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This study investigates the impact of Body Mass Index (BMI) on Quality of Life (QoL) and treatment outcomes in breast cancer (BC) patients, particularly focusing on underweight individuals with compromised nutritional status. A nonrandomized prospective study comprising 121 newly diagnosed patients across various BMI categories utilized FACT-B & FACIT-Sp-12 questionnaires. Follow-ups occurred at baseline, during (3rd and 6th), and after (12th month) anthracycline-taxane chemotherapy, either sequentially or concomitantly. Patients with low BMI (<18.5 kg/m2; 53.7%) exhibited significantly poorer QoL, marked by compromised nutritional indicators (low MUAC and SFT). Repeated measures ANOVA identified significant correlations between BMI groups in functional, social, and emotional QoL aspects (p < 0.05), with no notable differences in other domains. A Chi-square (ꭓ2) test underscored a significant link between BMI and treatment response (p < 0.0001), showing higher rates of non-responders among underweight patients (p = 4.259e−14). The study advocates pretreatment consultation with a dietitian as standard care for Indian BC patients, offering complimentary nutritional support for improved QoL outcomes and treatment responses. [ABSTRACT FROM AUTHOR]

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6–59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS‐4 [2015–2016] and NFHS‐5 [2019–2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference‐in‐differences (DID) approach. Utilization of ICDS increased from 58% in 2015–2016 to 71% in 2019–2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%–12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6–59 months in this period. Key messages: Utilization of ICDS services among children aged 6–59 months increased from 58% (2015–2016) to 71% (2019–2021) nationally. The programme's expansion was prominent in urban areas, showcasing progress across states.The prevalence of underweight among children in India declined by 5 percentage points from 2016 to 2021, but almost one‐third of children are still underweight.Increase in coverage and service delivery strengthening of ICDS explained 9%–12% of the observed reduction in underweight between 2016 and 2021.The findings suggest that optimizing quality of interventions under ICDS can have a modest but meaningful contribution in reducing childhood underweight in India. [ABSTRACT FROM AUTHOR]

Background: Three indicators of early childhood undernutrition and associated factors are evaluated among under-5 children in five National Family Health Surveys in India spanning 1992 to 2021. Methods: Data for 533,495 children under 5 years of age (U–5) were analysed in the context of three commonly used indicators of early childhood undernutrition – wasting, stunting and underweight. In addition to descriptive and inferential statistics, binary logistic regression was used to estimate the effects of specific explanatory factors on the three indicators using adjusted odds ratios. Results: Over the three-decade interval, stunting was reduced by 22.1% in boys and 20.9% in girls, followed by underweight, 19.3% in boys and 17.4% in girls; wasting, in contrast, was reduced to a considerably lesser extent, 2.8% in boys and 0.9% in girls. Demographic, maternal and socioeconomic factors were associated with the incidence of early childhood undernutrition, specifically among young mothers and those with less education in low-income families, and among children from Scheduled Tribes or Scheduled Castes. Stunting and underweight declined significantly over the past three decades while wasting changed negligibly. The disparity in the occurrence of early childhood undernutrition was apparent throughout socioeconomic categories and regions of India. Conclusions: The results highlight the need for special programs aimed at reducing waste among children and also the need for customized initiatives focused on the improvement of maternal education and wealth in addition to other ancillary factors related to regional variation. [ABSTRACT FROM AUTHOR]

The underweight status among older adults in India and its association with other health risks has received little attention. Using nationally representative data from the first wave of the Longitudinal Aging Study in India (LASI, 2017-18), this study examined the underweight status among the Indian older adults and investigated its relationship with various health outcomes. The effective sample size of this study was 28,050 older adults aged 60 years or above. Multivariable logistic and linear regression models were employed to meet the objectives of the study. Underweight status was found to be negatively associated functional health, cognitive function, and grip strength. However, no significant association was observed between underweight status and depressive symptoms. Moreover, socioeconomic, demographic, and geographic factors were identified as strong determinants of underweight status among Indian older adults. India has implemented a wide range of nutrition policies that primarily focus on children, mothers, and adolescents. While these policies are important, it is equally crucial to develop interventions specifically tailored for adults and older adults. [ABSTRACT FROM AUTHOR]

Background: Undernutrition is an important public health problem affecting one-third of under five-year-old children in India. Objectives: To assess the nutritional status of under five-year-old children along with child feeding practices. Materials and Methods: We adopted a systematic sampling procedure to carry out this community-based, cross-sectional study in all the districts of Haryana. Data was collected on socioeconomic and demographic particulars along with anthropometric measurements. Analysis was done using SPSS Windows 23. Results: The overall prevalence of stunting, underweight, and wasting was 34%, 27.5%, and 11%, while that of severe undernutrition was 11%, 8%, and 3%, respectively. The odds of underweight were significantly higher among children of the Muslim religion, children of scheduled caste, children of illiterate mothers, lower per capita income, HHs without electricity, landless HHs, low birth weight, no ANC care, and those early ages at complementary feeding. Stunting was significantly higher among children whose mothers were illiterate, children whose fathers were laborers, among landless HHs, with no separate kitchen and lower birth weight, while wasting was higher among children of Muslim religion, children of scheduled caste, with no sanitary latrine facility, low-birth-weight children and early initiation of complementary feeding. Conclusions: Undernutrition is observed to be associated with religion, community, education of mother, per capita income, land holding status, birth weight, and age at complementary feeding. Thus, improving maternal nutrition can improve birth weight, improving maternal knowledge about child feeding, and the household's socio-economic status may improve the nutritional status of children. [ABSTRACT FROM AUTHOR]

The study aimed to explore the association between body mass index (BMI) and cognitive function among older adults in India. Cross-sectional data on 21,000 older adults aged 60 years and older from the first wave of the Longitudinal Ageing Study of India (LASI), conducted in India during 2017-18, were used. Bivariate analysis and multivariate linear regression models were applied. The cognition tests include memory, orientation, arithmetic function, executive function, and object naming. The mean overall cognition score was 24.6 in the study population. Further, BMI status showed a significant and positive association with cognition. The association of underweight with poor cognition (β=-0.72; 95% CI = −0.89, −0.54) whereas overweight (β = 0.57; 95% CI = 0.39, 0.75) and obese (β = 0.97; 95% CI = 0.68, 1.26) with better cognition remained statistically significant after adjusting for sociodemographic, health-related behavior, and health covariates. The mean cognition score of female older adults was always lower than male older adults with normal BMI, irrespective of their BMI categories. This study shows that an underweight BMI is associated with poor cognition in both male and female older adults. In the context of providing health care for older individuals, underweight individuals should be given more attention in India. [ABSTRACT FROM AUTHOR]

A quasiexperimental field study was undertaken in 576 exclusively breastfed (EBF) infants from 0 to 14 weeks in Gujarat, India to assess the effect of the use of appropriate breastfeeding techniques on daily weight gain rate and on reducing the underweight rate in early infancy. The interventions were delivered through the existing health system and focused primarily on counselling pregnant women during antenatal and post‐natal sessions for ensuring 'effective breastfeeding' by adoption of the technique of 'cross cradle hold', appropriate breast attachment, emptying of one breast before shifting to the other along with conducting regular monitoring of infant's weight. The intervention care group (ICG) of 300 EBF infants were compared with 276 EBF infants in the control standard care group (SCG). The findings revealed that median weight gain per day between 0 and 14 weeks was significantly higher (p = 0.000) in ICG (32.7 g) as compared with SCG (28.05 g). The median weight‐for‐age Z at 14 weeks of age was also significantly higher in ICG compared with SCG (p = 0.000). Underweight prevalence was three times lower in ICG (5.3%) compared with SCG (16.7%) at 14 weeks of age. Infants in the ICG were noted to be 2.65‐fold more likely to achieve a weight gain of 30 g or more per day compared with infants in SCG. Nutrition interventions, therefore, must aim not only on mere promotion of EBF for up to 6 months but stress on ensuring EBF is 'effective' for optimum transfer of breastmilk through adoption of appropriate techniques, including cross‐cradle hold, by mothers. Key messages: Breastfeeding, even if exclusive, can be suboptimal if the skills of mothers are not appropriate resulting in poor breastmilk transfer and poor intake of nutrients by a baby.Effective counselling on appropriate attachment to the breast, hold and positioning, is important to increase secretion of milk and optimise the transfer of breastmilk and thus improve infant nutritional status.This study shows that counselling mothers on cross cradle hold technique of breastfeeding during antenatal and post‐natal care periods combined with the frequent weighing of infants significantly escalates daily weight gain to over 30 g/day in 0–14 weeks of age. [ABSTRACT FROM AUTHOR]

