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Ramachandran, Prema
- National Programmes to Improve Food Security and Nutritional Status
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1 Nutrition Foundation of India, New Delhi, IN
1 Nutrition Foundation of India, New Delhi, IN
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The Indian Journal of Nutrition and Dietetics, Vol 52, No 1 (2015), Pagination: 97-133Abstract
Dual nutrition burden in India is a challenge to the nutrition sector but this can also be considered as an opportunity for the health and nutrition services to show their mettle. The decline in under nutrition rates can be accelerated through the effective implementation of the Food Security Act, ongoing food supplementation of the vulnerable groups and improved access to health care for infections. Over nutrition (BMI>25) rates were less than 5% in the seventies and eighties. Over the last 15 years there has been a progressive but slow rise in over nutrition rates both in women and men. However over nutrition rates in India is still less than 15%. India has two major advantages in combating rising over nutrition rates. Unlike many developing countries economic growth in India was not associated with increased energy intake. Steep reduction in physical activity is the major factor responsible for the rise in over nutrition. The population is becoming aware that moderate physical activity is essential for optimal nutrition and health. If energetic steps are taken to promote discretionary physical activity in all segments of population it will be possible to prevent the projected rise in over nutrition. At present over half of the Indians are normally nourished. With the efforts to reduce under nutrition and steps to prevent escalation of over nutrition, it is possible that majority of Indians may remain normally nourished and not incur the health hazards associated with under and/or over nutrition.Keywords
National Programmes, Food Security, Nutritional Status, Food Security Mission, Horticultural Mission, National Health Mission, ICDS, Midday Meal Programme.
References
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- Millennium Development Goals:Tamil Nadu's Achievements
Abstract Views :269 |
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Authors
Affiliations
1 Nutrition Foundation of India, New Delhi, IN
1 Nutrition Foundation of India, New Delhi, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 53, No 3 (2016), Pagination: 252-267Abstract
India with 2.5% of the global land mass is the home of one sixth of the global population. India has always considered population as the major resource for national development. The country accorded high priority to development of human resources through investments in education, nutrition and health. The national Five Year Plans, enunciated the policies, laid down strategies, outlined programmes to improve health and nutritional status of the population, laid the goals to be achieved in specified time frame and provided the needed funds to implement the interventions. The National Health Policy set ambitious goals for health, population and nutrition sectors to be achieved by 2000 AD. Over years there has been substantial progress but given the vast country and varied problems in different states and various constraints, the progress towards these goals was uneven and the country could not achieve many of the goals set for 2000 AD.References
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- Dual Nutrition Burden in Women
Abstract Views :172 |
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Authors
Affiliations
1 Nutrition Foundation of India, New Delhi - 110 016, IN
1 Nutrition Foundation of India, New Delhi - 110 016, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 44, No 1 (2007), Pagination: 71-88Abstract
From time immemorial it has been recognized that women-especially pregnant and lactating women-form one of the most vulnerable segments of the population from nutritional point of view. Numerous studies in India and elsewhere have shown that in chronically undernourished women subsisting on unchanged low dietary intake, pregnancy and lactation have an adverse effect on maternal nutritional status. Maternal under nutrition is associated with low birth weight and all its attendant adverse consequences. Epidemiological studies from India documented the magnitude and adverse consequences of Chronic Energy Deficiency (CED) on the mother child dyad and paved way for intervention programmes to address under-nutrition during pregnancy and lactation.- Morbidity due to Infections in Preschool Children from Urban Low Income Households
Abstract Views :332 |
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 55, No 4 (2018), Pagination: 488-499Abstract
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.References
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- Singh, H.N., Devi, H.S., Singh, Y.M., Leikai, T.L., Gate, N.F. and Lamphel, I. Study on morbidity among under-five children of a rural area of manipur, thanga: A cross-sectional study. J. Evolu. Med. Dent. Sci., 2013, 16, 43-47.
