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Background: Nutrient deficiency after malabsorptive bariatric procedure is a common phenomenon. The study aims to determine the prevalence of nutritional insufficiencies (specific with Ascorbic acid, Cobalamin, calciferol and calcium) in obese population opting for One Ananstomosis Gastric Bypass surgery (OAGB), and also to understand the association of these nutrients with change in Body Mass Index (BMI) after the surgery. Methods: One hundred fifty subjects comprising males and females aged 20-60 years were randomly selected at a bariatric center in India. Subjects belonged to both grade III and grade II obesity. Plasma aa, serum vitB12, serum VitD3 and serum calcium concentrations were prospectively assessed at 0m, 3m, and 6m of surgery through high-performance liquid chromatography. Result: The values of nutrients beyond the standard levels are considered as deficiency. Both follow up values showed a significant increase in cobalamin, Calciferol, and ascorbic acid levels compared to baseline data. Conclusion: Nutrition depletion and deficiency are often seen in post bariatric cases. The contributing factors included high BMI, food intolerance, and non-adherence to supplements and correct dietary regimens. With the correction of weight and comorbidities, the levels also showed a stable and positive level. [ABSTRACT FROM AUTHOR]

Nature has been a great source of therapeutic compounds. The use of plants and plant-derived products as medicine has been a popular tradition as the beginning of human civilization. Plants are considered as the richest source of traditional and modern medications as well as food supplements, pharmaceutical intermediates and chemical entities for synthetic drugs. Among them, Azadirachta indica is one of the most versatile, multitudinous tree having immense potentials. Since Vedic times, it has been known as the multi-directional therapeutic uses in India. It is economically cheaper and safe and its different parts such as leaves, flowers, bark, fruits, gum, seeds, oil possesses great medicinal properties. The aim of this review is to assemble all the information regarding the distribution, botanical description, commercial and medicinal values of Azadirachta indica. This paper is fully based on secondary data. Information was gathered from about 28 published articles from various online portals and these gathered information is analyzed and presented well here in this paper. Azadirachta indica is commonly known as ‘Neem’ which is regarded beneficial to humans and animals. Different parts of neem has been used for treating various diseases such as cancer, Dental diseases, stress, ulcers, heart diseases, malaria, skin diseases, viral diseases, AIDS, oral diseases, sexually transmitted diseases, etc. Chemically diverse and structurally complex phytochemical constituents such as azadirachtin, nimbolinin, nimbidin, gedunin, nimbidol, Quercedin, gallic acid, glycoside, amino-acid, ascorbic acid, salannin and many others are found in Azadirachta indica which show anti-diabetic, antiviral, anti-oxidant, anti-microbial, anti-parasitic, anti-malarial, anti-cancer, anti-ulcer, hepatoprotective and gastro-protective activities. Thus, more attention must be given for the production of this plant. [ABSTRACT FROM AUTHOR]

Background: By encouraging treatment adherence and lowering mortality, dietary supplements can serve as adjuvant therapy for the success of medical interventions. We determined the effect of locally accessible food supplements on treatment outcomes, and health-related quality of life in patients with pulmonary tuberculosis initiating anti-tuberculosis treatment (ATT) in Odisha, India. Method: Between September 2017 and December 2018, implementation research in patients with newly diagnosed sputum smear-positive pulmonary tuberculosis initiating ATT in five districts of the tribal belt of Odisha, offered food supplements along with ATT in a phased manner. Clinical symptoms, anthropometry, sputum for M. tuberculosis (M. tb), health-related quality of life and return to normal function were assessed periodically, and favourable treatment outcome (cure or treatment completed) was measured at the end of treatment. The effect of the food supplement on unfavorable outcomes (treatment failure, death, or lost-to-follow-up) was modelled using mixed-effects Poisson regression to determine the risk factors. Results: Among the 761 participants enrolled, 614 participants received the food supplement and 147 did not receive the food supplement. Among the 614 participants in the supplement group, 537 (87%) had a favorable outcome and among the 147 participants in the no-supplement group, 113 (77%) had a favorable outcome (p = 0.0017). Higher age (>55 years) [aRR = 2.1(95% CI: 1.1–3.8)], male gender [aRR = 1.7(95% CI: 1.2–2.9)], and smear grading ≥2+ [aRR = 1.5 (95% CI: 1.1–2.2)] were associated with unfavorable treatment outcomes. Nutritional status, quality of life and lung health showed significant improvement from baseline in the supplement group. Conclusion: Improvement in the nutritional status of the patient can be considered a predictor of treatment success rates. Early food supplementation has a positive impact on the nutritional status. [ABSTRACT FROM AUTHOR]

High prevalence of anaemia is a severe public health problem in India. In 2018, India launched the Anemia Mukt Bharat (AMB) strategy that focuses on six beneficiary groups for coverage, six institutional mechanisms for health system strengthening and six programmatic interventions to accelerate reductions in anaemia prevalence. This paper uses the Health Management Information System data (2017-18 to 2019-20) to examine gains in IFA coverage across Indian states. A coverage-based AMB index is computed to review performance across states. After the launch of AMB strategy, the Iron and Folic Acid (IFA) supplementation coverage between 2017-18 and 2019-20 has increased for all beneficiary groups [pregnant women from 78% to 90%; lactating mothers from 34% to 49%; school going adolescent girls (boys) from 23% to 40% (21% to 42%); out-of-school adolescent girls from 6% to 23%; children 5-9 years from 8% to 3% and children 6-59 months from 7% to 15%]. Coverage was relatively low for target groups being served through a multi-departmental convergence mechanism (health and other departments such as education department for schools or women and child development department for Anganwadi centres) than compared to those served by health department alone. However, no major gender disparities are noted in the coverage of IFA supplementation among school-going girls and boys. Bulk of the variations in coverage is attributable to state-specific differences. Training and sensitization workshops for state and district officials are found to be associated with increased coverage across beneficiary groups. The paper argues that despite following international best practices in the field, it is important to harness synergy in programme implementation across line departments to eliminate coverage inefficiencies. [ABSTRACT FROM AUTHOR]

There are a plethora of plant species in India, which have been widely used in vegetable dishes, soups, desserts and herbal medicine. In addition to these traditional uses, today there is the extra possibility of also being able to use these plants in the nutritional supplements industry due to their favorable antioxidant and mineral composition. In this sense, thirteen vegetable species—Chanania lanzan, Ziziphus mauritiana, Nilumbo nucifera, Terminalia catappa, Terminalia arjuna, Terminalia bellirica, Terminalia chebula, Lagenaria siceraria, Luffa aegyptiaca, Praecitrullus fistulosus, Benincasa hispida, Citrullus lanatus var. lanatus and Cucurbita maxima—have been analyzed. In this paper we discuss the distribution of polyphenols and minerals (Na, K, Mg, Ca, Al, P, S, Cr, Mn, Fe, Cu, Zn, Mo, As and Pb) in different seed parts (the rhizome, pericarp, carpel, seed coat and kernel) of the above species and their possible use in the nutritional supplements industry. The concentrations of total polyphenols, flavonoids and minerals ranged from 407 to 3144 mg rutin hydrate/100 g, 24 to 3070 mg quercetin/100 g and 1433 to 7928 mg/100 g, respectively. K, Ca, P and S were abundant in these herbal fruits. In two species of herbal fruits, Terminalia arjuna and Terminalia chebula, only part of the seed structure was suitable for use in nutritional supplements. [ABSTRACT FROM AUTHOR]

In the holy Ramayana, a “magical herb” called “Sanjeevani Booti” or “Life-giving herb” which is found in Indian Himalayas has been mentioned. Sea buckthorn (Hippophae spp. L.) is popular as Sanjeevani of the Cold Desert of India. It is known for its magnificent effects from ancient times. It was believed that this magical herb has unique properties for all known and unknown ailments. Every part of the plant including fruit, flowers, leaf, twig, roots and thorns is traditionally used by the communities of the cold arid zone as medicine, nutritional supplement, fuel and fence. Therefore, it is important to explore more and more about this wonder herb mentioned in the Ramayana. In the present paper, an effort has been made to explore the sea buckthorn which is an ecologically and commercially significant actinorhizal plant. Its habitat, distribution, and economic benefits to society, as it contains a range of secondary metabolites such as alkaloids, flavonoids etc., have been discussed in this paper. [ABSTRACT FROM AUTHOR]

