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Aim: Diabetes is a chronic progressive disease. A healthy eating pattern is essential to achieve good glycemic control (HbA1c 7%) which aids in delaying and preventing diabetes-related complications. The pivotal role of diet, a modifiable risk factor for type 2 diabetes has not been understood completely especially in India where carbohydrate consumption is high. This study, therefore, aims to identify major dietary patterns associated with uncontrolled diabetes by using data reduction methods. Objective: To study and compare the association of dietary patterns with elevated HbA1c among known diabetic adults using three data reduction methods (principal component analysis (PCA), reduced rank regression (RRR), and partial least-squares (PLS) regression). Materials and Methods: The Chennai Urban Rural Epidemiological followed up study (CURES) was completed in 2410 adults. Adults with diabetes (both genders, aged >20years), 573 were selected for the present analysis. Dietary intake was assessed using food frequency questionnaire. Results: The PCA derived the non-vegetarian and vegetarian pattern. Both showed positive association with the risk of high HbA1c. The first pattern of RRR and PLS showed a positive association with many foods especially those contributing to increased intakes of total calories. Whereas the 2nd pattern of RRR and PLS scores both showed an inverse association with HbA1c especially with the reduction in rice-based recipes and total calories. Conclusions: The low intake of certain foods, especially white rice, directly decreased the total calories, total carbohydrate, glycemic load, and glycemic index which has a beneficial effect on glycemic control among those with diabetes.

Background: Asian Indians are culturally different and have diverse dietary and culinary habits. Further, there are potential biological differences in metabolism due to genetic or cultural factors. This warrants the development of a unique population-specific food-based diet score for prevention of noncommunicable disorders. Materials and Methods: Dietary intake was assessed using a validated food frequency questionnaire in 1033 adults who participated in the 10-year follow-up study of Chennai Urban Rural Epidemiological Study (CURES). The diet score was developed considering eight food groups and one major cooking oil that were either significantly associated with a higher or lower risk of incident type 2 diabetes (T2D). The foods that showed a protective effect was assigned higher scores and vice versa for foods that increased the risk of diabetes assigned the lower. We further assessed the effect of Indian Diet Quality score (IDQS) and three popular diet quality indices: the Healthy Eating Index-2015 (HEI), the Dietary Approach to Stop Hypertension (DASH), and Diabetes Diet Score (DDS) in relation to the risk of incidence of diabetes among Indian population. Results: Higher IDQS is associated with a significant lower risk of diabetes incidence; however, no such significant association was observed with diet quality indices (DASH, HEI-2015, and DDS) and diabetes incidence. This warrants the need for population-specific diet score for Indians. Conclusion: Higher IDQS was associated with a lower risk of T2D among South Indian adults. Thus, IDQS can be a suitable tool to identify the diet–disease relationship especially in a population with diverse dietary intakes.

Millets are the staple food for millions in Asian and several African countries. They are rich in dietary fiber, micronutrients, and beneficial phytochemicals. This study attempted to understand the consumption pattern of millets among south Indian adults in Chennai using a validated semi quantitative questionnaire which was administered telephonically. Purposive random sampling method was adopted for obtaining data from 100 millet consumers. The study results were analyzed using chi-square test, oneway analysis of variance, and correlation analysis. Equal percent of participants (41%) consumed millets 1-3 times a week and 1-3 times / month. Respondents considered millets nutritious and healthy as the main reason for consumption. Monthly income and family size significantly influenced frequency of consumption of millets. With reference to income groups, respondents belonging to income group >Rs. 50,000/month showed the highest percentage of frequency of consumption of millets, when compared to other income groups. Most consumers felt millets were affordable. Kali (stiff porridge/balls, kanji (porridge), pongal, upma, and biscuits were the most sought-after choices. Majority of the consumers combined other grains especially pulses in millet preparations such as pongal and kichidi. Finger millet preparations were the most commonly consumed millet-based preparation among all income groups or it could be concluded that consumers have a positive attitude toward millets for consumption and voiced the need for development of ready-to-cook and ready-to-eat value-added millet products such as millet dosa batter, noodles, flakes, breads, and millet-based beverages, for promoting consumers' health and fitness. [ABSTRACT FROM AUTHOR]

