P Moitra | SNDT WOMENS UNIVERSITY (original) (raw)
Papers by P Moitra
Diabetes Research and Clinical Practice
BMC Public Health
Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food en... more Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions. Methods A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factor...
Proceedings of the Nutrition Society, 2022
The growing interest in the potential of nutrigenomics and personalized nutrition to prevent, mit... more The growing interest in the potential of nutrigenomics and personalized nutrition to prevent, mitigate and manage chronic diseases necessitates a better understanding of nutrient-gene interactions among dietetic professionals. Information regarding the knowledge and attitudes of dietitians regarding nutrigenomics is, in general, limited and little is known about the perceived barriers, willingness to learn, and confidence to practice personalized nutrition (PN) among dietetic professionals in India. To our knowledge, there are no studies that have developed and evaluated the validity and reliability of questionnaires assessing the knowledge, attitudes, and behaviours related to nutrigenomics and personalized nutrition in India. Therefore, this study was conducted to test the psychometric properties of a novel instrument measuring knowledge and attitudes of dietetic professionals towards personalized nutrition and nutrigenomics in India. Extensive review of the literature followed by...
BMC Public Health, 2021
Background Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep qual... more Background Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10–15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. Methods Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI...
International Journal Of Community Medicine And Public Health, 2020
Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promot... more Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promote adequate activity levels. Prior studies have assessed the factors that influence food choices and activity among children, however, these perspectives may vary considerably across communities, cultures and social environments. Knowledge regarding determinants of diet and activity related behaviors among children in India is lacking; understanding these influences will help to develop appropriate interventions. This qualitative study employed the tenets of the health belief model to identify barriers and facilitators of healthy eating and physical activity levels in children in Mumbai, India.Methods: Fourteen focus group discussions were conducted with children, parents and teachers, selected from three aided and three private schools in Mumbai. The transcripts were coded and analyzed using the scissor and sort method to derive common themes as per the protocol questions.Results: The di...
Online survey administered among 10-15 years old adolescents to investigate the extent of screen ... more Online survey administered among 10-15 years old adolescents to investigate the extent of screen usage, screen time during the COVID 19 pandemic and their associations with eating habits, snacking patterns, physical activity levels, sleep duration, sleep quality and depression symptoms.
BMC Public Health, 2021
Background: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep qua... more Background: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to cooccur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. Methods: Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. Results: The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. Conclusions: The results indicated a coexistence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.
Proceedings of the Nutrition Society
Globally, an increasing prevalence of obesity and depression among adolescents has generated inte... more Globally, an increasing prevalence of obesity and depression among adolescents has generated interest in understanding the association between these conditions (1,2). Diet is a cornerstone strategy for the prevention of obesity and there is emerging evidence that unhealthy eating behaviours and nutritional inadequacies might exacerbate the duration and severity of depression (3,4). This crosssectional study was conducted to examine the association of eating behaviours with depression, anxiety, and stress symptoms in 10-15 years old overweight adolescents in Mumbai, India. Selection of adolescents attending grades 5 to 9 was done from four private and three government schools using a purposive sampling method. Adolescents ((n = 516) provided socio-demographic information and completed the 21 item Depression Anxiety Stress Scale (DASS-21) questionnaire for anxiety and depression symptoms. Three interviewer-administered 24h diet recalls were conducted to estimate nutrient intakes and a validated food frequency questionnaire (FFQ) evaluated the snacking patterns in a subsample (n = 242). Weight, height, and waist and hip circumferences were measured using standard procedures and sex specific body mass index (BMI) for age z scores helped classify the body weight status. Descriptive statistics and binary logistic regression analyses were performed to estimate the prevalence and predictors of anxiety and depression symptoms in overweight/ obese adolescents. Adolescents' mean age was 13.1(1.8) years, 54.3% were girls and 21.6% and 13.2% were overweight and obese respectively. Overall, a higher prevalence of obesity was observed in younger (10-12 years) and private school adolescents (p < 0.05). A significantly higher anxiety and stress scores but not of depression were observed in girls. Among overweight adolescents, 38.8% reported mild to moderate depression, 57.5% had anxiety, and 43.8% experienced stress symptoms. Moreover, adolescents having lower mean intakes of protein, fats, vitamin B 12, Vitamin C, iron and zinc reported significantly higher depression scores. Regression analyses indicated that being overweight was associated with a 2.35 fold increase in odds of having anxiety (95% CI 2.03-2.61, p <0.001) and 1.78 fold increase in depression (95% CI = 1.54-1.92, p 0.032). Attending private schools was associated with higher anxiety scores and a greater frequency of healthy eating behaviours such as breakfast, fruit, and nut consumption predicted decreased odds of having depression in adolescents. In this study, a substantial proportion of overweight adolescents experienced depression, anxiety, and stress symptoms. Several eating behaviours emerged as predictors of depression risk, suggesting a critical role that diet might play in mediating obesity and depression in adolescents. Future prospective studies are warranted to assert any causal relationships and to guide appropriate interventions.