Background: Micronutrient deficiency has long been recognized as a public health problem, particularly among vulnerable groups such as children, adolescents, pregnant and lactating women. Micronutrient deficiency could not be ruled out in spite of the implementation of various intervention strategies. Different interventions are being used to prevent and treat micronutrient deficiencies at the national and global level. The aim of this study is to systematically review the intervention strategies among different vulnerable age groups in India. Methods: The review was focused on identifying various interventions published based on the internet databases and the peer-reviewed papers from 2011 to 2021, on the predefined inclusive/exclusive criteria. The major intervention strategies implemented in India were recognized and evaluated based on dietary supplementation, micronutrient supplementation, knowledge interventions and food fortification among various age groups. Results: The results show that there are still considerable gaps in identifying the effective intervention strategies, research initiatives, programs and policies addressing to tackle micronutrient deficiencies in India. Multiple interventions are effective that could lead the road to innovations in approaches with diverse dietary intake, developing multiple micronutrient supplements, fortifying foods and nutrition interventions to address calcium, zinc, iodine, vitamin D and vitamin A deficiencies among the vulnerable population. Conclusion: Evidence-based multiple intervention studies covering a large population, in the long term cross-sectional, is the need for the hour to design policies and programs for improving the micronutrient status of vulnerable population in the community. [ABSTRACT FROM AUTHOR]

Background: More than half of women of reproductive age in India have anemia. Over the last decade, India has made some progress towards reducing anemia in pregnant women, but non-pregnant women, who make up the largest sub group of people with anemia, are largely disregarded., Objectives: The objective of this paper is to examine intentions to take iron supplements and factors associated with intentions to inform a social norms-based behavioral intervention to increase uptake of iron supplements and reduce anemia in Odisha, India., Methods: We collected data from 3,914 randomly sampled non-pregnant women of reproductive age in 81 villages. We conducted a survey and took hemocue (anemia level) readings from each participant. We analyzed data using linear regression models beginning with demographics and social norms and adding other factors such as self-efficacy to take iron supplements, anemia risk perception, and knowledge about anemia in a subsequent model., Results: 63% of women in our sample were anemic but less than 5% knew they were anemic. Despite national guidelines that all women of reproductive age should take weekly iron supplements to prevent anemia, less than 3% of women in our sample were currently taking them. While actual use was low, intentions were rather high. On a five point Likert scale where higher numbers meant more intentions to take supplements, average intentions were above the midpoint (M = 3.48, SD = 1.27) and intentions and iron supplement use were significantly correlated (r = .10, p < .001). Both injunctive norms and collective norms were associated with intentions to take iron supplements but descriptive norms were not. Other significant factors included age, breastfeeding, knowledge, self-efficacy, and outcome expectations. The final model accounted for 74% of the variance in iron supplement intentions., Conclusions: In this context, where the actual behavior is low but intentions to enact the behavior are high, starting an intervention with injunctive norms messaging (expectations around the behavior) and self-efficacy to enact the behavior is the step we recommend based on our results. As an intervention unfolds and iron supplement use increases, descriptive norms messaging (that people are indeed taking iron supplements) may add value., Competing Interests: The authors have declared that no competing interests exist.

Background: Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India. Objective: To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children. Materials and Methods: A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 µL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard. Results: The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants. Conclusions: Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system. [ABSTRACT FROM AUTHOR]

Background: In India, Nutrition Rehabilitation Centers (NRCs) established at public health facilities provide residential medical nutrition therapy for severe acute malnutrition (SAM) children with complications. A large proportion of their mothers are also malnourished. NRCs do not provide services to such mothers as part of routine practice. However, technical algorithm for delivering Maternal Nutrition (MN) services in facility settings is available. Objectives: To test the practical feasibility of layering the MN services in NRC as a routine service. Methods: The MN services were delivered by a nutrition counselor using a triage approach (assess, classify, supplement/counsel/treat). All mothers received diet, micronutrients, and group counseling, those at nutritional risk received individual counseling and SAM mothers also received catch-up diet during their stay. Program data were collected from mothers during January 1 to August 31, 2019 at the NRC in Kalawati Saran Children Hospital. To gain operational insights, a structured interview with nutrition counselor was conducted. Results: Out of 168 mothers, 8% were found to be pregnant and 89% were at nutrition or medical risk. The prevalence of short stature was 18%, severe/ thin 21%, overweight/obese 34%, and anemic 72%. Feedback from the nutrition counselor indicated no operational challenges, however, further efforts to ensure that mothers keep coming back for follow-up visits is needed. Conclusion: The findings indicated that existing staffs were able to deliver the MN services within the time, cost, and regime of the routine NRC. This paper provides four recommendations for layering the MN services in NRCs. [ABSTRACT FROM AUTHOR]

In this paper, I examine the philosophical foundations of the regulation of edible things with particular emphasis on interpretations of the ontological relationship between the categories of 'food' and 'drugs.' To illustrate the diversity of possible approaches to the regulation of food and drugs and their correlative ontological commitments, I focus on two different examples: the United States Food and Drug Administration's Dietary Supplement Health and Education Act (DSHEA) and the development of India's Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH). In my examination of these two regulatory bodies, my goal is not to provide a universal or absolute answer as to how the food-drug relationship ought to be interpreted or codified within regulatory policy. Rather, I aim to provide support for the following claims: (1) these regulatory policies are undergirded by philosophical assumptions regarding the ontological relationship between the categories of food and drugs, (2) the regulatory structure of the US Food & Drug Administration rests on a dichotomous interpretation of the food-drug relationship, (3) India's Ministry of AYUSH rests on an interpretation of the food-drug relationship that understands the categories of 'food' and 'drugs' as overlapping with one another, and (4) each of these approaches to the regulation of edible things has unique advantages and disadvantages that ought to be recognized and evaluated in developing and revising policy for the regulation of edible things. [ABSTRACT FROM AUTHOR]

Cycads are used mainly as source of food starch and in traditional medicine in Asia, Americas, Australia, Sub-Saharan Africa and some Pacific islands by the local communities. Of the 118 known species of the Cycas (Cycadaceae), Cycas sphaerica Roxb. is an endemic species of the Eastern Ghats of India having considerable ethno-botanical, nutritional and medicinal importance. The present paper reports for the first time the nutritional and anti-nutritional properties, physical and functional attributes and chemical constituents of C. sphaerica seed flour. Results of the present study revealed that the flour is rich source of carbohydrate (66.48 g/100 g), protein (16.8 g/100 g), fat (3.61 g/100 g), fibre (2.79 g/100 g), ash (2.32 g/100 g), essential amino acids (methionine: 0.37 g/100 g; threonine: 0.50 g/100 g; leucine: 0.92 g/100 g), non-essential amino acids (cystine: 1.39 g/100 g; serine:0.73 g/100 g; alanine: 0.77 g/100 g) and vitamin C (32.6 mg/100 g). Besides, it is a rich in potassium (10310 mg/100 g), magnesium (1260 mg/100 g), iron (15.67 mg/100 g) and manganese (3.61 mg/100 g). Antinutrients such as phytate, oxalate and tannin were detected within the safe dietary limits. The seed flour had good water and oil absorption capacities. The metabolite profiling of seed flour by GCQ-MS identified a total of 20 phytochemicals, out of which 3-O-methyl-D-glucose, ethyl α-D-glucopyranoside and cis-vaccenic acid were the most dominant components. The seed flour extract exhibited moderate antioxidant potential due to the presence of certain phenolics and flavonoids. Based on the present findings, it can be concluded that C. sphaerica seed flour has high nutritional value and may be used as a food supplement and nutraceutical. The identified phytoconstituents may serve as source compounds for pharmaceutical applications. [Display omitted] • Cycas sphaerica is an endemic cycad of Eastern Ghats region of India having multipurpose use. • Its seed flour is widely used by tribals of the region as a food supplement and nutraceutical. • This is the first report on the nutritional and phytochemical properties of this tribal food plant. • Seed flour was rich in carbohydrate, protein, fibre, amino acids, vitamin C and useful elements. • 3-O-methyl-D-glucose, ethylα-D-glucopyranoside & cis-vaccenic acid were the dominant phytoconstituents. [ABSTRACT FROM AUTHOR]