Nutritional status is an important aspect of childhood cancer, with a bearing on the disease and subsequent survivorship. We sought to evaluate the long-term anthropometric outcomes in a cohort of pediatric solid tumor survivors treated between 1994 and 2016. Anthropometry was noted at the time of presentation, after completion of therapy, and at the last follow-up. The z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated using WHO growth charts for ages <5 years and the Indian Academy of Pediatrics growth charts for age >/= 5 years. BMI was calculated for adult survivors. We included 317 survivors, comprising 48, 81, and 188 survivors of Hepatoblastoma (HB), Malignant Germ cell Tumor (MGCT), and Wilms Tumor (WT) respectively. The median age at diagnosis was 24.5 (IQR 59-13.2) months, with a follow-up ranging from 5 to 19.54 years. The z-scores of the collective cohort and individual cohorts of HB, MGCT, and WT showed an improving trend from diagnosis to the last follow-up. The difference in the prevalence of malnutrition was found to be statistically significant when any two-time points were compared. Of the 28 adult survivors, 43% were noted to be underweight. Thus, anthropometric measures improve during follow-up, however, up to 15% of children persist in being malnourished. [ABSTRACT FROM AUTHOR]

Most of the women who use alcohol and tobacco before pregnancy likely to use alcohol and tobacco during pregnancy. The objectives of this study was to describe alcohol and tobacco use, and to identify associated characteristics during preconception period. The Indian National Family Health Survey-4 was used. A total of 65,238 preconception, young, married women were included and analysed usingbivariate and multivariate analyses statistical techniques. The data revealed that 4.3% of preconception women in India were using alcohol and tobacco. The prevalence of alcohol and tobacco use was higher among older women (5.6%), Scheduled Tribes (14.2%), living in rural areas (5.0%), non-educated (8.9%), poorest households (9.1%), northeast region (25.0%) and with a low body mass index (BMI) (6.2%). The adjusted odds ratios shown that after controlling for important background factors, being Hindu, from scheduled tribes, already having children, being underweight, from poorest households and Northeast region had higher odds of alcohol and tobacco use compared to with their corresponding reference groups. Findings suggest that preconception women of reproductive age who use alcohol and tobacco should be strongly encouraged and supported to quit alcohol and tobacco use before pregnancy for preventing adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Survivors of childhood acute lymphoblastic leukemia (ALL) are vulnerable to late adverse events such as obesity and an associated metabolic syndrome. Children treated for ALL from 2002 to 2012 were included. BMI was calculated at diagnosis, end of treatment, and 5, 8, and 10-years from diagnosis. BMI-centiles were used to categorize the patients: underweight (<5th-percentile), normal (5th–85th percentile), overweight (85th–95th percentile), and obese (≥95th centile). The study included 179 children with ALL (median age: 59-months). The proportions of patients who were underweight, normal, overweight/obese, were 37%, 56% and 7%, respectively, at diagnosis; and 15%, 51% and 34%, respectively, at 5-years from diagnosis. The median (IQR) BMI Z-score at diagnosis was −1.12(−2.40, −0.26). The median (IQR) BMI z-score of the cohort was higher after 5 [0.22(−0.83,1.24), P < 0.001] and 10-years of diagnosis [0.30(−0.69,0.99), P < 0.001], respectively. The proportion of overweight/obese individuals was higher after 5 (34%, P < 0.001) and 10 (26%, P = 0.001) years. There was a significant correlation between the baseline BMI Z-score and that observed after 5-years (ρ = 0.49, P < 0.001), and 10-years (ρ = 0.55, P < 0.001). At 10-years of follow-up, >25% of children with ALL were overweight/obese. The BMI Z-score at the time of diagnosis continued to correlate with the Z-score after 10-years. [ABSTRACT FROM AUTHOR]

The present paper aims to propose a new hybrid multi-criteria decision-making (MCDM) framework with spherical fuzzy numbers (SFNs). We extend two recently developed algorithms such as level-based weight assessment (LBWA) and MULTIMOOSRAL in spherical fuzzy (SF) domain. We present a case study on six MSME units belonging to engineering cluster for examining their leanness. MSMEs form the backbone of the socioeconomic growth and therefore garner attention of the policy makers. Lean manufacturing (LM) has been a key enabler for the last three decades which help the organizations to achieve business growth. We consider the criteria like leadership, supplier focus, customer focus, process management, waste, culture, human resource focus, technology use and communication, and awareness to compare leanness of the MSMEs using expert opinions. We find that committed leadership, waste reduction, and customer value are given more weightage by the experts for achieving leanness in SMEs. Furthermore, the results show that medium and small units with focused product line score high in terms of leanness. We validate the results obtained by our proposed method by comparing with the same derived by using another widely used approach such as Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). We carry out sensitivity analysis for examining the stability in the solution with the changes in the given condition such as variations in the criteria weights. Our results using SF-LBWA-MULTIMOOSRAL show reasonable accuracy and stability. [ABSTRACT FROM AUTHOR]

Introduction: India is facing a dual burden of malnutrition with high prevalence of underweight and increasing prevalence of overweight/obesity. Methodology: This study reports anthropometric findings (body mass index, waist circumference [WC], and waist–hip ratio [WHR]) from the screening of 3296 students admitted during 2018–2019. Results: Majority of the students were male (70%), with a mean age of 18.57 years. About 31% and 19% of students were underweight and overweight, respectively. Given sex-specific cutoffs for WC and WHR, about 5% and 21% of students were at substantially increased risk of metabolic complications. About 14.5% of normal and underweight students were also found to be at substantially increased risk of metabolic complications. Multivariate analysis found increasing age (odds ratio [OR] = 0.92; 95% confidence interval [CI]: 0.88–0.98) and being male (OR = 0.74; 95% CI: 0.62–0.88) to be protective factors against underweight. We did not find any statistically significant correlation for overweight, for WHR among males, and WC and WHR among females. Conclusion: It has been noted that the college environment increases the risk of weight gain. Hence, it makes a case to periodically study changes in anthropometric measures through a longitudinal study, and accordingly develop life cycle-based interventions for prevention/management of undernutrition, obesity, and related complications. [ABSTRACT FROM AUTHOR]

Background: Infants and pre-school are most susceptible to undernutrition. Integrated Child Development Services is the programme focussing undernourished children by providing them supplementary nutrition. Aim& Objective: To study prevalence of undernutrition in 0-6 year old children and to study factors associated with it. To study impact of supplementary nutrition on undernourished children. Settings and Design: A longitudinal study. Methods and Material: The present longitudinal study was conducted in randomly selected Anganwadis of urban Meerut. Children found to be suffering from under nutrition were followed up at interval of six months to see the impact of supplementary nutrition provided to them at the anganwadi centre. A detailed history of relevant underlying factors responsible for causation of under nutrition were taken from mothers of these children. Statistical analysis used: chi square test was used to find out association between risk factors and undernutrition. Risk factor found statistically significant were further analysed using step wise multiple logistic regression analysis. The impact of supplementary nutrition was assessed using paired t test. Results: Iron folic acid supplementation during pregnancy, exclusive breast feeding in children, immunization and time of initiating complementary feed were found statistically significant on both chi-square and multiple logistic regression analysis. No impact of supplementary nutrition was found on anthropometric measurements of children. Conclusions: The main focus for fighting undernutrition in children (0-6 years) should be on preventing risk factors associated with mothers in antenatal period and during child rearing practices [ABSTRACT FROM AUTHOR]

Background Anemia and poor physical growth during adolescence have far-ranging consequences, but limited longitudinal evidence exists on how changes in these factors relate to changes in learning skills as adolescents mature. Objectives We examined the association between changes in anemia and physical growth during adolescence and learning outcomes. Methods We used longitudinal data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) project, which surveyed adolescents aged 10–19 y in northern India in 2015–2016 and 2018–2019 (n  = 5963). We used multilevel mixed-effects logistic regression models to examine associations between changes in anemia/thinness/stunting status (4 groups: never, improved, new, and persistent) and reading (ability to read a story) and math proficiency (ability to solve division problems) at follow-up. Results Persistent anemia and stunting were higher among girls than among boys (46% compared with 8% and 37% compared with 14%, respectively), but persistent thinness was lower (7% compared with 16%). Improvement in anemia, thinness, and stunting was 1.4–1.7 times higher among boys than among girls. Boys who were anemic in both waves were 74% [adjusted odds ratio (AOR): 0.26; 95% CI: 0.12, 0.59] and 65% (AOR: 0.35; 95% CI: 0.16, 0.76) less likely to be able to read a story and solve division problems, respectively, than boys who were nonanemic in both waves. Persistent thinness in boys was negatively associated with both reading (AOR: 0.37; 95% CI: 0.21, 0.66) and math proficiency (AOR: 0.27; 95% CI: 0.16, 0.46). Persistent stunting contributed to lower reading and math proficiency in boys and girls (AORs: 0.29–0.46). Boys whose anemia or thinness status improved and girls whose stunting status improved had similar learning skills at follow-up as those who were never anemic/thin/stunted. Conclusions Persistent anemia, thinness, and short stature during adolescence were associated with poor learning. Programs targeted at adolescents should contribute to nurturing environments that foster healthy growth and learning. [ABSTRACT FROM AUTHOR]