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- Nutritional Status of Pre-School Children from Urban Low Income Families
Abstract Views :291 |
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 56, No 3 (2019), Pagination: 265-273Abstract
India is currently the home of the largest number of under-nourished and over-nourished children in the world. Data from longitudinal studies in India indicate that both under nutrition and over-nutrition in childhood is associated with higher risk of over-nutrition and noncommunicable diseases in adult life. A community based mixed longitudinal study of underfive children from urban low income families was taken up to assess their nutritional status. Weight was taken every month in all; length was measured every month in infants and height was measured once in three months in 1-5 year children. BMI was computed in all. Nutritional status was assessed using the WHO anthro software package. Between 2012 and 2015, 3888 pre-school children were enrolled (49.4% boys and 50.6% girls); mean age of these children at enrolment was 22.5±16.17 months. The mean Z scores for height for age was - 1.79; weight for age was - 1.41 and -0.47 for BMI for age. Prevalence of stunting was 43.4%; underweight was 31.9%, wasting was 12% and over-nutrition was between 3-5%. The reduction in wasting rate between 0-3 years was mainly due to the increase in prevalence of stunting. With universal screening for early detection of wasting and over-nutrition and effective management of these, it will be possible to achieve the WHA targets of reducing and maintaining wasting below 5% and preventing increase in over-nutrition in this population. This may reduce the risk of over-nutrition and non-communicable diseases in these children during their adult life.Keywords
Under-Five Children, Nutritional Status, Stunting, Underweight, Wasting, Over-Nutrition.References
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- Can Iron and Folic Acid-IFA and Ca & Vitamin D Supplementation in Pregnancy be Fitted into Habitual Pattern of Three Meals A Day?
Abstract Views :378 |
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Authors
Affiliations
1 Nutrition Foundation of India, South Delhi, New Delhi-110 016, IN
1 Nutrition Foundation of India, South Delhi, New Delhi-110 016, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 56, No 4 (2019), Pagination: 341-350Abstract
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.References
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- Kalaivani, K. and Ramachandran, P. Time trends in prevalence of anaemia in pregnancy. The Ind. J. Med. Res., 2018, 147, 268-277.
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- Use of Mother Child Protection Card for Improving Infant Feeding Practices
Abstract Views :372 |
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 56, No 4 (2019), Pagination: 351-364Abstract
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 2/3rd at 5 months were solely breast-fed. By 8th 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.References
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- Ramachandran. P. and Kalaivani, K. Nutrition transition in India: challenges in achieving global targets. Proc. Ind. Natn. Sci. Acad., 2018, 84, 821-833.
- Gupta, A. and Thakur, N. Infant and young feeding practices in India: Current status and progress towards SDG targets. Proc. Ind. Natn. Sci. Acad., 2018, 84, 853-865.
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- IIPS. National Family Health Survey-3, http://rchiips.org/nfhs/pub_nfhs-3.shtml, accessed on 10 Dec 2018.
- IIPS - District Level Household and Facility Survey DLHS-1 http://rchiips.org/PRCH-1.html accessed on 28 March 2019.
- IIPS - District Level Household and Facility Survey DLHS-2http://rchiips.org/PRCH-2.html accessed on 28 March 2019.
- IIPS - District Level Household and Facility Survey DLHS-3http://rchiips.org/PRCH-3.html accessed on 28 March 2019.
- IIPS District Level Household and Facility Survey (DLHS-4) 2014 https://data.gov.in/.../district-level-household-and-facility-survey-dlhs-4 accessed on 28 March 2019.
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- Dual Nutrition Burden in Urban Women from Low Middle Income Families
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 1 (2020), Pagination: 10-24Abstract
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.References
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- Effect of Lactation on Nutritional Status in Urban Women from Low Middle Income Families
Abstract Views :212 |
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 3 (2020), Pagination: 222-239Abstract
In India breast feeding is universal. Studies carried out in the 1980s have shown that in women from low income families, lactation during the first six months was associated with weight loss. Over time there has been substantial reduction in under-nutrition across all groups including lactating women and over-nutrition has emerged as a public health problem. A study was taken up to assess the impact of universal and prolonged lactation on nutritional status and adiposity in 2240 women from urban low middle income group; 83.5% were 18-29 years of age and 16.5% were 30 years or older. As lactating women had to meet the energy cost of milk production, they weighed less and had lower mean BMI, MUAC, HC and WC as compared to non-lactating women. Prevalence of under-nutrition was higher and over-nutrition was lower in lactating women as compared to non-lactating women. In this community, prevalence of under-nutrition was low and lactation was not associated with persistent deterioration in nutritional status in either of the age groups; identifying lactating women who are under-nourished, providing them with nutrition education and take home rations continuously and monitoring their improvement may result in steep reduction in under-nutrition rates. Prevalence of over-nutrition in lactating women especially in ≥ 30 year age group was high; over-nutrition rates increased with waning lactation. Nutrition and health education on importance of increasing physical activity and interventions to promote discretionary physical activity are urgently required to halt the rise in over-nutrition and risk of non-communicable diseases in these women.Keywords
Adiposity, Abdominal Adiposity, Duration Of Lactation, Low Middle Income Families, Over Nutrition, Under-Nutrition, Urban Women.References
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- Ministry of women and child development Integrated Child Development Services ICDS- wcd.nic.in accessed on 10.12 2019.