Background: Buffaloes (Bubalus bubalis) have an immense importance in rural economy by virtue of their high production potential as triple purpose animal. Application of scientific technologies can further lead to significant productivity enhancement in buffaloes. Hence, the study was aimed to investigate adoption and effect of urea-molasses multinutrient block (UMMB) supplementation on buffalo productivity in rural areas of Punjab, India. Methods: An expost-facto research design was employed to collect data from selected buffalo farmers (N-501) through personal interview by using pretested research instrument. Based on the response, the buffalo farms were categorized as technology adopter farms (TAF) and non-adopter farms (TNAF). The effect of UMMB supplementation on productivity was evaluated by considering various productive and reproductive parameters of buffaloes. Both parametric and non-parametric statistical tests were employed to analyse the data by using SPSS software. Result: The results indicated that the buffalo farms (36.93%; 185/501) following an additional supplementation with UMMB had significantly (p<0.05) higher average daily milk yield per animal and lowered values of all reproductive parameters. This has proved the viability of UMMB technology at buffalo farms in study area. The study revealed that the technology plays valuable role in buffalo productivity enhancement, hence should be recommended to the government and propagated through vigorous activities at grassroot level to improve adoption. [ABSTRACT FROM AUTHOR]

Background: To improve coverage of key child health community practices, Home Based Infant Care (HBNC+) was implemented with support of Norway India Partnership Initiative (NIPI) in 4 States of Rajasthan, Madhya Pradesh, Bihar and Odisha. The innovation aimed at improving coverage of key child health interventions through home visits by community health worker, Accredited Social Health Activist (ASHA). Aims & Objective: This paper elucidates the results from the assessment of implementation in intervention versus control districts of Rajasthan. Material & Methods: A cross-sectional intervention-control design with a sample size of 3211 mothers of children in age group 0 to 23 months was adopted. Results: 85 percent of the children (aged 3-23 months) received at least one infant care home visit in the intervention districts in comparison to 32 percent in control. Significant improvements were found in terms of exclusive breastfeeding, weighing and Iron Folic Acid (IFA) consumption and availability of ORS and Iron Syrup in intervention districts. 15 percent additional children had weight plotted in growth charts and 24 percent more consumed IFA syrup bi-weekly in intervention districts. Conclusion: Home visits in infancy is a scalable model and can lead to improvement of community child health practices. [ABSTRACT FROM AUTHOR]

Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months - about 500 days - is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design: This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers). The conclusions now need to be advocated to policy-makers. Results: The priority problems addressed are: intrauterine growth restriction (IUGR), women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron-folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO) are unlikely to be met, especially in the poorest countries. Conclusions: This agenda requires policy decisions both at Ministry and donor levels, and throughout the administrative system. Evidence-based interventions are established as a basis for these decisions, there are clear advocacy messages, and there are no scientific reasons for delay. [ABSTRACT FROM AUTHOR]

Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence‐based MNIs were incorporated in national policies and programs in Bangladesh, Burkina Faso, Ethiopia and India. We compared the nutrition content of ANC protocols against global recommendations. We used survey data to elucidate the coverage of micronutrient supplementation, weight gain monitoring, dietary and breastfeeding counselling. We reviewed literature, formative research and program assessments to identify barriers and enabling factors of service provision and maternal nutrition practices. Nutrition information in national policies and protocols was often fragmented, incomplete and did not consistently follow global recommendations. Nationally representative data on MNIs in ANC was inadequate, except for iron and folic acid supplementation. Coverage data from subnational surveys showed similar patterns of strengths and weaknesses. MNI coverage was consistently lower than ANC coverage with the lowest coverage of weight gain monitoring and variable coverage of dietary and breastfeeding counselling. Key common factors associated with coverage were micronutrient supply disruptions; suboptimal counselling on maternal diet, weight gain, and breastfeeding; and limited or no record keeping. Adherence of women to micronutrient supplementation and dietary recommendations was low and associated with late and too few ANC contacts, poor maternal knowledge and self‐efficacy, and insufficient family and community support. Models of comprehensive nutrition protocols and health systems that deliver maternal nutrition services in ANC are urgently needed along with national data systems to track progress. Key points: Delivering nutrition services to all pregnant women is essential for maternal and child health outcomes but remains a challenge.Nutrition gaps in antenatal care (ANC) include lack of specificity in national guidelines and protocols, bottlenecks in micronutrient supplies, low ANC provider knowledge and skills, inadequate supervision to reinforce counseling, and not engaging families to encourage key practices.National protocols for ANC should be more specific for the four nutrition interventions (micronutrient supplements, weight gain monitoring, counseling on diets and counseling on breastfeeding) and assign accountability for coverage and quality.Country models are needed for improving provision and utilisation of nutrition interventions through ANC that are based on comprehensive policy frameworks. [ABSTRACT FROM AUTHOR]

OBJECTIVES: In India, despite the high prevalence of vitamin B12 (vit B12) deficiency, the current public health policy focuses solely on iron and folic acid supplementation as a measure to prevent anaemia. Vit B12 is an important cofactor for enzymatic reactions related to DNA synthesis, folate, and cell metabolism. While folate deficiency has been acknowledged in not only the prevention of neural tube defects and other adverse pregnancy outcomes, the effects of low vit B12 status have not been well defined. It is becoming recognized that there is a much higher prevalence of B12 deficiency than earlier suspected, and more of its effect on maternal and fetal health is being reported. The current study was planned as an observational study to correlate the effects of vit B12 deficiency with respect to various feto-maternal outcomes. STUDY DESIGN: In this prospective cohort study a total of 300 antenatal women were screened for vit B12 levels in the late first trimester and were followed up to find out co-existent folic acid deficiency, development of pregnancy complications like anemia, gestational hypertension/pre-eclampsia, fetal growth restriction (FGR), second-trimester abortions, gestational diabetes mellitus (GDM) and preterm deliveries. RESULTS: It was found that most of the women with low B12 levels were vegetarian and had co-existent folic acid deficiency. They had a statistically significant increase in the incidence of anemia, preeclampsia, gestational diabetes, (small for gestational age) SGA/FGR, and preterm births. CONCLUSION: The study suggests that low levels of vit B12 increase the likelihood of adverse fetomaternal outcomes. Further research involving larger sample sizes is necessary to confirm these findings and determine if vit B12 supplementation should be included in pregnancy nutritional supplements, especially in vegetarian women. [ABSTRACT FROM AUTHOR]

Background: Lysine intake in India is low mainly due to consumption of cereals as staple diet and processing loss of lysine. The present study was aimed to assess the impact of supplementation either in the form of dietary supplements of lysine, calcium and vitamin D in order to identify an appropriate approach for the improvement of body composition. Methods: One hundred and twenty volunteer subjects in the age group of 20-30 years residing in Punjab Agricultural University hostels were selected for supplementary trial. Supplementation of milk and its products in amounts to fill the gap of dietary intake and adequacy of protein as well as limiting amino acid lysine in their diets for a period of 12 weeks was done to determine its effect on body composition. Result: The diets were also poor in protein quality as the limiting amino acid lysine was only 55% of the recommended level. Supplementation of milk and its products resulted in a significant reduction in body fat (6.62%) and visceral fat rating (9.47%) and a significant increase in skeletal muscle mass (3.98%) and bone mass (2.72%). The study recommends that improving the quality of diets through dietary supplementation of lysine, calcium and vitamin D is an effective approach to achieve optimum body composition. [ABSTRACT FROM AUTHOR]

The study was carried out to measure the glycemic index (GI) of an oral food supplement for people with CKD as well as on patients on maintenance dialysis. The study was conducted as per international protocols for testing GI, was approved by the local institutional ethics committee, and was registered with the Clinical Trial Registry of India (CTRI). This was a crossover randomized controlled study which enrolled 15 participants between the ages of 18 and 45 years. The participants were randomly allotted to one group that consumed either the reference food (27.5 g of glucose monohydrate) or 118 g of the nutritional supplement which contained 25 g of available carbohydrates. Fasting capillary blood samples as well as blood samples at different time intervals as per the GI protocol, after consumption of either the supplement or the reference food were taken from the participants. Each testing day was separated by a 3‐day washout period. GI was calculated from the incremental area under the blood glucose response elicited by the nutritional supplement as a percentage of the response after the consumption of 25 g of glucose (27.5 g of glucose monohydrate) by the same participant using a standard formula. The GI of the nutritional supplement was calculated to be 10.3 ± 2.0 which is considered to be low as per international GI testing standards. The product was created to supplement the diet of people with CKD at different stages and to help prevent the progression from CKD to ESRD as well as the risk for CVD. This product was found to have a low GI which is desirable for people with CKD as well as diabetics in general who are at risk for developing CKD. [ABSTRACT FROM AUTHOR]