Background: The nutritional importance of brown rice (BR) is well established. Despite several nutritional benefits of BR, its consumption remains limited due to long cooking time and limited shelf-life. BR can be subjected to processing to improve shelf-life. Gamma irradiation is one such strategy, but it could induce changes in the grain and thus affect its glycemic properties. Aims and objectives: The aim of this study was to look at the 24-h glycemic response of irradiated and non-irradiated BR-based iso-caloric diets in Asian Indians. Methods: Fifteen (mean body mass index: 24 ± 2.6 kg/m2) Asian Indian adults without diabetes, aged 25--39 years, participated in this randomized cross-over study. Iso-caloric diets were prepared with two varieties (ADT 43 and Swarna) of parboiled gamma-irradiated brown rice with 750--820 Gy dosage (IBR) and non-irradiated brown rice (NIBR). After the participants consumed these diets, 24-h glycemic responses were recorded using a continuous glucose monitoring system. The mean positive change from baseline glucose concentration was calculated as the incremental area under the curve (IAUC) for both the diets. Results: The percentage difference in 24-h average IAUC was 10% lower in the IBR diets when compared with NIBR diets, irrespective of the variety of BR (P = 0.56). In the case of ADT 43 rice variety, both IBR and NIBR diets showed similar IAUC (P = 0.68). However, the IBR of Swarna rice variety showed 21% lower IAUC when compared with the NIBR diet (P = 0.21). Comparing the IBR varieties, Swarna showed 21% lower IAUC than ADT 43 (P = 0.21), whereas between NIBR varieties, only 0.79% difference was observed between ADT 43 and Swarna (P = 0.93). Conclusions: Gamma irradiation of parboiled BR did not produce significant differences in the 24-h glycemic responses for BR-based diets. Swarna variety was better than ADT 43 with regard to glycemic response. Judicious application of radiation technology to BR varieties may help in shelf-life extension without affecting the glycemic properties. [ABSTRACT FROM AUTHOR]

Brown rice (whole grain, BR) has lower glycemic index (GI), is a healthy replacement for white rice (WR). However, BR has a short shelf life, is susceptible to pest infestation. Gamma irradiation is a safe approach to prevent the latter. This study examines effect of gamma irradiation on the physical, cooking, nutritional, shelf life and glycemic properties of three Indian parboiled BR. Parboiled BR of ADT-43, BPT-5204, and Swarna rice varieties were packed in polyester and polypropylene pouches (60 µ thickness) and subjected to gamma irradiation [750–820 Gy] (IR). Appropriate controls without irradiation (NIR) were maintained. Irradiation did not induce major changes in the physical and nutritional properties, except for resistant starch which significantly increased after irradiation in ADT-43 and BPT-5204. Irradiation reduced the cooking time, increased loss of solids in the cooking water and decreased apparent water uptake (particularly in BPT-5204). IR varieties exhibited longer shelf life (8–9 months) compared to 6 months shelf life of NIR varieties. The shelf stability of IR Swarna rice was superior in terms of delayed rancidity development compared to all other rice. All BR samples exhibited the ranking of ‘like moderately’ in the sensory acceptability tests at 6 months of storage and scores decreased subsequently. Irradiation did not affect GI [all showed medium GI, except a high GI for IR BPT 5204] and helped in shelf life extension of parboiled BR by preventing insect infestation. [ABSTRACT FROM AUTHOR]