Aim: The aim of our study was to study and compare the impact and efficacy of medical nutrition therapy (MNT) with that of the standard nutrition therapy(SNT) in children diagnosed with Severe thiness in the age group of 5-10 years and diagnosed as severely thin. Study Design: It was a prospective comparative study, conducted over a period of 18 months at the Nutrition Rehabilitation, Research and Training Centre (NRRTC) associated with a tertiary care hospital in India. Methods and Materials: A total of 113 children in the age group of 5 to 10 years with severe thinness were enrolled and divided into 2 groups-58 were placed in the MNT group and 55 in the SNT group for a period of 8 weeks. The children in both groups received MNT and SNT diet over the said period of 8 weeks. Primary outcome variables were weight gain and body mass index (BMI) (i.e., change in nutritional status). Results: At the end of 8 weeks, the rate of weight gain (gm/ kg/day) was significantly greater in the MNT group, that is, 2.35 gm/kg/day as compared with the SNT group, that is, 0.73 gm/kg/day, and the change in nutritional status was significantly better in the MNT group (p < 0.001) with 62.1% achieving normal nutritional status, 32.8% remaining thin, and 5.2% remaining severely thin as compared to the SNT group in which 9.1% achieved normal nutritional status, 65.5% remained thin, and 25.5% remained severely thin. Conclusion: To conclude, MNT is superior to SNT for the treatment of severe thinness (ST). [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a period characterised by dramatic changes both physically and mentally. Under nutrition is a growing concern worldwide especially in developing countries like India. It has both short-term and long term concerns. Aim: To estimate the prevalence of thinness and stunting among school going early and mid-adolescents of Idukki district in rural Kerala, India. Materials and Methods: The present study was a cross-sectional study which was conducted from June to October 2020 on 1005 subjects aged 10-16 years from four schools-two government and two private sector, selected by simple random sampling. Age group 10-13 years were grouped as early adolescents and 14-16 years were grouped as middle adolescents. After obtaining informed consent from the parents and school authorities, anthropometric measurements such as weight and height were recorded by standard technique. Body Mass Index (BMI) was calculated from height and weight measurements using the formula weight (kg)/height2 (metre2). The values were then plotted on age specific World Health Organisation (WHO) charts for height and BMI. The degree of stunting and thinness was categorised according to the position of the plot. Data was entered into excel sheet and analysed using Statistical Package for the Social Sciences (SPSS) 16.0. Statistical analysis was done using Chi-square test, to test the association between anthropometric data and age group and gender. A p-value <0.05 was taken as significant. Results: 84 (8.4%) adolescents were stunted with equal prevalence in early (n=38, 8.5%) and mid-adolescents (n=46, 8.2%). There was no difference in the prevalence of stunting in males (n=44, 8.9%) and females (n=40, 7.9%). The overall prevalence of thinness among adolescents was 23.7%. with more thinness in early adolescents (27.4%) than midadolescents (20.7%). It was also found that males were thinner than girls especially among middle adolescents. Conclusions: Adolescent undernutrition continues to be an important public health problem in India. Hence, it will be prudent to give high emphasis on nutrition education programmes for adolescents. [ABSTRACT FROM AUTHOR]

Backrground: In India half of the under-5 mortality is attributed to undernutrition. As a consequence of malnutrition numerous health issues are seen in under-5 children. EEarly intervention during this period can reduce the morbidity and mortality. This Study aims to estimate the prevalence of Stunting, underweight, wasting and Thinness among anganwadi children in Dakshina Kannada district, Karnataka. Methodology: A cross-sectional study was conducted among 564 anganwadi children in Dakshina Kannada district, Karnataka. Data collection was carried out using a pre-tested questionnaire. Anthropometric parameters for the assessment of nutritional status of children were measured using standard guidelines. Results: Boys weighed slightly more than girls in the age groups 3 & 4 years whereas girls’ weight was more for age groups 5-7 years. Except for the age group of 6 years, boys were found to be taller than girls. The prevalence of Stunning, Under-weight, Wasting and Thinness in our study was found to be 25.9%, 22%, 27.8% and 24.1% respectively. The prevalence of all 4 parameters were higher among age group of 5 &6 year old children. Conclusion: Stunning, Under-weight, Wasting and Thinness are theissues which requires our country to ensure implementation of policies which are practical and effective and also the interventions across the life cycle that take into account the variations and the context of each state in our country. [ABSTRACT FROM AUTHOR]

Background: Malnutrition among under-five children is a foremost public health problem across India. United Nation estimates that 6.3 million under the age of five die in India, of which 45% die due to malnutrition. The objective of the study was to find out the prevalence and factors associated with malnutrition in terms of underweight, stunting, and wasting in children under five years of age in peri-tribal areas. Methods: Cross sectional study was conducted at the Anganwadi centres in 6 villages under the Rural Health Training Centre. Out of nine Anganwadi centres, five were selected using systematic random sampling method. Total of 370 children aged below five years were selected. Results: Among the 370 children aged 0-5 years, 29.1% children were normally nourished, 70.79% children were malnourished and had one or more form of malnutrition. Only stunting was present in 19.5% children and only wasting was present in 8.9% children. Both underweight and stunting were seen in 5.94% children. Both stunting and wasting were present in 22.16% children and wasting and underweight were present in 10.5% children. respectively, 1% Children were suffering from underweight, stunting and wasting. All three indices (Underweight, Stunting & Wasting) of under nutrition were found to be higher in low-birth-weight children. Conclusion: Mother's educational qualification is strongly associated with nutritional status of children. This might be due to better health care practices in terms of proper exclusive breast feeding, in-time complementary feeding and quality and quantity of complementary feeding among literate mothers as compared to illiterate mothers. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to investigate the prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight among children up to 3 years of age. Materials and Methods: We recruited 150 children of the Bhoksa Tribe aged between 2 to 36 months. Information related to nutritional indicators (length-for-age, weight-forage, and weight-for-length) of the child and sociodemographic variables of the household were collected. Results: The prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight was 15.4%, 32%, 29.98%, and 36.66%, respectively. The prevalence percentage of undernutrition was high among girls but the difference based on sex was not significant. A significant difference in mean birth weight was observed between low and high SES (2.45 kg v/s 2.93 kg). Conclusion: High prevalence of undernutrition concerning birth weight among the children of the Bhoksa Tribe was observed which may be due to socioeconomic inequality in the population. [ABSTRACT FROM AUTHOR]

Objective: To examine prevalence, risk factors, and consequences of maternal severe thinness in India.Methods: This mixed methods study analyzed data from the Indian National Family Health Survey (NFHS)-4 (2015-2016) to estimate the prevalence of and risk factors for severe thinness, followed by a desk review of literature from India.Results: Prevalence of severe thinness (defined by World Health Organization as body mass index [BMI] <16 in adult and BMI for age Z score < -2 SD in adolescents) was higher among pregnant adolescents (4.3%) compared with pregnant adult women (1.9%) and among postpartum adolescent women (6.3%) than postpartum adult women (2.4%) 2-6 months after delivery. Identified research studies showed prevalence of 4%-12% in pregnant women. Only 13/640 districts had at least three cases of severely thin pregnant women; others had lower numbers. Three or more postpartum women aged ≥20 years were severely thin in 32 districts. Among pregnant adolescents, earlier parity increased odds (OR 1.96; 95% CI, 1.18-3.27) of severe thinness. Access to household toilet facility reduced odds (OR 0.72; 95% CI, 0.52-0.99]. Among mothers aged ≥20 years, increasing education level was associated with decreasing odds of severe thinness (secondary: OR 0.74; 95% CI, 0.57-0.96 and Higher: OR 0.54; 95% CI, 0.32-0.91, compared with no education); household wealth and caste were also associated with severe thinness.Conclusion: This paper reveals the geographic pockets that need priority focus for managing severe thinness among pregnant women and mothers in India to limit the immediate and intergenerational adverse consequences emanating from these deprivations. [ABSTRACT FROM AUTHOR]

