P. R. Padma ¹, K. Kalaivani ²

Affiliations
1 Department of Biochemistry, Biotechnology and Bioinformatics, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore-641 043, IN
2 Department of Biochemistry, Kongunadu Arts and Science College, Coimbatore-641 029, IN

Abstract

All biological systems exist in a constant rage of redox reactions, which are a normal component of the metabolism. The oxidation- reduction status of a cell or tissue is maintained in a balanced state by various components in the cells. When this balance is tipped in favour of the oxidation reactions, a condition called oxidative stress ensues. Severe oxidative stress can result in several pathological conditions like diabetes, hypertension, cardiovascular disorders, neurological disorders and cancer. All aerobic organisms are equipped with an effective antioxidant defence system, which can efficiently counteract the oxidative stress.

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R. V. Lakshmi ¹, M. Sylvia Subapriya ², K. Kalaivani ¹, Prema Ramachandran ¹

Affiliations
1 Nutrition Foundation of India, C-13, Qutab Institutional Area, IN
2 Department of Food Science and Nutrition, Avinshilingam Institute for Home Science and Higher Education for Women, Coimbatore, IN

Abstract

Respiratory infection, diarrhea and fever are three common infections in underfive children; there are substantial differences in the reported prevalence and ranking of these three morbidities between studies and surveys. Seasonal and year to year variation in prevalence of morbidity and impact of health care on the duration and severity of infection has not been explored. A large scale mixed longitudinal study of under-five children from urban low income households was carried out to document year to year and seasonal variations in the prevalence and type of morbidity and utilization of health care for morbidity and their impact on duration and severity of morbidity. Between January 2012 and Dec 2015 a total of 3888 pre-school children were investigated and 74636 observations were made; prevalence of morbidity was 10.3% (range 7.2%-11.6%). Prevalence of morbidity was higher between July and October. Respiratory infection was the most common and diarrhea was the least common illness in children. Over years there was a rise in the respiratory illness because of increase in construction activity in the study area. There was a fall in diarrhoeal diseases after construction of water supply and drainage system. Majority of the households accessed health care; as a result duration of illness was short and severe morbidity was rare. Improvement in environmental hygiene can result in reduction in morbidity. Access to health care reduces duration and severity of infection.

Keywords

Pre-School Children, Morbidity, Seasonal Changes, Health Care, Environmental Hygiene.

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Prema Ramachandran ¹, Amrita Pramanik ¹, K. Kalaivani ¹

Affiliations
1 Nutrition Foundation of India, South Delhi, New Delhi-110 016, IN

Abstract

In India prevalence of anaemia and vitamin D deficiency in pregnancy are widespread. National programmes recommend that two tablets of iron and folic acid (IFA) and two tablets of calcium and vitamin D (Ca & Vit D) to be given every day from second trimester till delivery. To minimize the side effects and increase compliance, it is advised that each tablet should be taken after a meal. Most households follow a three meal pattern. A study was taken up to find out how IFA and Ca & Vit D supplementations can be fitted into the habitual three meal pattern. A short term crossover supplementation study was carried out on 38 pregnant women to assess side effects following consumption after lunch of one or two tablets containing 500mg elemental calcium (as calcium carbonate) and 250 IU vitamin D or 60 mg of elemental iron as ferrous sulphate. Prevalence of side effects was higher in women who received iron supplements as compared to Ca & Vit D supplements. Taking two tablets of Ca & Vit D together after meal was associated with significantly higher prevalence of side effects as compared to taking one tablet after meal. Taking two tablets of iron together after meal was not associated with any significant increase in prevalence of side effects as compared to one tablet. Giving two tablets of iron together after one meal and giving one tablet of calcium and vitamin after two meals is feasible option for providing two tablets each of iron and Ca & Vit D to pregnant women who habitually follow a three meal pattern.

Keywords

Iron Folic Acid Supplementation, Calcium and Vitamin D Supplementation, Pregnancy, Side Effects Following Supplementation.

