Nutrition India - Academia.edu (original) (raw)

Papers by Nutrition India

International journal of community medicine and public health/International journall of community medicine and public health, Jan 31, 2024

International Journal of Community Medicine and Public Health, Oct 30, 2023

Background: Research studies have shown that use of iron fortified iodised salt (DFS) improved Hb... more Background: Research studies have shown that use of iron fortified iodised salt (DFS) improved Hb in women, children and men. There are no publications on impact of stopping DFS on Hb levels. Methods: A community-based randomised study to assess the impact of DFS use on Hb was being carried out in Delhi. Between April-September 2020 salt could not be supplied and families were requested to purchase iodised salt (IS) from the market and use it. Blood samples from persons from these families were collected to assess impact of not using DFS for 6 months on Hb. Results: Comparison of mean Hb after 12 months use of the allocated salt and Hb after six-month use of IS by all three groups showed that: (1) there was a small reduction in Hb in all three groups after using IS for 6 months; fall was statistically significant in women in group 3; (2) women who had earlier used DFS had higher mean Hb and ferritin as compared to those who had used IS, both after 12 months of use of DFS and after 6 months of use of IS; (3) changes in ferritin varied and were not consistent. Conclusions: DFS users continued to have a higher mean Hb as compared to IS users even after discontinuing use of DFS for 6 months. The impact of this higher Hb when they restart using DFS for further 12 months has to be investigated.

IP Journal of Paediatrics and Nursing Science, Oct 14, 2023

Background: Studies on intra-family differences in nutritional status in under-five siblings repo... more Background: Studies on intra-family differences in nutritional status in under-five siblings reported that prevalence of stunting, underweight, and wasting were higher in the elder sibling. A mixed longitudinal study was taken up to document changes in anthropometric indicators with increasing age in preschool children and to assess whether the observed differences in nutritional status between the two under-five siblings were due to changes in anthropometric indices with increasing age. Materials and Methods: The study was undertaken in three groups of children from urban low middleincome families: Group A (cross-sectional data), Group B (paired data of the siblings, one in the 0-23 months and the other, in the 24-59 month age group), and Group C (first measurement in the 0-23 month age and the second measurement in the 24-59 month age in the same child). Changes in anthropometric indices and nutritional status in relation to age were computed in all three groups and compared. Results: There was an increase in stunting and underweight, and a decrease in wasting rates with increasing age in Groups A, B, and C. The trend and magnitude of change in nutritional status were similar in Groups A, B and C. Conclusion: Intra-family differences in the nutritional status of under-five siblings were due to the changes in nutritional status with increase in age. Interventions focussed on growth monitoring, early detection and effective management of growth faltering may reduce the deterioration in nutritional status with increasing age in children. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Medical research archives, Dec 31, 2022

Seven decades ago, over 80% of Indian pregnant women were anaemic. About 3/4 th of anaemia was du... more Seven decades ago, over 80% of Indian pregnant women were anaemic. About 3/4 th of anaemia was due to nutritional deficiencies of: iron (most common), folic acid (second) and vitamin B12 (not as common). Anaemia in pregnancy was associated with higher maternal morbidity and mortality, low birth weight and high perinatal mortality. Detection and appropriate management of anaemia, including parenteral iron therapy and intensive care for severe anaemia were important components of antenatal care in India, but only about 10% of women had access to antenatal care. In 1970s the national programme for anaemia in pregnancy focussed on identifying all pregnant women and providing them iron and folic acid (IFA) supplementation. The coverage and compliance with supplementation were low. In 1990 when the primary health care infrastructure was established, the anaemia control programme embarked on testing and providing appropriate treatment to anaemic women. The tertiary care centres operationalised this "test and treat" strategy. In primary and secondary care settings, accurate test for diagnosis of anaemia was not available. In the absence of accurate Hb estimation at all levels of care, it was not possible to provide appropriate treatment based on Hb levels. So, all pregnant women continued to receive one tablet of IFA throughout pregnancy. Over the next two decades, coverage under antenatal care and IFA supplementation improved but compliance with supplementation was low because about a third of pregnant women had gastrointestinal side effects with IFA. Despite these problems, between 2002 and 2015, there had been a decline in the prevalence of severe and moderate anaemia. To accelerate the decline in anaemia in pregnancy the country is focusing on the 'test and treat' strategy in pregnant women using an accurate method for Hb estimation and providing appropriate treatment. Nutrition education to improve iron intake prior to and during pregnancy, is focussing on dietary diversification and use of iron fortified salt or cereals. Progress will be monitored through national surveys and locale specific appropriate mid-course modifications in the programme will be made.