This paper answers research questions on screening and management of severe thinness in pregnancy, approaches that may potentially work in India, and what more is needed for implementing these approaches at scale. A desk review of studies in the last decade in South Asian countries was carried out collating evidence on six sets of strategies like balanced energy supplementation (BEP) alone and in combination with other interventions like nutrition education. Policies and guidelines from South Asian countries were reviewed to understand the approaches being used. A 10-point grid covering public health dimensions covered by World Health Organization and others was created for discussion with policymakers and implementers, and review of government documents sourced from Ministry of Health and Family Welfare. Eighteen studies were shortlisted covering Bangladesh, India, Nepal, and Pakistan. BEP for longer duration, preconception initiation of supplementation, and better pre-supplementation body mass index (BMI) positively influenced birthweight. Multiple micronutrient supplementation was more effective in improving gestational weight gain among women with better pre-supplementation BMI. Behavior change communication and nutrition education showed positive outcomes on dietary practices like higher dietary diversity. Among South Asian countries, Sri Lanka and Nepal are the only two countries to have management of maternal thinness in their country guidelines. India has at least nine variations of supplementary foods and three variations of full meals for pregnant women, which can be modified to meet additional nutritional needs of those severely thin. Under the National Nutrition Mission, almost all of the globally recommended maternal nutrition interventions are covered, but the challenge of reaching, identifying, and managing cases of maternal severe thinness persists. This paper provides four actions for addressing maternal severe thinness through available public health programs, infrastructure, and human resources. [ABSTRACT FROM AUTHOR]

Background: Drug resistant tuberculosis is a major public health threat that hinders progress in tuberculosis control worldwide. In 2019, India contributed highest cases of TB (27%) Worldwide. In 2019, 3.3% of new TB cases and 18% of previously treated cases had MDR/RRTB worldwide and India (27%) had the largest share of the global burden. This study was done to find out the sociodemographic and clinical profile of drug resistant TB patients. Methodology: It is an observational descriptive study with cross-sectional design, conducted at the drug resistant tuberculosis centre of R. G. Kar Medical College of Kolkata, West Bengal. Study Population consisted of the patients who were registered for the DR-TB regimen. Study duration was July 2016-March 2017. Pre-tested, semi-structured schedule was designed to capture their sociodemographic profile, treatment history, clinical findings and available medical records. Data were compiled in MS Excel and analyzed in IBM SPSS 23.0. Results: Out of 159 cases, 27% patients were between 21-30 years. Males were predominant (68.6%). Most patients (56.6%) were underweight (BMI<18.5kg/m2). HIV seropositivity was found in 4 (2.5%) cases. Among all cases, 81.1% had history of taking ATD and 34.4% was cured in previous episode of treatment. The commonest associated comorbidity was DM (15.7%). Rifampicin resistance (93.1%) was most common followed by Isoniazid (8.2%). Pallor was found among 94.3% patients. Most patients had bilateral (62.3%) and moderately extensive (57.2%) lesions in chest x-ray. Conclusion: DR-TB control should focus adequately on younger age group as numbers of resistance is increasing among them. Relapse in previously cured cases was found to be major contributor of DR-TB suspect cases. Though, Rifampicin resistance was so common but prevalence of resistance to 2nd line drugs is still low. Focus should be given on early detection of drug resistance in all TB cases and improvement of nutritional status of the TB patient. [ABSTRACT FROM AUTHOR]

Background: Under-nutrition is a big risk factor for increasing the morbidity and mortality burden in the society. Acute malnutrition contributes to almost 61% of diarrheal and 53% of pneumonia deaths. In urban slums like M-East ward, Mumbai, acute malnutrition prevalence ranges from 16% to 59.8%. Objectives: To assess the outcome of weight gain by providing nutritional supplements to the undernourished children along with nutritional counseling. Materials and Methods: RUTF (Ready-to-Use Therapeutic Food) and Hyderabad mix with nutritional counselling to parents of children were used to reduce the undernourishment among the under-five children in slums of this ward. Six hundred and fifty malnourished children and their caregivers were provided nutritional supplement and nutritional counselling over 6 months. Results: There was steady wight gain of enrolled children. Highest weight gain occurred over 13th week of the program. Conclusion: A minimum of thirteen weeks nutritional supplement program including fortnightly counselling is necessary and sufficient for converting undernourished children to normal. [ABSTRACT FROM AUTHOR]

Background: Child malnutrition remains a major public health issue in India. Along with myriad upstream and social determinants of these adverse outcomes, recent studies have highlighted regional differences in mean child malnutrition rates. This research helps policy makers look between urban and rural communities and states to take a population-level approach to addressing the root causes of child malnutrition. However, one gap in this between-population approach has been the omission of households as a unit of analysis. Households could represent important sources of variation in child malnutrition within communities, districts, and states. Methods: Using the fourth round of India's National Family Health Survey from 2015 to 2016, we analyzed four and five-level multilevel models to estimate the proportion of variation in child malnutrition attributable to states, districts, communities, households, and children. Results: Overall, we found that of the four levels that children were nested in (households, communities, districts, and states), the greatest proportion of variation in child height-for-age Z score, weight-for-age Z score, weight-for-height Z score, hemoglobin, birthweight, stunting, underweight, wasting, anemia, and low birthweight was attributable to households. Furthermore, we found that when the household level is omitted from models, the variance estimates for communities and children are overestimated. Conclusions: These findings highlight the importance of households as an important source of clustering and variation in child malnutrition outcomes. As such, policies and interventions should address household-level social determinants, such as asset and social deprivations, in order to prevent poor child growth outcomes among the most vulnerable households in India. [ABSTRACT FROM AUTHOR]

Background It is thought that there is a high risk of zinc deficiency in India, but there are no representative national estimates. Objectives We aimed to evaluate the national and state-level prevalence of low serum zinc concentrations (SZCs) in Indian children from the nationally representative Comprehensive National Nutrition Survey. Methods Prevalence of low SZC, adjusted for C-reactive protein, was estimated among preschool (1–4 y; n  = 7874) and school-age children (5–9 y; n  = 10,430) and adolescents (10–19 y; n  = 10,140), using SZC cutoffs defined by the International Zinc Nutrition Consultative Group. Results Prevalence of low SZC was high among adolescents (31.1%; 95% CI: 29.8%, 32.4%), compared with school-age (15.8%; 95% CI: 15.3%, 16.3%) or preschool children (17.4%; 95% CI: 16.7%, 18.0%). However, stratification of prevalence by fasting status or using an alternative lower SZC cutoff independent of fasting status led to a reduction in prevalence by 3.7% or 7.8% in children <10 y, respectively. The prevalence of low SZC was higher among rural preschool children, those belonging to households with poor socioeconomic status, and those with severe stunting or underweight. Preschool children with diarrhea (22.6%; 95% CI: 20.8%, 24.4%), productive cough (22.7%; 95% CI: 18.5%, 27.5%), or malaria/dengue (38.5%; 95% CI: 29.4%, 48.2%) in the 2 wk preceding the survey had a higher prevalence of low SZC than those without morbidity (16.5%; 95% CI: 15.9%, 17.2%; 17.6%; 95% CI: 16.9%, 18.2%; and 17.5%; 95% CI: 16.8%, 18.1%, respectively). Conclusions The national prevalence of low SZC among preschool (17%) or school-age children (16%) was <20%, which is considered the cutoff indicating a problem of public health significance; but there were variations by state and socioeconomic status. In adolescents, however, the prevalence of low SZC was 31%, which warrants further investigation. The association of low SZC with diarrhea in preschool children necessitates better coverage of Zn administration in the management of diarrhea. [ABSTRACT FROM AUTHOR]

Hidden hunger is widespread in India. Individual dietary diversity score (IDDS) is a measure of the nutrient adequacy of the diet. The FAO has set guidelines for the measurement of dietary diversity: the IDDS and the minimum dietary diversity score for women (MDD-W) to assess nutritional deficiency, but validation against nutritional biomarkers is required. Using available data among rural youth (17 years) from the Pune Maternal Nutrition Study, the validity of DDS was assessed to measure deficiencies of vitamin B12, folate and Hb. Of the 355 boys and 305 girls, 19 % were classified as underweight, 57 % as vitamin B12 deficient (<150 pmol/l) and 22 % as anaemic (<120/130 g/l). Cereals, legumes and 'other-vegetables' were the most frequently consumed foods. More boys than girls consumed milk, flesh, eggs and micronutrient-dense foods. Median IDDS of 4 (interquartile range (IQR) 3–4) and MDD-W of 6 (IQR 5–7) were low. Youth with vitamin B12 deficiency had a higher likelihood of an IDDS ≤ 4 (1·89; 95 % CI 1·24, 2·87) or an MDD-W ≤ 5 (1·40; 95 % CI 1·02, 1·94). Youth with anaemia were more likely to have an IDDS ≤ 4 (1·76; 95 % CI 1·01, 3·14) adjusted for socio-economic scores, BMI, energy intake and sex. Folate deficiency was low (3 %) and was not associated with either score. Youth with lowest plasma vitamin B12 and Hb infrequently or never consumed dairy products/non-vegetarian foods. These rural Indian youth were underweight, had low DDS and consumed foods low in good-quality proteins and micronutrients. Associations of DDS with circulating micronutrients indicate that DDS is a valid measure to predict vitamin B12 deficiency and anaemia. [ABSTRACT FROM AUTHOR]