Indian Journal of Public Health Research & Development
International Journal of Community Medicine and Public Health, 2020
Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promot... more Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promote adequate activity levels. Prior studies have assessed the factors that influence food choices and activity among children, however, these perspectives may vary considerably across communities, cultures and social environments. Knowledge regarding determinants of diet and activity related behaviors among children in India is lacking; understanding these influences will help to develop appropriate interventions. This qualitative study employed the tenets of Health Belief Model to identify barriers to and facilitators of healthy eating and physical activity levels in children in Mumbai, India. Methods: Fourteen focus group discussions were conducted with children, parents and teachers, selected from three aided and three private schools in Mumbai. The transcripts were coded and analyzed using the scissor and sort method to derive common themes as per the protocol questions. Results: The discussions revealed four main themes, namely a) knowledge regarding non communicable diseases and physical activity guidelines, b) perceived susceptibility and severity of consequences of unhealthy behaviors, c) socio-environmental factors such as availability and accessibility of foods at school and home, facilities for sports and peer support and d) individual determinants that shape choices such as time, academic pressure, convenience and will power. Variety in canteen menus, ‘fun’ outdoor activities, daily screen time monitoring and parent role modeling emerged as key facilitators. Conclusion: The results reiterated a need to improve parents’ nutrition knowledge, enforce strict school food sale policies and generate interest and motivation among children through targeted behavior change communication strategies.
Diabetes Research and Clinical Practice
BMC Public Health
Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food en... more Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions. Methods A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factor...
Proceedings of the Nutrition Society, 2022
The growing interest in the potential of nutrigenomics and personalized nutrition to prevent, mit... more The growing interest in the potential of nutrigenomics and personalized nutrition to prevent, mitigate and manage chronic diseases necessitates a better understanding of nutrient-gene interactions among dietetic professionals. Information regarding the knowledge and attitudes of dietitians regarding nutrigenomics is, in general, limited and little is known about the perceived barriers, willingness to learn, and confidence to practice personalized nutrition (PN) among dietetic professionals in India. To our knowledge, there are no studies that have developed and evaluated the validity and reliability of questionnaires assessing the knowledge, attitudes, and behaviours related to nutrigenomics and personalized nutrition in India. Therefore, this study was conducted to test the psychometric properties of a novel instrument measuring knowledge and attitudes of dietetic professionals towards personalized nutrition and nutrigenomics in India. Extensive review of the literature followed by...
BMC Public Health, 2021
Background Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep qual... more Background Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10–15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. Methods Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI...
International Journal Of Community Medicine And Public Health, 2020
Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promot... more Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promote adequate activity levels. Prior studies have assessed the factors that influence food choices and activity among children, however, these perspectives may vary considerably across communities, cultures and social environments. Knowledge regarding determinants of diet and activity related behaviors among children in India is lacking; understanding these influences will help to develop appropriate interventions. This qualitative study employed the tenets of the health belief model to identify barriers and facilitators of healthy eating and physical activity levels in children in Mumbai, India.Methods: Fourteen focus group discussions were conducted with children, parents and teachers, selected from three aided and three private schools in Mumbai. The transcripts were coded and analyzed using the scissor and sort method to derive common themes as per the protocol questions.Results: The di...
Online survey administered among 10-15 years old adolescents to investigate the extent of screen ... more Online survey administered among 10-15 years old adolescents to investigate the extent of screen usage, screen time during the COVID 19 pandemic and their associations with eating habits, snacking patterns, physical activity levels, sleep duration, sleep quality and depression symptoms.