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- Merchant, K., Martorell, R. and Haas, J. Maternal and fetal responses to the stresses of lactation concurrent with pregnancy and of short recuperative intervals. Am. J. Clin. Nutr., 1990, 52, 280-288.
- Kulkarni, B., Shatrugna, V., Nagalla, B. and Rani, K. U. Regional body composition changes during lactation in Indian women from the low-income group and their relationship to the growth of their infants. J. Am. College of Nutr., 2011, 30, 57-62.
- Anshi Goel, Thirumani,A., Kalaivani, K. and Ramachandran, P. Dual nutrition burden in urban women from low middle income families. The Ind. J. Nutr. Diet., 2020, 57, 10-24.
- Prabhakar, K., Kalaivani, K., Kowsalya, S. and Ramachandran, P. Use of mother child protection card for improving infant feeding practices. The Ind. J. Nutr. Diet., 2019, 56, 351-364.
- Growth Monitoring in Under-Three Children Using the Mother Child Protection Card
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Authors
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
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
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 4 (2020), Pagination: 368-386Abstract
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.References
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- ICDS programme Ministry of Women and Child Development: Integrated child development services program (ICDS) available at www./icds-wcd.nic.in/frameworkapip.pdf Accessed on 28 July 2020.
- Ramachandran, P. and Kalaivani, K. Nutrition transition in India: Challenges in achieving global targets. Proc. Ind. Nat. Sci. Acad., 2018, 84, 821-833.
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- Prabhakar, K., Kalaivani, K., Kowsalya, S. and Ramachandran, P. Use of mother child protection card for improving infant feeding practices. Ind. J. Nutr. Diet., 2019, 56, 351-364.
- Lakshmi, R.V., Subapriya, M., Kalaivani, K. and Ramachandran, P. Nutritional status of preschool children from urban low income families. Ind. J. Nutr. Diet., 2019, 56, 265-273.
- Food Security and Dietary Intake in Pregnant Women from Urban Low Income Group
Abstract Views :152 |
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi - 110 016, IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi - 110 016, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 58, No 2 (2021), Pagination: 161-173Abstract
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- Nutritional Status of Parents and their Pre-School Children
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi-110 016, IN
2 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi-110 016), IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi-110 016, IN
2 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi-110 016), IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 58, No 4 (2021), Pagination: 489-500Abstract
During 1970s poverty and household food inadequacy led to high under-nutrition rates in all age groups. Over years there has been an improvement in per capita income and household food security. In the last two decades there has been a steady decline in under-nutrition and increase in over-nutrition in adults, but child under-nutrition rates continue to be high. The present study was taken up in urban low income families, to assess the differences in the nutritional status of pre-school children and their parents. Height and weight measurements were taken in 3727 mother infant pairs; in 637 families father’s anthropometric parameters were available. Stunting, underweight and wasting rates in children were highest when the mothers were under-nourished (BMI <18.5) and least when the mother was over-nourished (BMI ?25). A similar but less distinct trend was observed in relation to nutritional status of the fathers and pre-school children. Even when the mother or father was under-nourished less than one fifth of the pre-school children were wasted and over 80% were normally nourished. Stunting rates were over 40% if the mother or father was in the lowest height tertile. However even when the father and mother were in the highest tertile for height, about one fourth of the children were stunted. These data suggest that maternal and paternal under-nutrition and low height are associated with higher child under-nutrition and stunting respectively. However, even when the mother or father was short or under-nourished, majority of the children were normal in height and normally nourished. In view of the intra-family differences in nutritional status, it is essential to undertake assessment of nutritional status of each member of the family and provide appropriate nutritional advice and intervention.