There is conflicting evidence about the association between dairy products and cardiometabolic risk (CMR). We aimed to assess the association of total dairy intake with CMR factors and to investigate the association of unfermented and fermented dairy intake with CMR in Asian Indians who are known to have greater susceptibility to type 2 diabetes and cardiovascular diseases compared to white Europeans. The study comprised 1033 Asian Indian adults with normal glucose tolerance chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a validated open-ended semi-quantitative food frequency questionnaire. Metabolic syndrome (MS) was diagnosed based on the new harmonising criteria using central obesity, dyslipidaemia [low high-density lipoprotein cholesterol (HDL) and increased serum triglycerides (TG)], hypertension and glucose intolerance. Increased consumption of dairy (≥5 cups per day of total, ≥4 cups per day of unfermented or ≥2 cups per day of fermented dairy) was associated with a lower risk of high fasting plasma glucose (FPG) [hazards ratio (HR), 95% confidence interval (CI): 0.68, 0.48–0.96 for total dairy; 0.57, 0.34–0.94 for unfermented dairy; and 0.64, 0.46–0.90 for fermented dairy; p < 0.05 for all] compared to a low dairy intake (≤1.4 cups per day of total dairy; ≤1 cup per day of unfermented dairy; and ≤0.1 cup per day of fermented dairy). A total dairy intake of ≥5 cups per day was also protective against high blood pressure (BP) (HR: 0.65, 95% CI: 0.43–0.99, p < 0.05), low HDL (HR: 0.63, 95% CI: 0.43–0.92, p < 0.05) and MS (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤1.4 cups per day. A high unfermented dairy intake (≥4 cups per day) was also associated with a lower risk of high body mass index (BMI) (HR: 0.52, 95% CI: 0.31–0.88, p < 0.05) compared to a low intake (≤1 cup per day), while a reduced risk of MS was observed with a fermented dairy intake of ≥2 cups per day (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤0.1 cup per day. In summary, increased consumption of dairy was associated with a lower risk of MS and components of CMR. [ABSTRACT FROM AUTHOR]

Background and Objectives: Beaten or flattened rice (flakes) is very popular in India for preparing the meal "upma." Commonly marketed rice flakes are fiber depleted, starchy, and may be nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such "upma" preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF). Materials and Methods: Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol. Results: BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant. Interpretation and Conclusions: BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties. [ABSTRACT FROM AUTHOR]

Background. Foods rich in protein and dietary fibre could potentially improve lipid profile in overweight or obese diabetic patients with dyslipidemia and, thereby, mitigate their risk of cardiovascular disease (CVD). In this study, the effect of providing high-protein high-fibre (HPHF) nutritional supplement in addition to standard care of type 2 diabetes mellitus (T2DM) on lipid profile was evaluated. Methods. In this open-label, parallel-arm, prospective, randomized study, a total of 100 overweight/obese participants with T2DM were randomized to either an intervention group (25 g HPHF nutritional supplement given twice daily along with a standard care of T2DM) or a control group (standard care of T2DM) for 24 weeks. Change from baseline in lipid parameters such as total cholesterol (TChol), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) was assessed between the intervention and control group at week 12 and week 24. Participant compliance was assessed using the dietary 24-hour recall. Statistical analysis was performed to assess the main effects on within- and between-group changes from baseline to end of 24 weeks. Results. Participants in the HPHF nutritional supplement group showed a statistically significant improvement in HDL-C levels by the end of 24 weeks (p = 0.04) and a significant increase in protein and total dietary fibre intake (p = 0.002 and p = 0.00 , respectively) compared to the control group. The TChol/HDL-C ratio was significantly lower (p = 0.03) in the HPHF group from baseline to 24 weeks. Conclusion. Twice-daily consumption of a HPHF nutritional supplement significantly improved HDL-C levels. Inclusion of the HPHF supplement would be a useful effective aid for managing dyslipidemia in overweight/obese individuals with T2DM. [ABSTRACT FROM AUTHOR]

To determine the glycemic index (GI) of selected cereals and association with their microstructure. The GI of whole grain pilaf (WGP), instant brown rice (IBR), whole maize ugali (MWU), and refined maize ugali (RMU) was assessed in a randomized trial. Fourteen healthy participants with mean age of 25 years were administered 50 g portions of available carbohydrates from glucose and various test foods after an overnight fast on separate occasions. Capillary blood samples of participants were used to measure blood glucose over 2 hr. The GI was calculated as per standard protocol. The microstructure of test foods, determined by scanning electron microscopy was evaluated to understand the measured GI values. The GI (mean ± standard error) of IBR was the highest (87.8 ± 6.8) followed by RMU (74.7 ± 6.5) and WMU (71.4 ± 5.1). WGP had medium GI (58.9 ± 5.1; P < 0.01 vs. IBR). Microstructure examination of IBR revealed disruption of bran layer and presence of fissures indicating loss of intactness of bran. Stereozoom images for WGP revealed intact bran and germ. For RMU and WMU, the grain was milled leading to loss of integrity. IBR, RMU, and WMU have high GI values, which is likely due to disruption of bran layer, endosperm modification (IBR), and loss of grain matrix (WMU, RMU). WGP has medium GI probably due to fairly intact bran and germ. Practical Application: Wholegrain or whole meal flour may not necessarily be low in glycemic index (GI; low GI < 55; medium 55 to 69 and high GI ≥70). "Ugali" a commonly consumed cereal staple food in Tanzania made from either refined or whole meal maize flour was found to be a high GI food. Intact whole grain foods, such as whole grain pilaf (mixed intact whole grains) is a healthier alternative to milled whole grains such as whole meal maize flour. Instant quick cooking brown rice exhibited a high GI, due to the processing method, suggesting that regular brown rice may be a healthier option. [ABSTRACT FROM AUTHOR]