Introduction: For balanced growth and childhood development, adequate nutrition is very necessary. The health and nutritional status of children is an indicator of the health and nutrition of the community and the nutritional profile of the entire country. Undernutrition is not only a significant cause of childhood morbidity and mortality, but it jeopardizes physical as well as mental development of children. The Public Distribution Scheme's bias toward calories and subsidies continued on rice and wheat and did not include more diverse and nutritious foods. Aims and Objectives: This study aims to determine the prevalence of undernutrition among preschool children (3–6 years) attending Anganwadi in Urban Mysuru. Materials and Methods: This community-based cross-sectional study was carried out in the field practice area of Bannimantap Urban Primary Health Centre for a period of 1 year. A total of 365 children (3–6 years) were included in the study. Required total sample size of 365 children in the age group of 3–6 years was selected from each Anganwadi as per population proportionate to size sampling technique. A pretested, semi-structured proforma was used to collect data pertaining to sociodemographic variables, maternal-related variables, and child-related variables. Data were coded and entered into MS Excel 2016 and analyzed using SPSS Version 22. Results: Among the total 365 children aged 3–6 years, 54.7% were males and 45.3% were females. Majority (60.8%) of the children hailed from nuclear family and 50% belonged to upper lower socioeconomic class. The prevalence of undernutrition which constitutes underweight, stunting, and wasting was 25.4%, 23.5%, and 10.2%, respectively. Prevalence of severe acute malnutrition was 0.3%. Conclusion: Lack of socioeconomic development along with ignorance of cost-effective nutritional diet intake contributed to undernutrition in our study area. [ABSTRACT FROM AUTHOR]

Background: Underweight, overweight, and anemia are common public health problems among elderly individuals. Objectives: The current study was conducted in a rural area of Ballabgarh, Haryana, to estimate the prevalence of underweight, overweight, and anemia among elderly persons and to find their association with sociodemographic variables. Materials and Methods: A total of 420 elderly persons aged ≥60 years were selected by simple random sampling. Information on variables was collected by an interview schedule. Body mass index (BMI) was calculated from height and arm-span of elderly persons. Hemoglobin was estimated with HemoCue® Hb 201+ system. Results: Of the total participants, 33.6% were underweight, 13.8% were overweight, 15.6% were obese, and 37.0% had normal BMI. None of the sociodemographic variables was found to be significantly associated with being underweight. Being female was significantly associated with being overweight/obese. The prevalence of anemia was 36.4%. None of the sociodemographic variables was associated with anemia. Conclusions: Underweight and anemia are common among elderly persons in rural areas. These need to be addressed through community-based interventions. [ABSTRACT FROM AUTHOR]

The rising/escalating problem of malnutrition, commonly envisioned as double burden due to increasing rate of both under-nutrition and obesity in third world including country like India in which high prevalence of undernutrition, which is assess by thinness more precisely. Thus, the present study aims to assess the prevalence of under nutrition among Birhor tribe of three villages of Korba district, Chhattisgarh, India. The data was collected from each available individual of the households of the villages on the day of investigation. The social and demographic profile was personally collected by interviewing them and the anthropometric measurement (height, weight, BMI and MUAC) was taken using standard procedures. All the statistical analysis was analysed in the Statistical Package for Social Science (SPSS) version 16.0. The t-test and Chi-square/Fisher Exact test were used to see the difference in anthropometric measurement and undernutrition of males and females. The study revealed that sex combined prevalence of thinness was found higher among children (86.6%), elderly (70%) and adult (58.2%) population than normal. The over-all age and sex combined prevalence of undernutrition is 64.2 % (of which 21.1% were came under grade III thinness, 10.1% were fall within grade II thinness and 33% were in grade I thinness) and 35.8% were normal. No statistically significant sexual difference (X² =0.86, df = 3, P>0.05) was found among them. The high prevalence of undernutrition shows their critical nutritional situation. [ABSTRACT FROM AUTHOR]

Background: Screen viewing has become predominant among children aged under 3 years that causing massive health issues. Nowadays, most of the young kids developed a habit of having food by watching smartphone. Seventy-seven percentage toddlers are using mobile phones every day. Researcher strongly believes that this habit among toddlers is linked, with either overweight or undernutrition. Aim: The present research study aimed to explore the relationship between screen dependency and its effects on child’s nourishment. Settings and Design: An explorative-correlational study was carried out on 280 toddlers. Toddlers were selected using quota sampling, and data were collected from areas of Vadodara district. Subjects and Methods: A structured screen dependency questionnaire was used. Subsequently, toddler nourishment was assessed by using Gomez’s classification scale. Descriptive and inferential statistics were applied to analyze the data by using SPSS-20 software. Linear regression analysis revealed that toddler nourishment was influenced by the level of screen dependency. Results: The majority toddlers 47.9% (n = 134) were severely dependent on screen, and child nourishment among them resulted that 43.9% (n = 123) were overweight, 2.9% (n = 89) found obese, and 28.2% (n = 79) were belong to malnutrition, the rest were normal. The linear regression analysis showed that screen dependency was significantly correlated with child nourishment beta coefficient (R = 0.321, P = 0.00) at significance of 0.05 level. Conclusions: The present study concluded that there is an influence of screen dependency on child’s nourishment. Therefore, the policymakers should also increase the awareness regarding negative impact of screen viewing to the mothers. [ABSTRACT FROM AUTHOR]

Dairy milk has been shown to contribute to child growth in many countries, but the relationship between milk intake and anthropometric outcomes among Indian children has not been studied. The objectives were to describe children aged 6–59 months who consume dairy milk in India and determine if dairy milk consumption was associated with lower odds of stunting, underweight and anthropometric failure among Indian children. This was a cross‐sectional study based on the fourth Indian National Family Health Survey (NFHS‐4), which was a national survey conducted between 2015 and 2016 by the Ministry of Health and Family Welfare. The primary exposure was the consumption of dairy milk within the past day or night. The primary outcomes were stunting (height‐for‐age z score < −2), underweight (weight‐for‐age z score < −2) and the composite index of anthropometric failure (CIAF), which is a combination of weight‐for‐age, weight‐for‐height and height‐for‐age. Multivariable logistic regression models and coarsened exact matching (CEM) were used to determine the relationship between dairy milk and odds ratios of each outcome. Setting was in India. Participants were children (N = 107,639) aged 6–59 months. Children who consumed dairy milk in the past day or night had an odds ratio of 0.95 for underweight (95% CI 0.92–0.98, P =.0005), 0.93 for stunting (95% CI 0.90–0.96, P <.0001) and 0.96 for CIAF (95% CI 0.93–0.99, P =.004), compared with children who did not consume dairy milk after adjusting for relevant covariates. When CEM was used among a subset (n = 28,207), evidence for relationships between dairy milk and anthropometric outcomes was consistent but slightly weaker. Widespread, equitable access to dairy milk among childhood may be part of an effort to lower the risk of anthropometric failure among children in India. [ABSTRACT FROM AUTHOR]

Globally, public health expenditure (PHE) is closely associated with Reproductive, Maternal, Newborn, Child Health, and Nutrition (RMNCHN) and Family Planning (FP) outcomes. In India, the role of PHE in shaping the progress towards the attainment of RMNCHN and FP-related Sustainable Development Goals (SDGs) is not widely documented. Using the four consecutive rounds of National Family Health Survey (NFHS), we have investigated the progress in RMNCHN and FP indicators and their association with PHE by applying robust econometric modelling. The findings suggest that although there is noticeable progress in the RMNCHN indicators from 1992–93–2015–16, India has failed to achieve RMNCHN targets related to Millennium Development Goals (MDGs). Lack of noteworthy correlation between FP indicators and PHE supports the argument that post National Rural Health Mission (2005), the core family welfare expenditure suffered a setback despite the absolute rise in PHE. However, correlation plots and the multivariate panel data regression analyses affirm that even with a moderate rise, PHE emerges as an important predictor of RMNCHN outcomes in the country. Thus, the road to achieving RMNCHN and FP-related SDGs demands to avoid austerity on PHE and strengthen the integration of RMNCHN and FP programmes at the operational level. [ABSTRACT FROM AUTHOR]

Background: Timely identification of adolescents with undernutrition is of utmost importance, and recently, midupper circumference (MUAC) had been considered as an alternative to body mass index (BMI) and BMI for age zscore (BAZ) for its screening. However, little is known about the MUAC cut-offs, specific to age and sex. The study was planned to assess the discriminatory performance of MUAC in identifying thin and severely thin adolescents and estimating age specific MUAC cut-offs, separately for males and females, against BAZ as the gold standard. Methods: The Comprehensive National Nutrition Survey (CNNS), India data was used for this analysis. The Receiver Operating Characteristic curve (ROC), area under curve (AUC), and Youden Index were used to estimate MUAC cut-off values for thin (BAZ < -2) and severely thin (BAZ < -3) adolescents. The current analysis was done on 31471 adolescents. Results: The MUAC cut-offs for identifying thin adolescents were: for 10-14 years -- 19.2/19.4 cm, for 15-19 years -- 22.9/21.7 cm for males and females respectively; and for severe thinness were: for 10-14 years -- 18.4/18.3 cm, for 15-19 years -- 21.9/20.2 cm for males/females. For thinness, the cut-off varied between 17.4-24.5 cm (for 10-19 years) among males, and for females, it varied between 17.5 -20.9 cm (for 10-19 years). For severe thinness, MUAC cut-off ranged between 16.4-23.7 cm (for 10-19 years) among males, and for females, between 17.3-20.7 cm (for 10-19 years). Conclusion: MUAC, a easy to use measure demonstrated an equivalent diagnostic performance for the identification of thinness and severe thinness against BAZ. Thus, age- and sex-specific cut-offs could be considered for screening thin and severely thin adolescents. [ABSTRACT FROM AUTHOR]