Purpose – Developing countries like India, accounts for about 40 percent of undernourished children in the World and it is largely due to the result of dietary inadequacy in relation to their needs. The purpose of this paper was to evaluate the changes in the nutritional status of the children, from their preschool days to the present primary school days.Design/methodology/approach – The present investigation was conducted at 20 Integrated Child Development Service (ICDS) centers (Center-A) and 15 primary schools (Center-B) in Bali Gram Panchayat, Arambag, Hooghly District of West Bengal, India, at an interval of three to four years. A total of 1,012 children (boys=498; girls=514) aged two to six years old enrolled in these ICDS centers and a total of 603 children (boys=300, girls=303), aged five to ten years were studied from the 15 primary schools who were the beneficiaries of ICDS centers. Underweight (weight-for-age Z-score (WAZ)) and wasting (weight-for height Z-score (WHZ)) were used to assess the nutritional status. Findings – The nutritional situation (both in case of underweight and wasting) was better in Center B as compared with Center A. In general, the nutritional condition of boys was better than girls. Center had a very significant effect on both WAZ as well as WHZ, irrespective of age and sex. Sex has a significant impact only on WAZ. Interestingly, there was no significant sex-center interaction for both WAZ as well as WHZ. The children of the area were getting Mid Day Meal supplied through the school authorities which was comparatively better than the ICDS centers’ food supplementation. Better monitoring of nutritional supplementation at primary schools may be an important factor. Practical implications – In ICDS centers, only the Anganwari worker is responsible in running and implementing the programs offered by the Government. However, at primary schools, the active involvement of all the teachers to run the program may have effectively led to have better results. Furthermore, the Government's focus should not be only on the increase the area covered by the ICDS program, but focus should be to increase the quality of food supplied, proper monitoring of the implementation and increase the allocation of funds. Appropriate measures may be taken by the authorities regarding this. Originality/value – The results of the study will help in policy making in reducing the prevalence of undernutrition. [ABSTRACT FROM AUTHOR]

Background/objectives: Vitamin B(12) (B(12)) deficiency is common in Indians and a major contributor to hyperhomocysteinemia, which may influence fetal growth, risk of type II diabetes and cardiovascular disease. The purpose of this paper was to study the effect of physiological doses of B(12) and folic acid on plasma total homocysteine (tHcy) concentration., Subjects/methods: A cluster randomized, placebo-controlled, double-blind, 2 x 3 factorial trial, using the family as the randomization unit. B(12) was given as 2 or 10 microg capsules, with or without 200 microg folic acid, forming six groups (B(0)F(0), B(2)F(0), B(10)F(0), B(0)F(200), B(2)F(200) and B(10)F(200)). Plasma tHcy concentration was measured before and after 4 and 12 months of supplementation., Results: From 119 families in the Pune Maternal Nutrition Study, 300 individuals were randomized. There was no interaction between B(12) and folic acid (P=0.14) in relation to tHcy concentration change and their effects were analyzed separately: B(0) vs. B(2) vs. B(10); and F(0) vs. F(200). At 12 months, tHcy concentration reduced by a mean 5.9 (95% CI: -7.8, -4.1) micromol/l in B(2), and by 7.1 (95% CI: -8.9, -5.4) micromol/l in B(10), compared to nonsignificant rise of 1.2 (95% CI: -0.5, 2.9) micromol/l in B(0). B(2) and B(10) did not differ significantly. In F(200), tHcy concentration decreased by 4.8 (95% CI: -6.3, -3.3) micromol/l compared to 2.8 (95% CI: -4.3, -1.2) micromol/l in F(0)., Conclusion: Daily oral supplementation with physiological doses of B(12) is an effective community intervention to reduce tHcy. Folic acid (200 microg per day) showed no additional benefit, neither had any unfavorable effects.

India contributes to a large number and proportion of child deaths, both due to higher under five mortality rate and large child population cohort in the country. The micronutrient malnutrition is an ignored area as it is not a direct cause of child mortality but a contributory factor in many deaths. The repeated surveys and studies have noted that iron deficiency anemia, vitamin A deficiency, iodine deficiency are highly prevalent amongst the children in the country and the preventive interventions are reaching only small proportion of 10-50% of the targeted populations. The contribution of these micronutrients (Iron, Vitamin A, Iodine and Zinc) towards child survival depends upon number of factors that are responsible for child mortality, and these situations vary from region to region, time to time and depend upon number of other socio demographic characteristics of the population. This paper discusses that although there may be debate on the role of some micronutrients in reducing childhood mortality, there is no doubt that these micronutrients are needed in small amount for overall child development. These micronutrients, both directly and indirectly, contribute to the child survival and should reach to each and every child in the country and the strategy is proven cost effective.

The aim of the study was to compare the efficacy of daily v. weekly oral vitamin D3 therapy in radiological healing of nutritional rickets. Children 6 months to 12 years (n 132) diagnosed with nutritional rickets were randomised into three groups (n 44): group A – 2000 IU daily vitamin D3 for 12 weeks, B – 60 000 IU weekly for 3 weeks, C – 60 000 IU weekly for 6 weeks. Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and X-ray score were estimated at baseline and 12 weeks (endline). The proportion of children who achieved complete radiological healing at endline was compared between three groups by χ 2 and delta change in laboratory parameters by ANOVA (parametric data) or Kruskal Wallis test (non-parametric data), respectively. Baseline 25(OH)D ≤ 20 ng/ml was seen in 119 (90·2 %), hyperparathyroidism in 90 (68·8 %) and hypocalcaemia in 96 (72·7 %). A total of 120/132 children completed the study. Complete radiological healing seen in 30 (75 %) in group A, 23 (60·5 %) in group B and 26 (61·9 %) in group C; P = 0·15, with comparable endline X-ray scores; P = 0·31. The median (interquartile range (IQR)) delta X-ray score (baseline–endline) was 7 (4,9), 5 (2·25, 6) and 6 (4,7) in groups A, B and C, respectively; P = 0·019. Median (IQR) 25(OH)D endline levels in groups A, B and C were 50·0 (26·5, 66·5), 42·1 (28·4, 54·4) and 53·5 (33·7, 71·2) ng/ml, respectively; P = 0·045. Radiological scores were comparable at endline among daily and weekly vitamin D groups with greater change from baseline in daily supplemented group. [ABSTRACT FROM AUTHOR]

Folate and vitamin B12 are essential for growth. Our objective was to estimate their long-term effects on linear growth in North Indian children. This is a follow-up study of a factorial designed, double-blind, randomised, placebo-controlled trial in 1000 young children. Starting at 6–30 months of age, we gave folic acid (approximately 2 RDA), vitamin B12 (approximately 2 RDA), both vitamins or a placebo daily for 6 months. Six years after the end of supplementation, we measured height in 791 children. We used the plasma concentrations of cobalamin, folate and total homocysteine to estimate vitamin status. The effect of the interventions, the association between height-for-age z-scores (HAZ) and baseline vitamin status, and the interactions between supplementation and baseline status were estimated in multiple regression models. Mean (sd) age at follow-up was 7·4 (0·7) years (range 6 to 9 years). There was a small, non-significant effect of vitamin B12 on linear growth and no effect of folic acid. We observed a subgroup effect of vitamin B12 supplementation in those with plasma cobalamin concentration < 200 pmol/l (P for interaction = 0·01). The effect of vitamin B12 supplementation in this group was 0·34 HAZ (95 % CI 0·11, 0·58). We found an association between cobalamin status and HAZ in children not given vitamin B12 (P for interaction = 0·001). In this group, each doubling of the cobalamin concentration was associated with 0·26 (95 % CI 0·15, 0·38) higher HAZ. Suboptimal vitamin B12 status in early childhood seemingly limits linear growth in North Indian children. [ABSTRACT FROM AUTHOR]