Fruits and vegetables (FVs) are recognized as healthy constituents of diet and a sustainable solution to the existing twin burden of micronutrient deficiencies and non-communicable diseases in developing and developed countries. In general, FVs are nutrient dense foods low in energy, containing varying amounts of vitamins and minerals including carotenoids, B vitamins, vitamin C, iron, zinc, potassium, calcium, magnesium and fibre. These are abundantly rich in phytochemicals that function as antioxidants, anti-atherosclerotic and anti-inflammatory agents. This review summarizes some epidemiological, prospective cohort and intervention studies on the health benefits of FVs in relation to cardiovascular disease, obesity and diabetes. The rich varieties of FVs available, their composition, production scenario in India, dietary intake and trends over time, barriers to sufficient intake mainly sociocultural, economic and horticulture environment, policies for promotion and prevention of diseases are considered. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that nut consumption decreases the risk of cardiovascular disease. However, there are few data on the health effects of cashew nuts among adults with type 2 diabetes (T2DM).Objective: The study aimed to investigate the effects of cashew nut supplementation on glycemia, body weight, blood pressure, and lipid profile in Asian Indians with T2DM.Methods: In a parallel-arm, randomized controlled trial, 300 adults with T2DM [mean ± SD age: 51 ± 9.3 y; body mass index (BMI; in kg/m2): 26.0 ± 3.4; 55% male] were randomly assigned to receive advice to follow a standard diabetic diet (control) or similar advice plus 30 g cashew nuts/d (intervention) for 12 wk. The macronutrient composition of the prescribed diabetic diet was 60-65% energy from carbohydrates, 15-25% from fat, and the rest from protein. Differences between groups in changes in anthropometric and biochemical variables were analyzed using linear models with robust variance estimation under an assumed independence working correlation.Results: Participants in the intervention group had a greater decrease in systolic blood pressure from baseline to 12 wk than did controls (-4.9 ± 13.7 compared with -1.7 ± 11.6 mm Hg; P = 0.04) and a greater increase in plasma HDL cholesterol compared with controls (+1.7 ± 5.6 compared with +0.1 ± 4.6 mg/dL; P = 0.01). There were no differences between the groups with respect to changes in body weight, BMI, blood lipid, and glycemic variables. Plasma oleic acid concentrations and self-reported dietary intake of nuts, oleic acid, and monounsaturated fatty acids suggested excellent compliance with the nut consumption.Conclusion: Cashew nut supplementation in Asian Indians with T2DM reduced systolic blood pressure and increased HDL cholesterol concentrations with no deleterious effects on body weight, glycemia, or other lipid variables. This study was registered at the clinical trial registry of India as CTRI/2017/07/009022. [ABSTRACT FROM AUTHOR]

India has the second largest number of people with diabetes in the world following China. Evidence indicates that consumption of whole grains can reduce the risk of type 2 diabetes. This article describes the study design and methods of a trial in progress evaluating the effects of substituting whole grain brown rice for polished (refined) white rice on biomarkers of diabetes risk (glucose metabolism, dyslipidemia, inflammation). This is a randomized controlled clinical trial with a crossover design conducted in Chennai, India among overweight but otherwise healthy volunteers aged 25–65 y with a body mass index ≥23 kg/m2and habitual rice consumption ≥200 g/day. The feasibility and cultural appropriateness of this type of intervention in the local environment will also be examined. If the intervention is efficacious, the findings can be incorporated into national-level policies which could include the provision of brown rice as an option or replacement for white rice in government institutions and food programs. This relatively simple dietary intervention has the potential to substantially diminish the burden of diabetes in Asia and elsewhere. [ABSTRACT FROM PUBLISHER]