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Kamini Prabhakar ¹, K. Kalaivani ¹, S. Kowsalya ², Prema Ramachandran ¹

Affiliations
1 Nutrition Foundation of India, C-13, Qutab Institutional Area, New Delhi - 110 016, IN
2 Department of Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore - 641 043, IN

Abstract

For the last four decades India had invested in interventions for improving household food security, supplementary feeding programmes and health care to pre-school children. However under-nutrition rates in under-five children continue to be high. Poor infant and young child feeding and caring practices had been identified as the major modifiable factors associated with under-nutrition especially in the critical first two years. Mother Child Protection Card (MCPC) was introduced as the critical intervention tool for combating these two factors and improving nutritional status of the children. A community based mixed longitudinal study was taken up in urban low middle income group mothers with under-three children to assess feasibility and impact of using MCPC as a supportive tool for nutrition and health education regarding infant and young child feeding and care during illness. Mothers readily accepted MCPC, kept it safely and produced it when requested. MCPC with authentic pictorial messages was used by all health and nutrition front line workers and research team; this practice ensured uniformity in nutrition and health education messages. Over 90% of infants at 2 months and over 2/3^rd at 5 months were solely breast-fed. By 8^th month almost all infants received semi-solid food. Almost all families accessed health care during illness and followed the advice regarding feeding during illness and convalescence. As a result the mean z scores for weight-for-age did not show any deterioration in the first year. MCPC is a useful tool in providing nutrition and health education and improving infant feeding practices.

Keywords

Mother Child Protection Card, Under-Three Children, Infant Feeding, Morbidity, Nutritional Status.

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Anshi Goel ¹, A. Thirumani Devi ², K. Kalaivani ¹, Prema Ramachandran ¹

Affiliations
1 Nutrition Foundation of India, New Delhi - 110 016, IN
2 Department of Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore - 641 043, IN

Abstract

 Currently India is experiencing dual nutrition burden. Prevalence of both under and over nutrition is reported to be higher in women as compared to men. Over nutrition rates in Delhi are among the highest in India. A mixed longitudinal study was undertaken to assess nutritional status of urban women from low middle income families. Between January 2015 and December 2017, 4155 non-pregnant non-lactating women were enrolled for this observational study. These women belonged to food secure low middle income families. They were living in highly congested urban localities in one or two room tenements and had no access to public spaces where they could go for walk or discretionary physical activities. In all women, height was measured at enrolment. Efforts were made to measure weight, mid upper arm, waist and hip circumferences once in three months. Prevalence of under nutrition (BMI < 18.5) in the 18-29 years age group was 12.1%, but 33.9% had BMI of ≥25. There was a progressive increase in over-nutrition, high waist and hip circumferences with increasing age; 68.4% of women aged 50 years and above were over-nourished. None of the undernourished women had waist circumference ≥ 80 cm; among the normally nourished 8.5% and in the over-nourished women 3/4th had waist circumference above 80cm. Hip circumference showed a similar trend but prevalence of ≥ 102 cm was lower. Prevalence of over nutrition, truncal and abdominal adiposity was high in women from Delhi low middle income families.

Keywords

Dual Nutrition Burden, Over Nutrition, Non-Pregnant Women, Bmi, Anthropometric Measurement.

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Kamini Prabhakar ¹, S. Kowsalya ², K. Kalaivani ¹, Prema Ramachandran ¹

Affiliations
1 Nutrition Foundation of India, C-13, Qutab Institutional Area, New Delhi - 110 016, IN
2 Department of Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore - 641 043, Tamil Nadu, IN

Abstract

Right from its inception, ICDS programme envisaged monthly weighing and monitoring of growth in under-three children for early detection of under-nutrition. Currently accurate portable digital balances are available in anganwadi and Mother Child Production Card (MCPC) with child growth charts has been provided to children. A community based mixed longitudinal study was taken up in under-three children from urban low middle income families to assess feasibility and impact of growth monitoring and appropriate nutrition education using MCPC. Monthly weighing of children and plotting the weight-for-age in the MCPC was carried out by the research staff. A total of 5708 children were enrolled and followed up over 32879 visits between 2015 and 2019. Plotting the weight-for-age of the child in growth chart enabled identification of underweight children at the time of the visit so that appropriate nutrition and health education and care can be provided. Monthly weighing and plotting weight-for-age in growth chart enabled identification of small children growing along their own trajectory and prevented them from being mislabelled as under-nourished. Children showing deterioration in Weight for age Z score (WAZ) as compared to earlier visit(s) were readily identified and given needed advice. Personalised nutrition and health education provided at each visit taking into account current nutritional status, morbidity and Infant and Young Child Feeding Practices (IYCF) helped in preventing rise in underweight rates in the first 18 months and brought about some improvement in nutritional status of moderate and severely underweight children. It is feasible to operationalize growth monitoring as envisaged in Poshan Abhiyaan and accelerate the pace of reduction in under-nutrition in under three children.

Keywords

Urban, Under-Three Children, Low Middle Income Families, Growth Monitoring, Mother Child Protection Card, Nutritional Status.