Despite strong policy and program commitment, essential maternal nutrition services are not reaching enough women in many countries. This paper examined multifactorial determinants (personal, family, community, and health services) associated with maternal nutrition practices in Uttar Pradesh, India. Data were from a household survey of pregnant (n = 667) and recently delivered women (n = 1,835). Multivariable regression analyses were conducted to examine the determinants of four outcomes: consumption of diverse diets, consumption of iron folic acid (IFA) and calcium tablets, and weight monitoring during pregnancy. Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal program implementation. During pregnancy, women consumed 28 IFA and 8 calcium tablets, 18% consumed diverse diet, and 17% were weighed ≥3 times. Nutrition knowledge was associated with consumption of diverse diet (odds ratio [OR] = 2.2 times), IFA (2.3 times), calcium (11.7 times), and weight monitoring (1.3 times). Beliefs and self‐efficacy were associated with IFA (OR = 2.0) and calcium consumption (OR = 4.6). Family support and adequate health services were also associated with better nutrition practices. Under optimal program implementation, we estimate that 51% of women would have adequate diet diversity, an average consumption of 98 IFA, and 106 calcium tablets, and women would be weighed 4.9 times during pregnancy. Strengthening existing program operations and increasing demand for services has the potential to result in large improvements in maternal nutrition practices from current baseline levels but may not be sufficient to meet World Health Organization‐recommended levels without creating an enabling environment including improvements in education and income levels to support behaviour change. [ABSTRACT FROM AUTHOR]

Protein breakdown by endogenous enzymes in the gastrointestinal (GI) tract results in generation of peptides and amino acids that act as building blocks in essential biological functions. Exogenous proteases possess immense potential as digestive enzyme supplements that can assist protein digestion in the GI system. Plant proteases, in addition to their promising activity, are considered to be safe in nature. The present study evaluated the potential application of a plant protease based proprietary formulation-MDZenPro in digesting raw whey protein, whey protein isolate and plant protein under INFOGEST simulated GI conditions. The gastric and GI digested protein products were analyzed for determining the degree of hydrolysis. The protein pro􀃶les were evaluated using SDS-PAGE. The results of the degree of hydrolysis study revealed that MDZenPro facilitated gastric and GI digestion of proteins. This increase in degree of hydrolysis was noted to be higher than that observed in proteins that were not treated with MDZenPro. The SDS-PAGE pro􀃶le further supported these 􀃶ndings wherein, the MDZenPro treated protein samples displayed low molecular weight fragmented peptides in contrast to the pro􀃶le of undigested proteins. The present study thus highlights the promising application of 'MDZenPro' as an effective supplement for protein digestion. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency (VDD) is a global health issue that affects both industrialized and emerging countries. With prevalence rates across all age categories in India, vitamin D deficiency is across the entire Indian continent. Regardless of the fact that there is sufficient sunlight in India which is required for endogenous vitamin D synthesis. Nutrient D inadequacy is probably going to play a significant part in the exceptionally high pervasiveness of osteoporosis, rickets, cardiovascular disease, diabetes, sicknesses and contaminations like tuberculosis in India. In India, regularly consumed foods only occasionally contain vitamin D supplements such as in dairy products. Numerous factors might contribute to vitamin D deficiency, such as skin color, lack of sunshine exposure, vegetarian eating habits, and low consuming of meals enriched with vitamin D. A sufficient amount of sun exposure, eating dietary sources of vitamin D, and fortifying foods with vitamin D can all help avoid VDD. [ABSTRACT FROM AUTHOR]

Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full-text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India. [ABSTRACT FROM AUTHOR]

The authors discuss the decline of stunting rates among children in India. Topics include high rates of child malnutrition in various states of the country, the nutrition-specific interventions for acute malnutrition management, and the determinants of nutrition and nutrition-sensitive interventions.

Dietary intake during pregnancy plays a vital role in determining the health of both mother and baby. Maternal undernutrition affects a large proportion of women in low and lower middle income countries (LLMIC) likely influencing high maternal, infant, and child mortality in these countries. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This paper reviews the literature to evaluate the effectiveness of mHealth interventions on improving dietary/nutrients intake of pregnant women in LLMIC. Eight electronic databases were searched from inception up to April 2018, including the MEDLINE, EMBASE, CINAHL, Cochrane, Web of Science, Scopus, Global Index Medicus, and Maternity and Infant Care. Using Covidence, two reviewers assessed articles for inclusion, assessed study quality and extracted data. Only studies published in English language were included. Data were summarised narratively. In total, 6,778 were identified of which four were included, with three randomised controlled trials and one prepost experimental study. Studies were conducted in India (n = 2), Indonesia (n = 1), and Kenya (n = 1). All articles evaluated the use of nutrient supplements; iron supplements (n = 1), vitamin supplements (composition not mentioned; n = 1), or calcium supplements (n = 1). This review suggests that mHealth interventions can be used to improve intake of micronutrient supplementation and nutritional status of pregnant women in LLMIC. Further studies are needed to address the limited evidence base related to mHealth nutrition interventions targeting dietary intakes of pregnant women in LLMIC. [ABSTRACT FROM AUTHOR]

India plays an important role in the production of oilseeds, which are mainly cultivated for future extraction of their oil. In addition to the energic and nutritional contribution of these seeds, oilseeds are rich sources of bioactive compounds (e.g., phenolic compounds, proteins, minerals). A regular and moderate dietary supplementation of oilseeds promotes health, prevents the appearance of certain diseases (e.g., cardiovascular diseases (CVDs), cancers) and delays the aging process. Due to their relevant content in nutraceutical molecules, oilseeds and some of their associated processing wastes have raised interest in food and pharmaceutical industries searching for innovative products whose application provides health benefits to consumers. Furthermore, a circular economy approach could be considered regarding the re-use of oilseeds' processing waste. The present article highlights the different oilseed types, the oilseeds-derived bioactive compounds as well as the health benefits associated with their consumption. In addition, the different types of extractive techniques that can be used to obtain vegetable oils rich from oilseeds, such as microwave-assisted extraction (MAE), ultrasonic-assisted extraction (UAE) and supercritical fluid extraction (SFE), are reported. We conclude that the development and improvement of oilseed markets and their byproducts could offer even more health benefits in the future, when added to other foods. [ABSTRACT FROM AUTHOR]

Background: Diabetes is the ninth leading cause of death among women globally causing 2.1 million deaths per year. Pregnancy complicated with gestational diabetes mellitus (GDM) causes physiological resistance to insulin that predisposes to maternal (pregnancy-induced hypertension, macrosomia, and obstructed labor due to shoulder dystocia) and fetal (macrosomia, birth injuries, hypoglycemia, respiratory distress) complications associated with the GDM. Given the complications associated with GDM in South India, the study hypothesized that a novel idea of probiotics supplementation as adjunct therapy with comprehensive intervention would show considerable improvement in maternal glycemic control among GDM. Methods/Design: It is a single-center, double-blind randomized controlled trial. Study population: Expectant women with GDM in their second trimester were randomized to control and intervention group. Intervention: The package included supplementation with probiotics (probiotic capsules with routine care), while the control group: received a placebo capsule (placebo capsule with routine care) to GDM women. The study participants were followed up till delivery. Outcome measures: Maternal blood glucose levels as fasting and postprandial blood glucose levels are measured at the 20th, 32nd, and 40th weeks of gestational age. Secondary outcome measures: Maternal parameters are monitored at their regular follow-up visits, and neonatal parameters are measured after delivery. Statistical analysis: Descriptive and inferential analyses were performed that satisfied the per protocol compliance using the recent version of Statistical Package for the Social Sciences. Conclusion: Probiotic supplementation is one of the emerging trends that shows a significant impact on maternal blood glucose levels, which will in turn have beneficial effects on maternal and neonatal morbidity and mortality. In a developing country like India, with the growing burden of diabetes and GDM, developing an innovative effective intervention that promotes glycemic health that can easily be replicated across various settings will become a priority. If the intervention is concluded to be effective, this study would become a guideline model to reinforce probiotics as an intervention to treat GDM and contribute to improved maternal and neonatal health in South India. [ABSTRACT FROM AUTHOR]