Context: There is little data correlating dietary fibre (DF) intake and cardiovascular risk in Asian Indians with diabetes. Aim: To assess the DF intake and its association with lipid profile (total serum cholesterol and low density lipoprotein [LDL] - cholesterol levels) in urban Asian Indians with diabetes. Subjects and Methods: Dietary assessment using validated Food Frequency Questionnaire was conducted in 1191 free-living adults with known diabetes in the Chennai Urban Rural Epidemiology Study. Subjects taking medication for dyslipidemia, and those with cardiovascular disease and implausible energy intake (n = 262) were excluded, leaving 929 participants. Anthropometric and relevant biochemical parameters were measured using standardized techniques. Results: Diabetic individuals who consumed DF median intake of DF group. The risk of hypercholesterolemia (odds ratio [OR] =1.38 [95% confidence interval [CI]: 1.02-1.85], P = 0.04), and high LDL cholesterol (OR: 1.43 [95% CI: 1.06-1.94], P = 0.02) was higher among those whose DF intake was less than the median. Serum triglycerides and high density lipoprotein cholesterol were not associated with DF intake. The main sources of DF were vegetables and legumes. Conclusion: In urban Asian Indians with diabetes, lower DF intake is positively related to total cholesterol and LDL cholesterol levels. [ABSTRACT FROM AUTHOR]

There is little data on the type of vegetable oil used and the prevalence of metabolic syndrome (MS) in Asian Indians. Food frequency questionnaire was used to document the type of cooking oil in 1875 adults in Chennai city. MS was assessed by new harmonizing criteria. The prevalence of MS was higher among sunflower oil users (30.7%) than palmolein (23.2%) and traditional oil (17.1%, p < 0.001) users. The higher prevalence of MS in sunflower oil group persisted even when stratified according to body mass index, except in obese groups. The risk of MS was further compounded by quantity of refined cereals consumed. Higher LA%E and linoleic acid/alpha-linolenic acid ratio in sunflower oil probably contributes to increased risk of MS. [ABSTRACT FROM AUTHOR]

There is little data on the type of vegetable oil used and the prevalence of metabolic syndrome (MS) in Asian Indians. Food frequency questionnaire was used to document the type of cooking oil in 1875 adults in Chennai city. MS was assessed by new harmonizing criteria. The prevalence of MS was higher among sunflower oil users (30.7%) than palmolein (23.2%) and traditional oil (17.1%, p < 0.001) users. The higher prevalence of MS in sunflower oil group persisted even when stratified according to body mass index, except in obese groups. The risk of MS was further compounded by quantity of refined cereals consumed. Higher LA% E and linoleic acid/alpha-linolenic acid ratio in sunflower oil probably contributes to increased risk of MS. [ABSTRACT FROM AUTHOR]

Single nutrients are no solution to the problem of malnutrition. It is essential that food based dietary guidelines (FBDG) are developed and implemented to overcome the diet related diseases and promote health in the population. A multidisciplinary group was constituted to develop FBDGs in India. A manual with scientific details and an abridged version were prepared with 6 goals and 14 dietary guidelines covering all age groups to overcome the public health nutritional problems. The guidelines are based on dietary patterns and specific outcomes of health and disease. Dietary diversification has been suggested as the practical approach. Diets from locally available and culturally accepted foods in household measures have been suggested to ensure optimal health. For successful implementation of FBDGs, political/bureaucratic commitment are essential. It must become a tool in the developmental plans for food, nutrition, agriculture, rural, educational and biotechnology policies. Workshops and meetings were organized to sensitise the administrative set-up. The intersectoral nature of FBDG for implementation was highlighted. The department of women and child development, which is responsible for implementing the National Nutritional Policy, was recognized as nodal agency. Meetings were organised for secondary target audiences. The press was invited to participate in popularisation of the FBDGs. Social marketing strategies were used to match the local dietary and cultural aspects. Interpersonal communication and professional societies were used for better dissemination. Industry and legislative bodies were requested to take active action in this regard. The FBDGs have to be implemented to achieve food and nutrition security and the Millennium Development Goals. [ABSTRACT FROM AUTHOR]