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Amrita Pramanik ¹, K. Kalaivani ¹, Prema Ramachandran ¹

Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi - 110 016, IN

Abstract

In the 1970s poverty leading to low dietary intake prior to and during pregnancy was the major factor responsible for maternal under-nutrition and low birth weight. Over the last four decades there has been reduction in poverty and household food insecurity; concurrently there has been a steep decline in physical activity and some decline in energy intake. As a result of all these changes currently both under-nutrition and over-nutrition are major public health problems in women. A study was undertaken to assess food security status of the family and dietary intake of pregnant women from urban low income families using 24 hour dietary recall. Dietary intakes of pregnant women were compared with intakes of Non-Pregnant Non-Lactating women (NPNL) from the same family. Dietary intakes of both NPNL and pregnant women were compared with Estimated Average Requirement (EAR). Computation of energy intake/CU/day from the diet survey showed that these families were food secure. Both in NPNL and in pregnant women, intakes of cereal and ischolar_mains and tubers were adequate; pulse, leafy vegetables and other vegetables and milk consumption was below EAR; fat consumption was above EAR. Mean energy intake was higher than EAR in NPNL women. There was a small increase in energy intake during pregnancy and intakes met EAR in pregnant women. Dietary intake of iron was below EAR in pregnant women. In urban sedentary women from food secure families, a small but sustained higher than EAR energy intake over years appears to contribute to progressive increase in over-nutrition with increasing age.

Keywords

Urban, Pregnant Women, Non-pregnant Non-lactating Women, Dietary Intake, Food Security, Estimated Average Intake, Micro-nutrients And Macro-nutrients

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Amrita Pramanik ¹, Prema Ramachandran ¹, K. Kalaivani ¹

Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN

Abstract

In the 1970s low dietary intake, pre-pregnancy under-nutrition and low weight gain during pregnancy were thought to be the major factors responsible for over 1/3rd of infants being born with low birth weight in India. Over decades there has been improvement in nutritional status of women; currently both maternal under-nutrition and over-nutrition are major public health problems. Despite improvement in maternal nutritional status, there has been no improvement in birth weight. A study was taken up in women from urban low-middle-income families, to assess maternal nutritional status, weight gain during pregnancy and birth weight; in a sub-group of women the magnitude of residual post-pregnancy weight retention was investigated. Urban women from low-middle-income families (1235) attending antenatal clinics in primary health care institution or receiving antenatal care in community settings, were enrolled for this longitudinal observational study. Gestational age and weight were recorded in 1235 women during 4467 antenatal visits. Mean weight gain in 2nd and 3rd trimester was 7.5 kg. Data on birth-weight was available in 853 women; mean birth-weight was 2.7 kg. In 145 women in whom pre- and post-pregnancy weight was available; the post-pregnancy weight retention was 1.9 kg. Women were heavier before and during pregnancy and there has been improvement in pregnancy weight gain as compared to two decades ago but there was no change in mean birth-weight. Screening, identifying under- or over-nourished pregnant women and providing them with appropriate nutrition and health care can enable improvement in maternal nutrition and birth weight.

Keywords

Pre Pregnancy Weight, Pregnancy Weight Gain, Post Pregnancy Weight Retention, Women from Low Middle Income Groups, Birth Weight

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Honey Kumari ¹, K. Kalaivani ¹, Prema Ramachandran ¹

Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, Delhi, IN

Abstract

In the 1970s Green Revolution enabled India to become self-sufficient in food production, but poverty, low dietary intake and under-nutrition were high. India identified poor families on the basis of energy consumption, provided employment to these families to improve purchasing power, subsidized food grains through PDS to improve family food security and food supplementation through ICDS to children and women from poor families to bridge the gap in their dietary intake. Over years, there has been a decline in under-nutrition but rate of decline was slow. The country is currently having persistent high under-nutrition in children, rise in over-nutrition in adults and increasing intra-family differences in nutritional status. A study was taken up in 547 urban low middle-income families with dual nutrition burden, to assess the current food and macronutrient consumption and food security status of the families and the nutritional status of the individual family members. The average energy intake of these families was 1900 Kcal. This was lower than the EAR for reference population (2110 Kcal/day) but higher by 140 Kcal when compared to the EAR for average Indian population (1760 Kcal/day). In pre-school and school-age children stunting rates were high but wasting and over-nutrition rates were low. Over-nutrition rates in adults were high perhaps due to higher energy intake as compared to the requirements for the short-statured sedentary adults. In view of these findings, it may be useful to explore a dual approach: programmes aimed at improving household food security continue to focus on families; while programmes aimed at improving nutritional status focus on anthropometric screening of individual members (children and adults) for early identification of under-or over-nutrition, appropriate management and monitoring improvement.

Keywords

Dietary Intake, Nutritional Status, Non-communicable Diseases, Children, Women, Men, Urban

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