Exposure to lead among children, as well as adults, is a major global health issue. With diverse routes of exposure (e.g., food, air, and water) either environmentally or occupationally, lead among children can cause mild, moderate, to severe health complications in the later stages of life. The average blood lead level reported by CDC in 2021 is 3.5 µg/dL, and the level of blood lead toxicity is ≥ 10 μg/dL. In this study, we planned to systematically analyze the association between blood lead levels (BLLs) (≥ 10 μg/dL and < 10 μg/dL) and the risk of anemia (hemoglobin level < 11 g/dL) among Indian children aged between ≥ 1 and ≤ 18 years. An online literature search of 5 databases, PubMed, Ovid, EMBASE, Web of Science, and Google Scholar was accomplished with a search updated until 8th March 2021. Study designs included cohort, cross-sectional, and case–control studies that have evaluated the association of lead toxicity or exposure with anemia (Hb < 11 g/dL) reported in urban and/or rural Indian children. Meta-analysis was performed among a total of 864 children from 4 cross-sectional studies. The association between lead toxicity (BLLs ≥ 10 μg/dL) and the risk of being anemic was not statistically significant (RR = 1.15 (95% CI: 0.86–1.55, I2 = 77%). The risks of bias in all included studies were low according to the Newcastle Ottawa Scale. Increased blood lead levels did not appear to be the major contributor to anemia in Indian Children. We need to focus primarily on improving the nutritional quality, fortified food supplements, and a balanced diet for children to reduce the anemia burden in India. Lead toxicity should be sought as an etiological factor only in areas of high environmental risk factors which were leaded paints, leaded batteries, a house near major road/traffic areas, and pesticide exposure. [ABSTRACT FROM AUTHOR]

Fe deficiency has negative effects on voluntary physical activity (PA); however, the impact of consuming Fe-biofortified staple foods on voluntary PA remains unclear. This study compared the effects of consuming Fe-biofortified pearl millet or a conventional pearl millet on measures of voluntary PA in Indian schoolchildren (ages 12–16 years) during a 6-month randomised controlled feeding trial. PA data were collected from 130 children using Actigraph GT3X accelerometers for 6 d at baseline and endline. Minutes spent in light and in moderate-to-vigorous PA were calculated from accelerometer counts using Crouter's refined two-regression model for children. Mixed regression models adjusting for covariates were used to assess relationships between intervention treatment or change in Fe status and PA. Children who consumed Fe-biofortified pearl millet performed 22·3 (95 % CI 1·8, 42·8, P = 0·034) more minutes of light PA each day compared with conventional pearl millet. There was no effect of treatment on moderate-to-vigorous PA. The amount of Fe consumed from pearl millet was related to minutes spent in light PA (estimate 3·4 min/mg Fe (95 % CI 0·3, 6·5, P = 0·031)) and inversely related to daily sedentary minutes (estimate −5·4 min/mg Fe (95 % CI –9·9, −0·9, P = 0·020)). Consuming Fe-biofortified pearl millet increased light PA and decreased sedentary time in Indian schoolchildren in a dose-dependent manner. [ABSTRACT FROM AUTHOR]

Supplementation with lipids and oils is one of the most efficient strategies for reducing enteric methane emission. However, high costs and adverse impacts on fiber degradation restrict the use of conventional oils. Silkworm pupae, a non-conventional oil source rarely used for human consumption in India, could be one of the cheaper alternatives for methane mitigation. The objective of this study was to investigate the effect on sheep of long-term supplementation (180 days) of silkworm pupae oil (SWPO) with two distinct supplementation regimes (daily and biweekly) on daily enteric methane emission, methane yield, nutrient digestibility, rumen fermentation, ruminal archaea community composition, and protozoal population. The effect of the discontinuation of oil supplementation on enteric methane emission was also investigated. Eighteen adult male sheep, randomly divided into three groups (n = 6), were provisioned with a mixed diet consisting of 10.1% crude protein (CP) and 11.7 MJ/kg metabolizable energy formulated using finger millet straw and concentrate in a 55:45 ratio. SWPO was supplemented at 2% of dry matter intake (DMI) in test groups either daily (CON) or biweekly (INT), while no oil was supplemented in the control group (CTR). DMI (p = 0.15) and CP (p = 0.16) in the CON and INT groups were similar to that of the CTR group; however, the energy intake (MJ/kg) in the supplemented groups (CON and INT) was higher (p < 0.001) than in CTR. In the CON group, body weight gain (kg, p = 0.02) and average daily gain (g, p = 0.02) were both higher than in the CTR. The daily methane emission in the CON (17.5 g/day) and INT (18.0 g/day) groups was lower (p = 0.01) than the CTR group (23.6 g/day), indicating a reduction of 23–25% due to SWPO supplementation. Similarly, compared with the CTR group, methane yields (g/kg DMI) in test groups were also significantly lower (p < 0.01). The transient nature of the anti-methanogenic effect of SWPO was demonstrated in the oil discontinuation study, where daily methane emission reverted to pre-supplementation levels after a short period. The recorded methanogens were affiliated to the families Methanobacteriaceae , Methanomassilliicoccaceae , and Methanosarcinaceae. The long-term supplementation of oil did not induce any significant change in the rumen archaeal community, whereas minor species such as Group3b exhibited differing abundance among the groups. Methanobrevibacter , irrespective of treatment, was the largest genus, while Methanobrevibacter gottschalkii was the dominant species. Oil supplementation in CON and INT compared with CTR decreased (p < 0.01) the numbers of total protozoa (× 107 cells/ml), Entodiniomorphs (× 107 cells/ml), and Holotrichs (× 106 cells/ml). SWPO continuous supplementation (CON group) resulted in the largest reduction in enteric methane emission and relatively higher body weight gain (p = 0.02) in sheep. [ABSTRACT FROM AUTHOR]

Introduction: Despite an agricultural country, India confronting malnutrition as a major public health challenge, where every second child is at risk of malnutrition. The nation ranking second in population with disproportionate rural and urban demography, further poor penetration of government assisted programs in remote, underserved areas fuelling the malnutrition in rural areas. Methods: This cross-sectional study was conducted in Department of Community Medicine of Rohilkhand Medical College and Hospital. Total 465 schoolchildren in rural and urban areas of Bareilly district were screened for malnutrition and their socio-demographic profiles were studied. Results: Overall, the prevalence of malnutrition in schoolchildren of Bareilly district was %40.2. Fraction contributed by urban and rural territories was %35.2 and %43, respectively. The prevalence of malnutrition was found higher in rural area as compared to urban area and the difference was statistically significant (P<0.001). Conclusion: The study shows %43 prevalence of malnutrition in rural areas and under nutrition was the main cause of malnutrition attributed by poverty and illiteracy. However, urban areas reported %7.8 lower prevalence of malnutrition, but alarming trends of overweight and obesity %15.2. [ABSTRACT FROM AUTHOR]

Child malnutrition is a critical global challenge. India alone is home to nearly 46 million stunted children, a third of the world's total. Supplementing locally-produced foods has been acknowledged as a sustainable strategy for combating child malnutrition. We used an established protein malnutrition (PM) model in young mice to evaluate the safety and efficacy of the SAVI-enriched diet as a food supplement to combat child malnutrition in India. Results indicate that feeding the SAVI-enriched diet improves body weight, lean muscle mass, bone, and immune health in PM young mice. Based on the results of our study in mice, we suggest future human trials to examine the supplement's potential benefits for humans. [ABSTRACT FROM AUTHOR]