Indian Journal of Medical Research, 2015

How to prevent and manage low birth weight The easiest way to order: w w w.karger.com/nniws Growt... more How to prevent and manage low birth weight The easiest way to order: w w w.karger.com/nniws Growth and nutrition during the fetal period and the first 24 months after birth are important determinants of development in early childhood. Optimal nutrition and health care of both the mother and infant during these first 1,000 days of an infant's life are closely linked to growth, learning potential and neurodevelopment, in turn affecting long-term outcomes. Children with low birth weight do not only include premature babies, but also those with intrauterine growth restrictions who consequently have a very high risk of developing metabolic syndrome in the future. Epidemiology, epigenetic programming, the correct nutrition strategy and monitoring of outcomes are thus looked at carefully in this book. More specifically, two important nutritional issues are dealt with in depth: the first being the prevention of low birth weight, starting with the health of adolescent girls, through the prepregnancy and pregnancy stages and ending with lactation. The second point of focus concerns the nutritional follow-up and feeding opportunities in relation to dietary requirements of children with low birth weight. Contents

Annals of the National Academy of Medical Sciences. India, 2018

Introduction: Anaemia in adolescent girls has been recognised as a major public health problem. T... more Introduction: Anaemia in adolescent girls has been recognised as a major public health problem. The Midday meal programme guidelines envisage inclusion of 75 g/day of vegetables and use of iron fortified iodised salt for hot cooked meal. The National Iron Plus Initiative envisages weekly iron-folic acid (IFA) supplementation for adolescent girls; however, coverage and compliance have been reported to be low. Data from national surveys carried out in the last two decades were analysed to assess changes, if any, in Hb levels and prevalence of anaemia in adolescent girls. Material and Methods: Raw data from National Family Health Surveys (NFHS)-2,-3, and-4, District Level Household Surveys (DLHS) 2 and 4, and Annual Health Survey-related to Clinical, Anthropometric and Biochemical Components (AHS-CAB) were analysed to assess mean Hb, prevalence of anaemia and frequency distribution of Hb in adolescent girls. Comparison in these parameters was made between non-pregnant girls 10-14 years and 15-19 years of age in DLHS-2,-4 and AHS-CAB; in the 15-19 year age group comparisons were made between pregnant and nonpregnant girls in NFHS series and DLHS AHS series. Results: There were no clear and consistent changes in mean Hb, prevalence of anaemia and frequency distribution of Hb in pregnant and non-pregnant adolescent girls between NFHS-2,-3 and-4 either at national or at State level. However, there was a 0.7 and 1.3 g/dL increase in mean Hb levels in nonpregnant girls (10-19 yrs) between DLHS-2 and AHS-CAB and DLHS-4 States, respectively. The increase in mean Hb of pregnant girls (15-19 yrs) was 1.1 g/dL and 1.4g/dL in AHS-CAB and DLHS 4 States, respectively. There was significant reduction in prevalence of anaemia in both pregnant and non-pregnant girls between DLHS 2 and DLHS 4 and AHS-CAB at the aggregate level for each survey and in all States except Uttarakhand. Conclusion: There has been some improvement in Hb levels in adolescent girls in the last two decades. Improving dietary intake of vegetables and promoting use of iron fortified iodised salt in all households in the country have to be taken up so that iron intake across all age groups improves. This when combined with daily IFA supplementation for three months in a year in adolescent girls, might lead to sustained improvement in Hb.

Indian Journal of Medical Research, May 1, 2013

Indian Journal of Medical Research, Apr 1, 2006

DOAJ (DOAJ: Directory of Open Access Journals), 2015

India is home to one-sixth of the global population. When India became independent in 1947, the c... more India is home to one-sixth of the global population. When India became independent in 1947, the country was not self-sufficient in food production and did not have an appropriate food distribution system. There were pockets in the country which faced threat of famine and starvation whenever monsoon failed or staple production was low. Over three fourth of the population was poor, food insecure and suffered from chronic macro and micro nutrient deficiencies. High prevalence of infections due to poor access to safe drinking water, sanitation, overcrowded and ill ventilated housing led to loss of nutrients. Lack of access to health care facilities and poor utilization of even the available health care facilities due to low literacy and lack of awareness, prolonged the illness and increased the nutrition toll of infection. Famine and starvation hit the headlines because they were acute, localised, caused profound suffering and fatalities. Wide spread silent problem of chronic low food intake resulting in undernutrition and micronutrient deficiencies (directly or indirectly) caused more deaths than famine but these were unrecognised and not reported

PubMed, Aug 1, 1991

This article describes the efforts at early surveillance of HIV infection in India and calls for ... more This article describes the efforts at early surveillance of HIV infection in India and calls for continued sentinel surveillance. The fact that Asia was the last continent to be affected by the AIDS has granted India an opportunity to contain the epidemic at an early stage. Seizing this opportunity, the Indian Council of Medical Research (ICMR) began an national serosurveillance program for the detection of HIV infection. This surveillance program has given health officials an idea as to the magnitude and major mode to transmission of HIV while the epidemic is still at an early stage. The 1st phase of the program began on October 1985 with the screening of 3027 people from high risk groups; 10 prostitutes were found to be infected with HIV. The 1st AIDS case was detected in May 1986. That same year, ICMR moved on to phase II, a national serosurveillance and clinical surveillance designed to gather information concerning the prevalence and major mode of transmission. The 2nd phase, which ended on October 1987, screened a total of 53,907 persons. 135 HIV and 14 AIDS cases were reported, indicating a low rate of infection even among high risk groups. The 3rd phase began in November 1987 and ended on October 1988. 109,632 individuals were screened, and 387 seropositive and 11 AIDS cases were detected. In 1990, a screening drug users in the state of Manipur showed an extremely high rate of infection. Drug users now compose the 2nd largest high- risk group after promiscuous heterosexuals. The surveillance findings have resulted in intervention measures, but sustained sentinel surveillance will be needed to provide midcourse corrections for ongoing intervention programs.