India has been recognized all over the world for spices and medicinal plants. Both exhibit a wide range of physiological and pharmacological properties. Current biomedical efforts are focused on their scientific merits, to provide science-based evidence for the traditional uses and to develop either functional foods or nutraceuticals. The Indian traditional medical systems use turmeric for wound healing, rheumatic disorders, gastrointestinal symptoms, deworming, rhinitis and as a cosmetic. Studies in India have explored its anti-inflammatory, cholekinetic and anti-oxidant potentials with the recent investigations focusing on its preventive effect on pre-carcinogenic, anti-inflammatory and anti atherosclerotic effects in biological systems both under in vitro and in vivo conditions in animals and humans. Both turmeric and curcumin were found to increase detoxifying enzymes, prevent DNA damage, improve DNA repair, decrease mutations and tumour formation and exhibit anti-oxidative potential in animals. Limited clinical studies suggest that turmeric can significantly impact excretion of mutagens in urine in smokers and regress precancerous palatal lesions. It reduces DNA adducts and micro-nuclei in oral epithelial cells. It prevents formation of nitroso compounds both in vivo and in vitro. It delays induced cataract in diabetes and reduces hyperlipidemia in obese rats. Recently several molecular targets have been identified for therapeutic / preventive effects of turmeric. Fenugreek seeds, a rich source of soluble fiber used in Indian cuisine reduces blood glucose and lipids and can be used as a food adjuvant in diabetes. Similarly garlic, onions, and ginger have been found to modulate favourably the process of carcinogenesis. [ABSTRACT FROM AUTHOR]

Optimal nutrition is the foundation for the development and maintenance of a healthy immune system. An optimal supply of nutrients is required for biosynthesis of immune factors and immune cell proliferation. Nutrient deficiency/inadequacy and hidden hunger, which manifests as depleted nutrients reserves, increase the risk of infectious diseases and aggravate disease severity. Therefore, an adequate and balanced diet containing an abundant diversity of foods, nutrients, and non-nutrient chemicals is paramount for an optimal immune defense against infectious diseases, including cold/flu and non-communicable diseases. Some nutrients and foods play a larger role than others in the support of the immune system. Oats are a nutritious whole grain and contain several immunomodulating nutrients. In this narrative review, we discuss the contribution of oat nutrients, including dietary fiber (β-glucans), copper, iron, selenium, and zinc, polyphenolics (ferulic acid and avenanthramides), and proteins (glutamine) in optimizing the innate and adaptive immune system's response to infections directly by modulating the innate and adaptive immunity and indirectly by eliciting changes in the gut microbiota and related metabolites. [ABSTRACT FROM AUTHOR]

Discusses the role of spices as a functional food in the prevention of cancer in India. Mortality rate of cancer; Documented studies on oral cancers in betel nut chewers and smokers; Nonnutrient components in vegetables and spices; Role of turmeric in cancer prevention; Role of turmeric as a functional food; Effect of micronutrient deficiencies in India.

Presents a study assessing lead nephrotoxicity in automobile mechanics in India by means of renal clearance, urinary N-acetyl-3-D-glucosaminidase (NAG) activity and beta-2-microglobulin levels. Blood lead levels and clinical findings; Correlation of blood lead and NAG activity.

Disturbances in the tryptophan-niacin pathway seen in endemic pellagra among sorghum eaters have been ascribed to high dietary intake of leucine. Vitamin B6 plays an important role in several steps of this pathway. Therefore, studies on possible metabolic interrelations between excess dietary leucine and vitamin B6 were undertaken in normal healthy human subjects. The results indicated that vitamin B6 could successfully counteract the effects of leucine on quinolinic acid excretion in urine, and on in vitro nicotinamide nucleotide synthesis by erythrocytes, and also could correct the abnormalities of 5-hydroxytryptamine metabolism induced by excess leucine. These observations suggest that vitamin B6 nutritional status may have a contributory role in the pathogenesis of endemic pellagra. [ABSTRACT FROM AUTHOR]