Hippophae tibetana is valuable wild edible berry, which is utilized as a supplement of food, traditional‐folk medicine system by rural populace of the Johar valley, Pithoragarh district India. The study focused on quantitating the nutrient composition, polyphenols, and free radical scavenging activities of the specie (in different solvent extracts). Results represented a various concentration range of polyphenolics and antioxidants among studied solvents, and fresh berries exhibited good sources of polyphenols (phenolics 1.64; tannins 5.87; proanthcyanidins 1.47; flavonoids 5.74; flavonols 0.62 mg/g), antioxidants, and free radical scavenging activities (FRAP 9.55; DPPH 1.35; NO·1.14; ABTS 4.10; OH· 0.69 mM AAE/100 g), nutrients (carbohydrates 2.05; proteins 0.67; methionine 0.73; proline 1.03; sodium 0.37; potassium 3.0.25 mg/g) and vitamins (vitamin C 1.03; vitamin E 0.87; Vitamin A 0.59 mg/g), respectively, followed by dry berries and pomace. Outcomes of the study revealed that acetone and methanol are good for extraction for harnessing maximum potential from the species. Practical applications: H. tibetana has emerged as a potential source of nutritional and bioactive constituents, and moderate polarity solvents (acetone and methanol) are best for extraction and acetone should be prioritized for commercial utilization.In the present scenario, several communities worldwide are focused to consume natural antioxidant compounds for improving their health, immunity, and reducing the deficiency of malnutrition. The fresh berries of H. tibetana and their processed foodstuffs can be considered an option for fulfilling the basic requirements of nutrients in the future and will be helpful for reducing deficiency of malnutrition in the Himalayan populace.Present study highlighted that berries of H. tibetana are rich sources of various nutrients, polyphenols, and antioxidant contents and for harnessing maximum potential from the species their mass scale cultivation is required. Therefore, sensitization workshops and capacity‐building programs (for skill development) should be organized in the higher Himalayas for the promotion of cultivation practices/large‐scale plantation of H. tibetana in their suitable habitat (cold desert) through participatory approaches, also required to strengthen the sub help groups (SHG). This approach will fulfill the major issues of biodiversity conservation, wasteland reclamation, and generate employment opportunities for the local communities of Himalayas. [ABSTRACT FROM AUTHOR]

In India, poor feeding practices in early childhood contribute to the burden of malnutrition as well as infant and child mortality. This paper aims to use the newly developed World Health Organization (WHO) infant feeding indicators to determine the prevalence of complementary feeding indicators among children of 6-23 months of age and to identify the determinants of inappropriate complementary feeding practices in India. The study data on 15 028 last-born children aged 6-23 months was obtained from the National Family Health Survey 2005-2006. Inappropriate complementary feeding indicators were examined against a set of child, parental, household, health service and community level characteristics. The prevalence of timely introduction of complementary feeding among infants aged 6-8 months was 55%. Among children aged 6-23 months, minimum dietary diversity rate was 15.2%, minimum meal frequency 41.5% and minimum acceptable diet 9.2%. Children in northern and western geographical regions of India had higher odds for inappropriate complementary feeding indicators than in other geographical regions. Richest households were less likely to delay introduction of complementary foods than other households. Other determinants of not meeting minimum dietary diversity and minimum acceptable diet were: no maternal education, lower maternal Body Mass Index (BMI) (<18.5 kg/m2), lower wealth index, less frequent (<7) antenatal clinic visits, lack of post-natal visits and poor exposure to media. A very low proportion of children aged 6-23 months in India received adequate complementary foods as measured by the WHO indicators. [ABSTRACT FROM AUTHOR]

Maternal iodine (I) status is critical in embryonic and foetal development. We examined the effect of preconception iodine supplementation on maternal iodine status and on birth outcomes. Non‐pregnant women in Guatemala, India and Pakistan (n ~ 100 per arm per site) were randomized ≥ 3 months prior to conception to one of three intervention arms: a multimicronutrient‐fortified lipid‐based nutrient supplement containing 250‐μg I per day started immediately after randomization (Arm 1), the same supplement started at ~12 weeks gestation (Arm 2) and no intervention supplement (Arm 3). Urinary I (μg/L) to creatinine (mg/dl) ratios (I/Cr) were determined at 12 weeks for Arm 1 versus Arm 2 (before supplement started) and 34 weeks for all arms. Generalized linear models were used to assess the relationship of I/Cr with arm and with newborn anthropometry. At 12 weeks gestation, adjusted mean I/Cr (μg/g) for all sites combined was significantly higher for Arm 1 versus Arm 2: (203 [95% CI: 189, 217] vs. 163 [95% CI: 152, 175], p < 0.0001). Overall adjusted prevalence of I/Cr < 150 μg/g was also lower in Arm 1 versus Arm 2: 32% (95% CI: 26%, 38%) versus 43% (95% CI: 37%, 49%) (p = 0.0052). At 34 weeks, adjusted mean I/Cr for Arm 1 (235, 95% CI: 220, 252) and Arm 2 (254, 95% CI: 238, 272) did not differ significantly but were significantly higher than Arm 3 (200, 95% CI: 184, 218) (p < 0.0001). Nominally significant positive associations were observed between I/Cr at 12 weeks and birth length and head circumference z‐scores (p = 0.028 and p = 0.005, respectively). These findings support the importance of first trimester iodine status and suggest need for preconception supplementation beyond salt iodization alone. [ABSTRACT FROM AUTHOR]

Purpose: Malnutrition is a serious public health problem, which occurs because of an inadequate supply of nutrients and therefore affects many children and women (especially pregnant and lactating women of low economic class) worldwide. There is a great need to develop cost-effective fortified food supplements to overcome this problem. Therefore, this study aims to examine the factors that should be considered in the development of low-cost supplementary foods for breastfeeding women. Design/methodology/approach: A wide variety of relevant publications were identified through search in electronic databases (ScienceDirect, PubMed, SciELO, Google Scholar, SpringerLink and ResearchGate) based on different keywords such as malnutrition, specific considerations, supplementary foods and breastfeeding women, which were published before 2020. After looking for adequate literature, 71 articles were examined, which provided an overview of these aspects. Findings: Various food supplements and food products already available in the market are generally expensive and go beyond the purchasing power of lower- or middle-class families. Traditionally, efforts have been made to prepare such supplements at home, but the composition of these products varies based on the economic status of consumers. Therefore, the nutritional status is clearly compromised because of the low standard of living, which requires a great need to develop low-cost nutritious food products, accessible to all and that meet the appropriate nutritional, sensory and economic attributes without ignoring the regulatory guidelines. Originality/value: This review is majorly focused on the specific considerations, alternative sources, ensuring nutritional and sensorial attributes and economic aspects for the development of supplementary low-cost food products for breastfeeding women with the goal of eliminating malnutrition. [ABSTRACT FROM AUTHOR]

Background: Vitamins B12 and folate participate in the one-carbon metabolism cycle and hence regulate fetal growth. Though vitamin B12 deficiency is widely prevalent, the current public health policy in India is to supplement only iron and folic acid for the prevention of anaemia. Prompted by our research findings of the importance of maternal vitamin B12 status for a healthy pregnancy, birth and offspring health outcomes, we evaluated available literature evidence using a systematic review approach, to inform policy. Methods: A systematic search was performed for relevant Indian studies in the MEDLINE/PubMed and IndMed databases. We selected studies reporting maternal vitamin B12 status (dietary intake or blood concentrations), and/or metabolic markers of vitamin B12 deficiency (homocysteine, methylmalonic acid) or haematological indices during pregnancy and their associations with outcomes of pregnancy, infancy or in later life. Intervention trials of vitamin B12 during pregnancy were also included. Quality of evidence was assessed on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Of the 635 articles identified, 46 studies met the inclusion criteria (cohort studies-26, case-control studies-13, RCT's -7). There is a high prevalence of vitamin B12 deficiency in Indian women during pregnancy (40-70%) (3 studies). Observational studies support associations (adjusted for potential sociodemographic confounders, maternal body size, postnatal factors) of lower maternal B12, higher homocysteine or an imbalance between vitamin B12-folate status with a higher risk of NTDs (6 studies), pregnancy complications (recurrent pregnancy losses, gestational diabetes, pre-eclampsia) (9 studies), lower birth weight (10 studies) and adverse longer-term health outcomes in the offspring (cognitive functions, adiposity, insulin resistance) (11 studies). Vitamin B12 supplementation (7 RCT's) in pregnancy showed a beneficial effect on offspring neurocognitive development and an effect on birth weight was inconclusive. There is a high quality evidence to support the role of low maternal vitamin B12 in higher risk for NTD and low birth weight and moderate-quality evidence for higher risk of gestational diabetes and later life adverse health outcomes (cognitive functions, risk for diabetes) in offspring. Conclusion: In the Indian population low maternal vitaminB12 status, is associated with adverse maternal and child health outcomes. The level of evidence supports adding vitamin B12 to existing nutritional programs in India for extended benefits on outcomes in pregnancy and offspring health besides control of anaemia. Systematic Review Registration: [website], identifier [registration number] [ABSTRACT FROM AUTHOR]