Introduction: India is going through a nutritional, epidemic and economic transition. Despite undernutrition among adolescents being a major health concern, there is an additional increased burden of overweight and obesity in this group of individuals. Aim: To determine the prevalence of dual burden of undernutrition and overweight or obesity among school going adolescents aged 10 to 17 years at the population level and determine the associated socioeconomic factors. Materials and Methods: A Cross-sectional community based observational model comprising of 900 school going adolescents aged 10 to 17 years in and around Adichunchanagiri Institute of Medical Sciences, BG Nagara was adopted. A semi structured questionnaire was administered to obtain the sociodemographic details. Height, weight, waist circumference and hip circumference were measured using prior validated and standard tools. Association between nutritional parameters and various risk factors was done by chi-square test or Fisher Exact test. Logistic regression analysis was done. p <0.05 was considered as statistically significant. Results: The prevalence of stunting and underweight was (110/900) 12.2% & (524/900) 58.2% respectively. Prevalence of overweight and obesity was 3.3% & 0.8% respectively. Prevalence of dual burden (underweight, overweight and obesity) was 62.3 %. There was significant association between dual burden and age, maternal education and socioeconomic status (p-0.019, p≤0.001, p≤0.001 respectively). Conclusion: The prevalence of dual burden was high among adolescents. There is a need for policy makers to take measures to combat this dual burden to reduce the morbidity and mortality associated with dual burden of malnutrition. [ABSTRACT FROM AUTHOR]

Objectives: This article highlights the prevalence of symptom frequencies in Nagaland, India, with a focus on depressed mood and hot flashes. We also examine how symptoms cluster together among Naga women and identify factors associated with symptom experience. We hypothesized an elevated frequency of depressed mood because of the stresses associated with social responsibilities within a patriarchal culture, and a low frequency of hot flashes because of the thinness of the population. Methods: Standardized questionnaires with close‐ended questions were used to determine the frequency of symptoms and sociodemographic and health parameters among women aged 35 to 65 years (n = 352). Factor analysis was used to examine the relations among symptoms. Bivariate analyses and linear regressions were also employed to identify sociodemographic and health factors associated with symptoms. Results: Menopausal symptoms, such as feeling dizzy or faint, anxiety or panic, and excitable, were significantly higher in premenopausal women; hot flashes in perimenopausal women; and feeling tired or lack in energy, headaches, difficulty in sleeping, and muscle or joint pain in postmenopausal women. Four symptom factors were identified: symptoms related to the loss of estradiol, psychosomatic symptoms, uneasiness, and depressed mood. After adjusting for menopausal status, socioeconomic status, education, and self‐reported health status, body mass index was observed to be inversely associated with the depressed mood factor but not other factors. Conclusion: In the context of Nagaland, India, having extra weight may contribute to emotional well‐being; however, further research is warranted. [ABSTRACT FROM AUTHOR]

Background: Despite economic growth observed in developing countries, under-nutrition still continues to be a major health problem. Undernutrition in adolescence can disrupt normal growth and puberty development and may have long-term impact. Therefore, it is important to study the undernutrition among adolescents. This study aimed to assess the prevalence and the associated factors of stunting, thinness and the coexistence of both (stunting and thinness) among the adolescent belonging to Uttar Pradesh and Bihar, India. Methods: The study utilized data from Understanding the Lives of Adolescents and Young Adults (UDAYA) project survey, which was conducted in two Indian states Uttar Pradesh and Bihar, in 2016 by Population Council under the guidance of Ministry of Health and Family Welfare, Government of India. Utilizing information on 20,594 adolescents aged 10–19 years (adolescent boys-5,969 and adolescent girls-14,625), the study examined three outcome variables, i.e., thinness, stunting, and co-existence of both. The study used descriptive and bivariate analysis. Furthermore, the study examined income-related inequality in stunting and thinness through concentration index. At last, the study used Wagstaff decomposition analysis to decompose the concentration index. Results: The prevalence of thinness was higher among adolescent boys as compared to girls (25.8 per cent vs. 13.1 per cent). However, stunting was more prevalent among girls (25.6 per cent) than in boys (39.3 per cent). The odds of stunting were higher among late adolescents [Boys- OR:1.79; CI: 1.39, 2.30] and [Girls- OR: 2.25; CI: 1.90,2.67], uneducated adolescents [Boys- OR:2.90; CI: 1.67, 5.05] and [Girls- OR: 1.82; CI: 1.44,2.30], and poorest adolescents [Boys- OR:2.54; CI: 1.80, 3.58] and [Girls- OR: 1.79; CI: 1.38,2.32]. Similarly age, educational status, working status and wealth index were significantly associated with thinness among adolescent boys and girls. Media exposure [Boys- OR: 11.8% and Girls- 58.1%] and Wealth index [Boys: 80.1% and Girls: 66.2%] contributed significantly to the inequality in the prevalence of thinness among adolescents. Similarly, wealth index [Boys: 85.2% and Girls: 84.1%] was the only significant contributor to the inequality in the prevalence of stunting among adolescents. Conclusion: The study provides an understanding that stunting and thinness is a significant public health concern among adolescents, and there is a need to tackle the issue comprehensively. By tackling the issue comprehensively, we mean that the state government of Uttar Pradesh and Bihar shall screen, assess, and monitor the nutritional status of adolescent boys and girls. The interventions shall focus towards both boys as well as girl adolescents, and particular emphasis should be given to adolescents who belonged to poor households. Also, efforts should be taken by stakeholders to increase family wealth status. [ABSTRACT FROM AUTHOR]

Background: School-going children and adolescents are rarely targeted in nutrition surveys, despite the significant impact of nutritional status on their health, cognition, educational achievements and future economic productivity. The present secondary data analysis evaluated the nutritional status of children and adolescents in the 5-18 years age group.Materials and Methods: The anthropometric measurements of children and adolescents studying in the government and government-aided schools were collected under the 'Rashtriya Bal Swasthya Karyakram' in the District Fatehgarh Sahib of Punjab, India between March and August 2018. It was analyzed using SPSS version 21. Mean and standard deviation for weight-for-age, height-for-age, body mass index (BMI) for age z-scores were calculated using World Health Organization's Anthro-plus software.Results: A total of 897 children's data were included in the study. Out of 352 children in 5-9 years age group, mean weight, height and BMI were 15.7 ± 3.8 kg, 110.7 ± 10.6 cm and 12.7 ± 2.1 kg/m2. About 58.8%, 37.4% and 31.8% of the children were categorized as severely underweight, stunted and thin, respectively. In the 10-18 years age group, mean weight, height and BMI were 30.5 ± 9.5 kg, 140 ± 13.4 cm and 15.2 ± 2.6 kg/m2. Severe stunting was present in 19.4% of adolescents, while 26.9% were severely thin.Conclusion: Our study depicts a high level of undernutrition in school-going children and adolescents. There is a need to strengthen the nutrition interventions for middle childhood and adolescence period that can help in a healthy transition from childhood to adulthood and break the intergenerational cycle of malnutrition. Lay summaryNational and state-level health-priorities focus mainly on improving the nutrition status of under-5-year children, while the school-going children and adolescents are usually neglected. The present secondary data analysis estimates the burden of malnutrition in school-going children and adolescents. These data were collected under one of India's national health programs that intend to tackle childhood illnesses. Our study depicts a high level of undernutrition in school-going children and adolescents. We found that girls were affected more by malnutrition in middle childhood, i.e. during 5-9 years (both by stunting and thinness) compared to boys. But in middle and late adolescence, males were more stunted and thin compared to females. Programs to support adolescents' nutrition interventions could provide an opportunity for a healthy transition from childhood to adulthood and could be an essential step in breaking the intergenerational cycle of malnutrition. [ABSTRACT FROM AUTHOR]

