching ways to fortify salt with micronutrients.

'I probably cured more people than my doctor did'

Developing the salt was no simple task.

When Diosady combined iron and iodine, the iodine evaporated away.

"We had to come up with technology that would allow the two to coexist," he said.  

His team came up with a way of encapsulating the iron — essentially putting each iron molecule into its own tiny bubble so the two wouldn't touch — and double-fortified salt (DTS) was born.

Finding the right taste and colour took years of trial and error.

But, if you ask Diosady, it was all worth it.

"It's a fabulous thing to say, as an engineer, that I probably cured more people than my doctor did," he said.

His team is now looking at ways to fortify salt with folic acid, vitamin B12 and zinc.