Indian Journal of Medical Research, Aug 1, 2014

DOAJ (DOAJ: Directory of Open Access Journals), 2017

Adolescent health and nutrition receives low attention in developing countries because of the rel... more Adolescent health and nutrition receives low attention in developing countries because of the relatively low morbidity and mortality rates. Currently, there are over 1.2 billion adolescents and 90 per cent of them live in developing countries. It is estimated that the adolescent population will increase to 1.3 billion by 2030; of these, 500 million will be girls in the age group 10-17 yr. Nearly 16 million adolescent girls give birth every year; most of these girls live in developing countries and are married. There are ongoing efforts to improve obstetric care to these high risk pregnant adolescents. Despite this, prevalence of morbidity, obstetric problems, perinatal and maternal morbidity and mortality rates are higher in these girls. Early age at menarche, increased sexual activity in teenage, rising obesity rate and its adverse health and reproductive consequences are some of the problems in adolescent girls which need urgent attention.

PubMed, Oct 1, 2007

At the time of independence majority of Indians were poor. In spite of spending over 80 per cent ... more At the time of independence majority of Indians were poor. In spite of spending over 80 per cent of their income on food, they could not get adequate food. Living in areas of poor environmental sanitation they had high morbidity due to infections; nutrition toll due to infections was high because of poor access to health care. As a result, majority of Indians especially children were undernourished. The country initiated programmes to improve economic growth, reduce poverty, improve household food security and nutritional status of its citizens, especially women and children. India defined poverty on the basis of calorie requirement and focused its attention on providing subsidized food and essential services to people below poverty line. After a period of slow but steady economic growth, the last decade witnessed acceleration of economic growth. India is now one of the fastest growing economies in the world with gross domestic product (GDP) growth over 8 per cent. There has been a steady but slow decline in poverty; but last decade's rapid economic growth did not translate in to rapid decline in poverty. In 1970s, country became self sufficient in food production; adequate buffer stocks have been built up. Poor had access to subsidized food through the public distribution system. As a result, famines have been eliminated, though pockets of food scarcity still existed. Over the years there has been a decline in household expenditure on food due to availability of food grains at low cost but energy intake has declined except among for the poor. In spite of unaltered/declining energy intake there has been some reduction in undernutrition and increase in overnutrition in adults. This is most probably due to reduction in physical activity. Under the Integrated Child Development Services (ICDS) programme food supplements are being provided to children, pregnant and lactating women in the entire country. In spite of these, low birth weight rates are still over 30 per cent and about half the children are undernourished. While poverty and mortality rates came down by 50 per cent, fertility rate by 40 per cent, the reduction in undernutrition in children is only 20 per cent. National surveys indicate that a third of the children from high income group who have not experienced any deprivations are undernourished. The high undernutrition rates among children appears to be mainly due to high low birthweight rates, poor infant and young child feeding and caring practices. At the other end of the spectrum, surveys in school children from high income groups indicate that between 10-20 per cent are overnourished; the major factor responsible appears to be reduction in physical activity. Some aspects of the rapidly changing, complex relationship between economic status, poverty, dietary intake, nutritional and health status are explored in this review.

Indian Journal of Medical Research, 2018

Background & objectives: The prevalence of anaemia in pregnancy in India is among the highest... more Background & objectives: The prevalence of anaemia in pregnancy in India is among the highest in the world. In the last two decades, several national surveys have estimated haemoglobin levels in pregnant women. In this study, data from these surveys were analyzed to find out changes, if any, in prevalence of anaemia in pregnancy. Methods: National and State-level estimates on the prevalence of anaemia were tabulated from the reports of the National Family Health Survey (NFHS) 2, NFHS 3, Fact Sheets of NFHS 4 and District Level Household Survey (DLHS) 2. Unit level data from DLHS 4 and Annual Health Survey Clinical Anthropometric and Biochemical component (AHS CAB) were obtained and State level prevalence of different grades of anaemia was estimated. Time trends in the prevalence of anaemia and different grades of anaemia were assessed from these surveys. Results: NFHS 2, 3 and 4 reported relatively lower prevalence of anaemia as compared to DLHS and AHS CAB. There was not much change in the prevalence or severity of anaemia between NFHS 2, 3 and 4. There was substantial reduction in the prevalence and severity of anaemia in all States except Uttarakhand between DLHS 2 and 4 and DLHS 2 and AHS CAB. Interpretation & conclusions: There was a reduction in the prevalence and severity of anaemia in the last 15 years. The two-pronged strategy of increasing iron intake (dietary diversification and use of iron-fortified iodized salt) in all the population and testing, and detecting and treating pregnant women with anaemia will accelerate the pace of reduction in anaemia.

The Indian journal of nutrition and dietetics, Jun 1, 2023

Indian Journal of Obstetrics and Gynecology Research, Aug 15, 2022