Like several indigenous populations, Sauria Paharias, a vulnerable indigenous tribal group residing in a biodiverse environment of Jharkhand, India, have high levels of undernutrition. We assessed agroforestry and dietary diversity, food consumption especially indigenous food (IF) intake and nutritional status of Sauria Paharia women through a cross‐sectional study conducted in 18 villages of Godda district, Jharkhand. Household level information was elicited through household surveys including a dietary survey and a food frequency questionnaire. Twenty‐four‐hour dietary recalls (24 HDR) and anthropometric assessments were taken on one randomly selected woman per household. An index, Food Accessed Diversity Index (FADI) created to measure agroforestry diversity, showed a low mean score of 0.21 ± 0.15 and range: 0, 0.85. Fifty‐nine percent of women consumed any IF during 24 HDR. Median minimum dietary diversity score for women (MDD‐W) was 3 (acceptable score ≥5). More than 96% of women had intakes below estimated average requirements for all nutrients studied (energy; vitamins A, C, thiamine, riboflavin, niacin, pyridoxine; folate; iron; calcium and zinc) except protein; 41% women were underweight. IF consumption was independently associated with calcium and vitamin A intake. Decision trees developed for micronutrient consumption at different levels of MDD‐W score and IF consumption scenarios revealed 1.3 to 2.9 times higher consumption of micronutrients among women with MDD‐W ≥ 3 or 4. Strategies like agricultural extension programmes promoting indigenous varieties and nutrition education for increasing dietary diversity with IFs have potential to address undernutrition in Sauria Paharia women. [ABSTRACT FROM AUTHOR]

Objectives: Nutritional status is the sensitive indicator of a child's health, and they constitute the most vulnerable segment of any community. Undernutrition causes a great deal of physical, mental, and emotional suffering. Anganwadi is a part of the Integrated Child Development Services program started to combat child hunger and child malnutrition. This study was undertaken to assess the nutritional status of the children (6 months--6 years) in Anganwadis and determine the sociodemographic factors associated with malnutrition and to assess their dietary intake. Materials and Methods: This cross-sectional study was undertaken among 580 children in Anganwadis in the urban field practice area of a Medical college in Tumkur. Results: In this study, the overall prevalence of underweight, stunting, and wasting was found to be 34.14%, 45.52%, and 35.52%, respectively. Age, socioeconomic status, immunization status, religion, and mother's education was associated with undernutrition. The deficient intake of calorie and protein was seen in 90% and 64.8% of the study participants. Conclusion: The present study showed that there is still a high prevalence of undernutrition among the Anganwadi children aged 6--72 months. Socioeconomic factors have a significant role in child nutrition, which manifests itself as poor development. [ABSTRACT FROM AUTHOR]

Introduction: For balanced growth and childhood development, adequate nutrition is very necessary. The health and nutritional status of children is an indicator of the health and nutrition of the community and the nutritional profile of the entire country. Undernutrition is not only a significant cause of childhood morbidity and mortality, but it jeopardizes physical as well as mental development of children. The Public Distribution Scheme's bias toward calories and subsidies continued on rice and wheat and did not include more diverse and nutritious foods. Aims and Objectives: This study aims to determine the prevalence of undernutrition among preschool children (3-6 years) attending Anganwadi in Urban Mysuru. Materials and Methods: This community-based cross-sectional study was carried out in the field practice area of Bannimantap Urban Primary Health Centre for a period of 1 year. A total of 365 children (3--6 years) were included in the study. Required total sample size of 365 children in the age group of 3-6 years was selected from each Anganwadi as per population proportionate to size sampling technique. A pretested, semi-structured proforma was used to collect data pertaining to sociodemographic variables, maternal-related variables, and child-related variables. Data were coded and entered into MS Excel 2016 and analyzed using SPSS Version 22. Results: Among the total 365 children aged 3-6 years, 54.7% were males and 45.3% were females. Majority (60.8%) of the children hailed from nuclear family and 50% belonged to upper lower socioeconomic class. The prevalence of undernutrition which constitutes underweight, stunting, and wasting was 25.4%, 23.5%, and 10.2%, respectively. Prevalence of severe acute malnutrition was 0.3%. Conclusion: Lack of socioeconomic development along with ignorance of cost-effective nutritional diet intake contributed to undernutrition in our study area. [ABSTRACT FROM AUTHOR]

A quarter of 400 million urban Indian residents are poor. Urban poor women are as undernourished as or worse than rural women but urban averages mask this disparity. We present the spectrum of malnutrition and their determinants for more than 26,000 urban women who gave birth within 5 years from the last two rounds of Demographic Health Survey 2006 and 2016. Among urban mothers in the lowest quartile by wealth index (urban poor), 12.8% (95% CI [11.3%, 14.5%]) were short or with height < 145 cm; 20.6% (95% CI [19%, 22.3%]) were thin or with body mass index < 18.5 kg/m2; 57.4% (95% CI [55.5%, 59.3%]) had any anaemia (haemoglobin < 12 g/dL), whereas 32.4% (95% CI [30.5%, 34.3%]) had moderate to severe anaemia; and 21.1% (95% CI [19.3%, 23%]) were obese (body mass index ≥ 25 kg/m2). Decadal gains were significant for thinness reduction (17p.p.) but obesity increased by 12 p.p. Belonging to a tribal household increased odds of thinness by 1.5 (95% CI [1.06, 2.18]) times among urban poor mothers compared with other socially vulnerable groups. Secondary education reduced odds of thinness (0.61; 95% CI [0.48, 0.77]) and higher education of short stature (0.41; 95% CI [0.18, 0.940]). Consuming milk/milk products, pulses/beans/eggs/meats, and dark green leafy vegetables daily reduced the odds of short stature (0.52; 95% CI [0.35, 0.78]) and thinness (0.72; 95% CI [0.54, 0.98]). Urban poor mothers should be screened for nutritional risks due to the high prevalence of all forms of malnutrition and counselled or treated as per risk. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) Child Growth Standards ("WHO Standards") 2007 are the most recent and updated indicators which provide a single international standard that represents the best description of physiological growth for all children. Objectives: The objective of the study was to estimate the prevalence of malnutrition as per anthropometric indicators, namely underweight, stunting, and wasting among rural children in Raipur district, Chhattisgarh, using the WHO Child Growth Standards. Materials and Methods: Nutritional assessment of children was conducted in rural areas using standard anthropometric measurements of height and weight. Totally 10,730 children were screened in 61 schools and 30 Anganwadis belonging to 26 villages across 3 major blocks in Raipur district, Chhattisgarh, during June 2013 to February 2018. Weight-for-age, height-for-age, and body mass index-for-age z-scores were calculated using WHO AnthroPlus software. Results: The prevalence of underweight (≤2 standard deviation) was 45.7% in the children examined. The prevalence of stunting and wasting was 40.4% and 22.0%, respectively. Twenty-two of the 26 villages screened reported malnutrition in more than 30.0% of children, namely every third child lags behind in his or her growth curve despite the Mid-Day Meal Program implemented across the nation including this region since several decades. Conclusion: Malnutrition remains an ongoing health problem in school-going children. WHO AnthroPlus software can be very useful for analysis of state- and national-level data of nutritional status of children and could be used to shape health policies for this age group accordingly. [ABSTRACT FROM AUTHOR]

Thinness is a major underlying problem among tribal preschool children in the developing countries including India. To assess the prevalence of low body weight/ thinness based on age and sex specific new international BMI (proposed by Cole et al.2007) cut-off points, among 2-5 years tribal preschool children of West Bengal, India. A total 643(328 boys and 315 girls) tribal preschool children were studied from 36 villages using the stratified random sampling method. Commonly used indicators, that is, height, weight, and BMI were used to evaluate the nutritional status. The present study revealed that the nutritional status of the studied tribal preschool children was poor with a very high rate of thinness in boys and girls (69.5% and 69.2%, respectively). Significant age differences in mean height, weight and BMI (p= <0.001) among boys and girls were observed. The results of the present study clearly indicate that the nutritional status of these children is unsatisfactory. Very high prevalence of thinness was present among the pre-school children and this was indicative of major nutritional deprivation. The proposed values may be useful in evaluating growth and nutritional status of tribal preschool children. It may also be used for comparisons with other ethnic groups. [ABSTRACT FROM AUTHOR]

