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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]

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]

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]

Background & objectives: Consumption of high glycaemic index (GI) food is associated with a high risk for diabetes. There is a felt need to understand the GI of common Indian traditional foods using standard GI protocols. The present study was aimed to analyse the carbohydrate profile of common traditional Indian food preparation and to determine their GI using standardized protocols. Methods: Twelve food preparations made of millets, wheat, maize and pulses were evaluated for nutrient composition including detailed carbohydrate profiling and tested for GI in healthy volunteers using standard methodology. Capillary blood glucose responses for the test foods containing 50 g available carbohydrates were recorded and compared to the reference food (50 g glucose). GI was calculated from the incremental area under the curve (IUAC) for the test and reference foods. Results: Available carbohydrate content of the food preparations ranged between 13.6 and 49.4 g per cent. Maize roti showed the highest total dietary fibre (7.5 g%). White chick pea ‘sundal’ showed highest resistant starch content (3.95 g%). Amongst the 12 test foods, five fell in the high GI category (finger millet balls, sorghum, pearl millet and maize roti), four in the medium GI category (sorghum idli, wheat dosa, methi roti and adai) and three in the low GI category (broken wheat upma, white peas sundal and white chick peas sundal). Interpretation & conclusions: Merely being a whole grain-based food does not qualify for a lower GI. The method of processing, food structural integrity and preparation could influence the GI. The type and quality of fibre are important than the quantity of fibre alone. Judicious planning of accompaniments using low GI legumes may favourably modify the glycaemic response to high GI foods in a meal. [ABSTRACT FROM AUTHOR]

Background & objectives: Millets are widely marketed as healthier alternatives to white rice (WR). This study was conducted with two aims: firstly, to look at the nature and quality of minor millets available in the Chennai market and secondly, to estimate the glycaemic index (GI) of unpolished forms of the two most widely available minor millets, i.e. little (LM) and foxtail millet (FXM). Methods: A market survey was conducted of 100 food stores in four zones of Chennai, south India. Morphological features of market millet samples were compared with that of unpolished millets under stereo-zoom microscope, and the claims declared on the pack were evaluated. A consumer perception survey was conducted among 20 minor millet-consuming female homemakers. Finally, the GI of unpolished LM and FXM was evaluated using a validated protocol in 12 healthy volunteers. Results: Forty eight brands of minor millets were available, with LM and FXM being the most common. Most of the millet samples were identified as highly polished grains using stereo-zoom microscope. The product labels were misleading and showed no scientific backing for claims mentioned on the label. Most participants (12 of 20) were unaware of the fact that millets can also be polished like rice. Both LM and FXM exhibited high GI (88.6±5.7 and 88.6±8.7, respectively). Interpretation & conclusions: The availability and knowledge regarding unpolished millets was low. Both LM and FXM exhibited high GI. Hence, substituting millets for WR might be of limited benefit considering the glycaemic property in the prevention and management of chronic non-communicable diseases such as T2DM. [ABSTRACT FROM AUTHOR]

Background and Objectives: To evaluate the reproducibility and construct validity of the Madras Diabetes Research Foundation FFQ (MDRF-FFQ) with biomarkers for its use in epidemiological settings in India.Methods and Study Design: The MDRF-FFQ was administered to 500 participants representing rural and urban areas of 10 Indian states, twice at an interval of 12 months. Reproducibility was assessed using intra cluster correlation coefficients (ICC). Construct validity of carbohydrate and fat intake was assessed using baseline serum lipids by regression analysis.Results: Reproducibility as measured by ICC was 0.50-0.77 for saturated fatty acids (SFA) and energy in urban and 0.61-0.72 for protein and SFA in rural areas. The ICC for food groups was 0.53-0.77 for whole grains, fruits and vegetables in urban and 0.50-0.89 for animal foods and whole grains in rural areas. After adjusting for potential confounders, carbohydrate intake was positively associated with serum triglycerides (TG) (β [SE]: +2.3 [0.72] mg/dL; p=0.002) and inversely with high density lipoprotein cholesterol (HDL) (β [SE]:-0.48 [0.12], p<0.001), while dietary fat and SFA (% Energy) were positively associated with HDL, low density lipoprotein (LDL) and total cholesterol and inversely with TG.Conclusions: The MDRF-FFQ can be considered as a reliable and valid tool to measure the long-term dietary exposure in respect of macronutrient intakes in Indian populations despite diverse dietary practices. [ABSTRACT FROM AUTHOR]