BMC Public Health, 2021
Background: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep qua... more Background: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to cooccur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. Methods: Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. Results: The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. Conclusions: The results indicated a coexistence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.
Proceedings of the Nutrition Society
Globally, an increasing prevalence of obesity and depression among adolescents has generated inte... more Globally, an increasing prevalence of obesity and depression among adolescents has generated interest in understanding the association between these conditions (1,2). Diet is a cornerstone strategy for the prevention of obesity and there is emerging evidence that unhealthy eating behaviours and nutritional inadequacies might exacerbate the duration and severity of depression (3,4). This crosssectional study was conducted to examine the association of eating behaviours with depression, anxiety, and stress symptoms in 10-15 years old overweight adolescents in Mumbai, India. Selection of adolescents attending grades 5 to 9 was done from four private and three government schools using a purposive sampling method. Adolescents ((n = 516) provided socio-demographic information and completed the 21 item Depression Anxiety Stress Scale (DASS-21) questionnaire for anxiety and depression symptoms. Three interviewer-administered 24h diet recalls were conducted to estimate nutrient intakes and a validated food frequency questionnaire (FFQ) evaluated the snacking patterns in a subsample (n = 242). Weight, height, and waist and hip circumferences were measured using standard procedures and sex specific body mass index (BMI) for age z scores helped classify the body weight status. Descriptive statistics and binary logistic regression analyses were performed to estimate the prevalence and predictors of anxiety and depression symptoms in overweight/ obese adolescents. Adolescents' mean age was 13.1(1.8) years, 54.3% were girls and 21.6% and 13.2% were overweight and obese respectively. Overall, a higher prevalence of obesity was observed in younger (10-12 years) and private school adolescents (p < 0.05). A significantly higher anxiety and stress scores but not of depression were observed in girls. Among overweight adolescents, 38.8% reported mild to moderate depression, 57.5% had anxiety, and 43.8% experienced stress symptoms. Moreover, adolescents having lower mean intakes of protein, fats, vitamin B 12, Vitamin C, iron and zinc reported significantly higher depression scores. Regression analyses indicated that being overweight was associated with a 2.35 fold increase in odds of having anxiety (95% CI 2.03-2.61, p <0.001) and 1.78 fold increase in depression (95% CI = 1.54-1.92, p 0.032). Attending private schools was associated with higher anxiety scores and a greater frequency of healthy eating behaviours such as breakfast, fruit, and nut consumption predicted decreased odds of having depression in adolescents. In this study, a substantial proportion of overweight adolescents experienced depression, anxiety, and stress symptoms. Several eating behaviours emerged as predictors of depression risk, suggesting a critical role that diet might play in mediating obesity and depression in adolescents. Future prospective studies are warranted to assert any causal relationships and to guide appropriate interventions.
Indian Journal of Public Health Research & Development
International Journal of Community Medicine and Public Health, 2020
Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promot... more Background: Childhood offers a critical opportunity to inculcate healthy eating habits and promote adequate activity levels. Prior studies have assessed the factors that influence food choices and activity among children, however, these perspectives may vary considerably across communities, cultures and social environments. Knowledge regarding determinants of diet and activity related behaviors among children in India is lacking; understanding these influences will help to develop appropriate interventions. This qualitative study employed the tenets of Health Belief Model to identify barriers to and facilitators of healthy eating and physical activity levels in children in Mumbai, India. Methods: Fourteen focus group discussions were conducted with children, parents and teachers, selected from three aided and three private schools in Mumbai. The transcripts were coded and analyzed using the scissor and sort method to derive common themes as per the protocol questions. Results: The discussions revealed four main themes, namely a) knowledge regarding non communicable diseases and physical activity guidelines, b) perceived susceptibility and severity of consequences of unhealthy behaviors, c) socio-environmental factors such as availability and accessibility of foods at school and home, facilities for sports and peer support and d) individual determinants that shape choices such as time, academic pressure, convenience and will power. Variety in canteen menus, ‘fun’ outdoor activities, daily screen time monitoring and parent role modeling emerged as key facilitators. Conclusion: The results reiterated a need to improve parents’ nutrition knowledge, enforce strict school food sale policies and generate interest and motivation among children through targeted behavior change communication strategies.