Background: In West Bengal, according to the National Family Health Survey (NFHS-4) 2015-16, undernutrition and anemia are particularly common among scheduled tribe women and children. The purpose of this research is to assess the nutritional status of Adivasi mothers and child feeding patterns, relevant for clinical practice and the design of future preventive actions. These baseline characteristics were obtained in the scope of a feeding trial aimed at improving the hemoglobin concentration of the index child (6–39 months). Methods: In February 2015, the baseline survey was conducted in 21 tribal villages. In total, 288 mothers and 307 children were recruited for their hemoglobin levels (HemoCue Hb201+), as well as anthropometric indices height/length, weight and MUAC. By questionnaire-based interview aspects on child feeding practices, childcare, family scheduling, and prenatal care were elucidated. Results: The majority of mothers belong to the Santal tribe (93.8%). Nearly half of mothers suffered from underweight including severe forms (BMI < 18.5: 49.4%), and the majority of mothers were anemic (Hb < 12 g/dl: 86.2%). Similarly, undernutrition was highly prevalent among the index children. Ever breastfeeding was almost universal in the study area (99.6%), with all infants aged < 12 months at the time of the interview still being breastfed. The majority of children were breastfed within the first hour after birth (75.7%), still every third child (32.2%) was deprived of colostrum. Merely 32.9% of infants were exclusively breastfed for 6 months (180 days) according to the recommendations of the WHO/UNICEF. When relating to the proposed complementary feeding (CF) indicator then 89.6% of children have received CF (mainly family foods/biscuits/plain rice) during the first 6 to 8 months, and 46.8% of children aged 6 to 23 months fulfilled the minimum acceptable diet (2 to 3 meals per day and ≥ 4 food groups per day), corresponding to 58.1% among children aged 12 to 23 months versa 25% among infants aged 6 to 11 months. Conclusion: The maternal nutritional status was poor and showed interrelations with the nutritional status of the index child. Inadequate feeding and caring practices were common. In particular the younger age group (< 12 months) was found at risk of being offered inadequate CF, which needs to be tackled by future programs. Trial registration: The trial was retrospectively registered at the German Clinical Trials Register on the 1st July 2019 (DRKS00017388). [ABSTRACT FROM AUTHOR]

Assessment of presence of the phenotypic characteristic of Polycystic Ovarian Syndrome among young adult girls in a selected college in Kanchipuram District, Tamil Nadu. The Objectives are to assess the phenotypic characteristics of polycystic ovarian syndrome among young adult girls. To determine the association between phenotypic characteristics with selected demographic variables. The convenience sampling technique was used to select 295 sampling. Validity and Reliability data collection tools were established. The data were collected by self-structured questionnaires. The collected data were tabulated and analyzed. The findings of the present study Shows that the presence of phenotypic characteristics of PCOS based on score of hirsutism was estimated to be (39.7%) and based on grading of acne was estimated to be (66.8%) of young adult girls have mild acne characteristics of PCOS, (13.5%) of young adult girls have moderate acne characteristics of PCOS.(11.9%) have severe acne characteristics of PCOS and (7.8%) have very severe acne characteristics of PCOS. There is significant association between the demographic variables and the scoring of hirsutism of young adult girls in their age, residence, age of menarche, regulation of menstrual cycle, length of menstrual cycle, BMI at p value= <0.05 level of significant. And there is significant association between demographic variables and the grading of acne among young adult girls in their residence, menstrual cycle, length of menstrual cycle, family history of PCOS, co-morbidities, BMI at p value= <0.05% level of significant. [ABSTRACT FROM AUTHOR]

Objectives: The present study was designed with the objective to study the prevalence of depression and anxiety symptoms among adolescents and to explore the association of these disorders with Body Mass Index. Settings and Design: School setting and Cross-Sectional study design. Participants: 546 adolescents, aged 13-15 years, studying in public schools (n=5) in Delhi (Purposive sampling). Methods and Material: Anthropometric measurements: Height of the subjects was measured using a stadiometer in cm (to nearest 0.5cm). Weight was assessed using TANITA's Body Fat Monitor (UM-076). After gathering height and weight data, BMI (kg/m2) Z scores were calculated and classified into four categories: Underweight, Normal weight, Overweight and Obesity based on WHO's growth standards for BMI for age cutoffs. Mental Health Assessment: For this purpose, we used the Child Behavior Checklist (CBCL) for ages 6-18 years; parent report version. Results: A V shaped curve (trend) was observed between the association of depression and anxiety scores in four BMI categories; with majority of the malnourished adolescents having higher scores for depression and anxiety symptoms. It was interesting to note that any deviation from normal weight, either underweight or overweight/obese was significantly associated with depression (p = <0.001) and anxiety (p = <0.001) scores. Conclusions: The study emphasizes the association between body weight and depression and anxiety symptoms among adolescents studying in public schools of Delhi. It adds to the growing body of research in the area of nutritional psychiatry which needs to be promoted for the prevention and management of these disorders through a healthy diet. [ABSTRACT FROM AUTHOR]

The present study was aimed to assess the effect of socio-demographic, economic and dietary factors on nutritional status among children of 6–11 years of age in an urban megacity of India. It was a descriptive cross-sectional study conducted among 251 urban children living in slums, non-slums and squatters of North Kolkata. The study reveals that prevalence of underweight was much higher among children of squatters (66.7%), whereas a significant proportion of children belonged to non-slums were found overweight (23.7%). Although the prevalence of both underweight and overweight was more among girls (16.8% and 34.5%), stunting was found marginally higher among boys (18.9%) than girls (17.7%). The risk of being malnourished increases significantly with increasing number of own siblings, low educational status of mother, improper food intake, etc. Multi-pronged strategies are required to implement comprehensive nutrition–education programme for improving dietary habits among children. [ABSTRACT FROM AUTHOR]

Background: Plateletpheresis procedures are generally safe and associated with low adverse reactions. Although donor reactions and injuries are self-limited events, they may discourage donors from future platelet donations. Aim: The purpose of this study was to determine the prevalence and predictors of adverse donor reactions in plateletpheresis donors, which could serve as targets for interventions to reduce reactions. Materials and Methods: The study included 106 platelet donors over a period of 2 years. The demographic, biometric, and clinical parameters were noted. The data were analyzed for predictors of adverse donor reactions. Statistical Analysis Used: The data were analyzed using independent sample t-test to correlate donor variables such as gender. To correlate other variables such as age, weight, and whole blood processed, Chi-square test was used. Results: A total of 106 plateletpheresis donations were performed and 13.2% of vasovagal reactions were observed. The significant predictive factors for reactions were young female donors with low body weight in which more than 2.5 L volume of whole blood was processed and more than 250 ml of acid, citrate, and dextrose-A was infused and with single venous access procedures. Conclusions: The results of this study are encouraging and helpful in identifying donors at risk for developing adverse reactions during plateletpheresis so that proper and close observation during and after donation as well as timely intervention can prevent most of the unpleasant events of plateletpheresis donors. [ABSTRACT FROM AUTHOR]

Maternal education plays a central role in children's health, but there has been little research comparing the role of maternal education across health outcomes. It is important to distinguish child health outcomes from medical care outcomes. Health outcomes such as short-term morbidity and stunting are multifactorial in origin and determined by a range of factors not necessarily under a mother's control. Mother's education, given the necessary structural factors such as medical centres, is likely to lead to increased access to, and uptake of, medical services. Using data from the 2004-05 India Human Development Survey, eight separate logistic regressions were carried out on 11,026 women of reproductive age and their last-born child under five years of age. The results showed that maternal education had the strongest association with medical care, immunization (except polio) and iron supplementation for pregnant mothers, moderate association with underweight and weak association with short-term diseases and stunting. In addition, the study investigated whether maternal education impacts child health and medical care outcomes through the intervening roles of empowerment and human, social and cultural capital. These intervening linkages were found to be missing for short-term diseases and stunting, bolstering the argument that the influence of maternal education is limited for these outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite a fast-growing economy and the largest anti-malnutrition programme, India has the world's worst level of child malnutrition. Despite India's 50% increase in GDP since 1991, more than one third of the world's malnourished children live in India. Among these, half of the children under age 3 years are underweight and a third of wealthiest children are over-nutrient. One of the major causes for malnutrition in India is economic inequality. Therefore, using the data from the fourth round of National Family Health Survey (2015–16), present study aims to examine the socio-economic inequality in childhood malnutrition across 640 districts of India. Method: Concentration curve and generalized concentration index were used to examine the socioeconomic inequalities in malnutrition. However, regression-based decomposition methodology was used to decomposes the causes of inequality in childhood malnutrition. Result: Result shows that about 38% children in India were stunted and 35% were underweight during 2015–16. Prevalence of stunting and underweight children varies considerably across Indian districts (13 to 65% and 7 to 67% respectively). Districts having the higher share of undernourished children is coming from the particular regions like central, east and west part of the country. On an average about 35% of household in a district having the access of safe drinking water and 42% of household in a district exposed to open defecation. The study found the inverse relationship between district's economic development with childhood stunting and underweight. The concentration of stunted as well as underweight children were found in least developed districts of India. Decomposition approach found that practice of open defecation is positively influenced the inequality in stunting and underweight. Further, inequality in undernutrition is accelerated by the height and education of the mother, and availability of safe drinking water in a district. Conclusions: The districts that lied out in a spectrum of developmental diversity are required some specific set of information's that covering socio-economic, demographic and health-related quality of life of people in those backward districts. More generally, policies to avail improved water and sanitation facility to public and female literacy should be continued. It is also important to see that the benefits of both infrastructure and more general economic development are spread more evenly across districts. [ABSTRACT FROM AUTHOR]