Calcium and vitamin D are inseparable nutrients required for bone health. In the past half a century, the dietary calcium intake of rural, tribal, and urban India has declined. Though India is the largest producer of milk and cereals, the major source of calcium in India is through non-dairy products. The highest intake of cereals and lowest intake of milk & milk products was observed in rural and tribal subjects whereas, the intake of cereals, milk & milk products were similar in both urban and metropolitan subjects. One of the reasons for lower calcium intake was the proportion of calcium derived from dairy sources. Over the past half a century, the average 30-day consumption of cereals in the rural and urban population has declined by 30%. The Per Capita Cereal Consumption (PCCC)has declined despite sustained raise in Monthly Per capita Consumption Expenditure (MPCE) in both rural and urban households. The cereal consumption was the highest in the lowest income group, despite spending smaller portion of their income, as cereals were supplied through public distribution system (PDS). About 85% of the Indian population are vitamin D deficient despite abundant sunlight. Dietary calcium deficiency can cause secondary vitamin D deficiency. Though India as a nation is the largest producer of milk, there is profound shortage of calcium intake in the diet with all negative consequences on bone health. There is a decline in dietary calcium in the background of upward revision of RDI/RDA. There is a gap in the production-consumption-supply chain with respect to dietary calcium. To achieve a strong bone health across India, it is imperative to have population based strategies addressing different segments including supplementing dietary/supplemental calcium in ICDS, mid-day-meals scheme, public distribution system, educational strategies. Other measures like mass food fortification, biofortification, bioaddition, leveraging digital technologies, investments from corporate sector are some measures which can address this problem. India is a vast country with diverse social, cultural and dietary habits. No single measure can address this problem and requires a multi-pronged strategic approach to tackle the dietary calcium deficiency to achieve strong bone health while solving the problem of nutritional deficiency. [ABSTRACT FROM AUTHOR]

Multiple micronutrient deficiencies (MNDs) co‐exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6–17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B12 and C‐reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B12 deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B12 remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes. [ABSTRACT FROM AUTHOR]

Objective: To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India.Design: We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls).Setting: Birbhum Health and Demographic Surveillance System.Participants: A total of 4448 adolescents 10-19 years of age participated in the study.Results: The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects.Conclusions: The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme. [ABSTRACT FROM AUTHOR]

Background: Orofacial clefts are the most common congenital anomaly worldwide. Cleft etiology appears to be multifactorial, with genetic and environmental components. Although periconceptional folic acid supplementation has been shown to be protective for neural tube defects, current evidence for its role in cleft prevention is mixed with few studies from low- and middle-income countries. Aim: To investigate the association between periconceptional folic acid intake and incidence of nonsyndromic orofacial clefts among infants in Bangalore, India. Methods: A hospital-based case–control study (106 cases, 212 controls) utilizing a questionnaire to collect data on prenatal supplements, dietary folate, and potentially confounding factors. Multivariate logistic regression analysis was used to assess relationships between folic acid supplementation and all nonsyndromic clefts, and in separate analyses for cleft lip and/or palate (CL/P) and cleft palate (CP), adjusting for statistically significant variables. Results: A statistically significant protective association was found for separate folic acid supplements (not combined with iron or multivitamins) taken in the periconceptional period and all clefts combined (adjusted odds ratio [OR]: 0.62, 95% confidence interval [CI], 0.45-0.86) and CL/P (adjusted OR: 0.57; 95% CI, 0.38-0.86). Higher levels of dietary folate were found to be associated with a reduced risk for all clefts (adjusted OR: 0.98, 95% CI, 0.96-0.99), CL/P (adjusted OR: 0.98, 95% CI, 0.96-0.99), and CP (adjusted OR: 0.96, 95% CI, 0.93-0.99). Conclusion: This study provides limited evidence for a protective association of periconceptional folic acid supplementation with nonsyndromic orofacial clefts. The low proportion of mothers taking folic acid supplements in the periconceptional period highlights the need for increased education and awareness regarding prenatal nutrition. [ABSTRACT FROM AUTHOR]

Background: To reduce the prevalence of anemia, the Indian government recommends daily iron and folic acid supplements (iron supplements) for pregnant women and weekly iron supplements for adolescents and all women of reproductive age. The government has distributed free iron supplements to adolescents and pregnant women for over four decades. However, initial uptake and adherence remain inadequate and non-pregnant women of reproductive age are largely ignored. The aim of this study is to examine the multilevel barriers to iron supplement use and to subsequently identify promising areas to intervene.Methods: We conducted a qualitative study in the state of Odisha, India. Data collection included key informant interviews, focus group discussions with women, husbands, and mothers-in-law, and direct observations in health centers, pharmacies and village health and nutrition days.Results: We found that at the individual level, participants knew that iron supplements prevent anemia but underestimated anemia prevalence and risk in their community. Participants also believed that taking too many iron supplements during pregnancy would "make your baby big" causing a painful birth and a costly cesarean section. At the interpersonal level, mothers-in-law were not supportive of their daughters-in-law taking regular iron supplements during pregnancy but husbands were more supportive. At the community level, participants reported that only pregnant women and adolescents are taking iron supplements, ignoring non-pregnant women altogether. Unequal gender norms are also an upstream barrier for non-pregnant women to prioritize their health to obtain iron supplements. At the policy level, frontline health workers distribute iron supplements to pregnant women only and do not follow up on adherence.Conclusions: Interventions should address multiple barriers to iron supplement use along the socio-ecological model. They should also be tailored to a woman's reproductive life course stage: adolescents, pregnancy, and non-pregnant women of reproductive age because social norms and available services differ between the subpopulations. [ABSTRACT FROM AUTHOR]

Objective: Over half of pregnant women in India are affected by anaemia, which can lead to premature birth, low birth weight and maternal and child mortality. Using formative research, we aimed to understand social and cultural factors around iron and folic acid (IFA) supplement provision and adherence to identify potential strategies for improving adherence and behaviours to prevent and treat anaemia among pregnant and lactating Indian women.Design: In-depth interviews and focus group discussions with women and key informant interviews with health officials and workers.Setting: Four districts in two Indian states: Allahabad and Bara Banki districts in Uttar Pradesh and Chikkballapura and Mandya districts in Karnataka.Participants: Pregnant and lactating women (n 65) and district officials and community health workers (n 14).Results: Most women were aware of anaemia but did not understand its seriousness and consequences. All women received IFA supplements (predominantly for free), but many were not adherent because of side effects; lack of information from healthcare providers on the causes of anaemia, its seriousness and solutions and low social support. To address anaemia, women were most confident in their ability to prepare and eat healthier foods but lacked control over resources such as appropriate food availability.Conclusions: Based on the findings, we recommend multicomponent interventions to train healthcare providers, address systemic barriers and involve family members to support IFA supplement adherence and dietary changes. Future research will determine which strategies are most effective to reduce the burden of anaemia in India among pregnant and lactating women. [ABSTRACT FROM AUTHOR]

Prolonged consumption of fluoride-contaminated water poses health problems like dental and skeletal fluorosis in many parts of the world including India. In regions with acute water scarcity, it demands immediate intervention like de-fluoridation of water before consumption. In the current study, fluoride-resistant bacteria were isolated from fluoride-contaminated groundwater and soil samples collected from Dungarpur district, India, for their potential use in defluoridation. Out of a total of 53 bacterial isolates that were recovered and screened for fluoride resistance, three highly fluoride-resistant isolates DWC1, DWC2 and DWB5, resistant to up to 9200 mg L−1, 7200 mg L−1 and 5200 mg L−1 fluoride respectively, were characterized and identified as Aeromonas sp., Brevibacterium sp. and Paenibacillus sp. respectively. The fluoride removal capacity of isolates DWC1, DWC2, DWB5 and a consortium of all the three isolates was found to be 68.7%, 73.4%, 76.7 % and 70.1% respectively on nutrient broth supplemented with NaF (2000 mg L−1) after 8 days of incubation. Defluoridation conditions for the strain showing the best result (Paenibacillus sp.) were optimized for real fluoride-rich water collected from Ajmer District, India, using the Taguchi design of experiment. A defluoridation of up to 73.3% was observed at 40 °C temperature and pH 8 with inoculum: water ratio of 2:1 after 8 days of incubation. To the best of our knowledge, the defluoridation capacity of Paenibacillus sp. is the highest reported in literature to date for real water samples and could be investigated in further detail for commercial application. [ABSTRACT FROM AUTHOR]