Keywords
Paternal Nutrition, Maternal Nutrition, Child Nutrition, Intra-Family Differences in Nutritional Status.- Maternal Nutrition and Birth Weight in Dual Nutrition Burden Era
Abstract Views :139 |
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 59, No 2 (2022), Pagination: 187-196Abstract
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 WeightReferences
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- Food Consumption and Nutritional Status of Urban Low Middle-Income Families
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, Delhi, IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, Delhi, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 59, No 3 (2022), Pagination: 357-368Abstract
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, UrbanReferences
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- Calcium and vitamin D supplementation to pregnant women in urban hospital and community settings
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
2 National Institute of Nutrition, Hyderabad - 500 007., IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
2 National Institute of Nutrition, Hyderabad - 500 007., IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 60, No 1 (2023), Pagination: 1-16Abstract
In India, calcium intake is low and the prevalence of Vitamin D deficiency in pregnant women is high. The National Guidelines envisage elemental calcium 500 mg (as calcium carbonate salt) and 250 IU vitamin D supplements should be provided to pregnant and lactating women. In Delhi, iron folic acid tablets are given twice a day after meals in anaemic women and one tablet of calcium and vitamin D daily after a meal in all pregnant women. A study was taken up to assess the availability and compliance with calcium and vitamin D supplementation in primary health care institutions under research (Group 1 - 387 women) and service conditions (Group 2 - 400 women) and in urban community setting (Group 3 - 448 women). Women in Group 1 received Ca and Vitamin D tablets regularly from the research staff. In Group 2 and Group 3 tablets, were provided as and when government supplies were available and prescriptions were given when they were not available. Ca and Vitamin D tablets were expensive; families bought the tablets as and when they had the funds. As a result, the number of tablets available for consumption was lower in Group 2 and 3. In all three groups, side effects were rare and nearly all available tablets were consumed. In Group 1, Vitamin D estimation was done at enrolment and after supplementation for three months; 83% of women at enrolment and 68% of women after three months of supplementation had serum vitamin D levels below 20 ng/ml. These data suggest that one tablet of Ca and Vit D per day is insufficient for correcting maternal vitamin D deficiency. It is essential to carry out studies to assess the impact of supplementation with two tablets of Ca and Vit D on maternal vitamin D levels.
Keywords
Vitamin D Deficiency in Pregnancy, Calcium and Vitamin D Supplementation, Availability of Calcium and Vitamin D Supplements, Compliance With Supplementation, Impact of SupplementationReferences
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- Calcium and Vitamin D Supplementation to Improve Linear Growth in Children
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Authors
Affiliations
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 60, No 2 (2023), Pagination: 185-200Abstract
In India, the prevalence of vitamin D deficiency as assessed by vitamin D levels below 20 ng/ml is high across the country, in all socio-economic, age and sex groups. Studies from India have documented that prevalence of vitamin D deficiency is high in breast-fed infants. Stunting in young children continues to be a major public health problem in India. It is possible that in addition to low birth weight and chronic energy deficiency, vitamin D deficiency may contribute to the high stunting rates in breast-fed Indian children. If this were so, vitamin D supplementation may reduce the magnitude of linear growth retardation in the first two years of life. A community-based randomised, double-blind supervised daily supplementation of 250 mg of calcium and 250 IU of Vitamin D (Group A) or placebo (Group B) to breast-fed infants from the first month up to 23 months of age was undertaken to assess the impact, if any, of vitamin D supplementation on linear growth in children and height attained at 23 months. At enrolment, there were no significant differences in weight, length and BMI between infants belonging to Group A or Group B. There were no significant differences in infant and young child feeding practices, morbidity due to infection, or linear growth and height attained at 23 months between Group A and Group B. These data suggest that daily supplementation of calcium and vitamin D between 0-23 months did not have any significant impact on linear growth of children from urban low middle income families.
Keywords
Infants and Young Children, Calcium and Vitamin D Supplementation, Linear Growth, Morbidity due to Infections, Randomised Double-Blind Placebo Control Trial.References
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