Background and Objectives: Finger millet (Eleusine coracana L.) (FM) is rich in dietary fibre and is therefore expected to elicit a lower glycemic response compared to other grains. However, there is little data on the glycemic properties of FM-based products. We evaluated the nutritional, sensory and glycemic properties of decorticated millet with lower polish (DFM-LDP), flakes (FMF), vermicelli (FMV) and extruded snack (FMES) (both FMV and FMES with 7-8% added soluble fibre).Methods and Study Design: The nutrient contents of the FM products were evaluated by standard AOAC (Association of Official Analytical Chemists) and AACC (American Association of Cereal Chemists) methods. Sensory evaluation was conducted monadically using a 9-point hedonic scale using untrained panel members. GI testing was conducted using a standardized validated protocol. The study was conducted according to the guidelines laid down by the Declaration of Helsinki, and was approved by the Ethics Committee of the Madras Diabetes Research Foundation.Results: The products had dietary fibre (DF) content between 5.8-15.6 g%. FMES was unique in having a very low fat content (0.17%). Evaluation of sensory perception revealed moderate acceptance of millet based products. The glycemic indices (GI) (mean±SEM) of the products were 84.7±7.7%, 82.3±6.4%, 65.5±5.1% and 65.0±6.6% for DFM-LDP, FMF, FMV and FMES respectively.Conclusions: DFM-LDP and FMF (purely finger millet based products) elicited higher glycemic responses. Comparatively, FMV and FMES (with added functional ingredients) exhibited medium GI values and, are healthier dietary options. It is possible to prepare FM products with lower GI by utilizing functional ingredients. [ABSTRACT FROM AUTHOR]

Background and Objectives: To evaluate the effect of polishing on the glycemic properties of Indian parboiled brown rice.Methods and Study Design: We evaluated the effect of different degrees of polishing on the glycemic and insulinemic responses of Bapatla (BPT-5204), Indian parboiled Indica rice variety. Brown rice (BR), under milled rice (UMR) and white rice (WR) with 2.3% and 9.7% degree of polishing (DOP), respectively, were prepared and evaluated for the glycemic properties. Incremental Area Under the Curves (IAUC) were estimated for both glycemic index (GI) in 12 healthy participants (6 men, 6 women) and 24 hr glycemic response studies in 13 overweight participants (5 men, 8 women) using continuous glucose monitoring (CGM) system with ≈2000 kcal/day rice diets. Differences in pre and post meal insulin (Δ) were assessed.Results: The GI of WR (GI=79.6) and UMR (GI=73) were significantly higher than BR (GI=57.6) (p<0.01). Similar results were obtained for 24 hr glycemic responses [IAUC: WR=58.4, UMR=55.5, BR=34.7 mg*5 min/dL, respectively]. The Δ Insulin responses were lower with BR meals compared with UMR and WR (p=0.025; p=0.003).Conclusions: Both UMR and WR had a high GI while BR had a medium GI. This could have influenced the 24 h glycaemic and insulinemic responses of BR which had the lowest responses as compared with UMR and WR, and the latter two had similar higher responses. Thus any degree of polishing leads to higher glycaemic responses. [ABSTRACT FROM AUTHOR]

Background & objectives: Despite the rising prevalence of non-communicable diseases (NCDs) in rural India, data on the dietary profile of the rural Indian population in relation to the recommendations for prevention of NCDs are scarce. This study was conducted to assess the dietary intake of a rural south Indian population in relation to the current dietary recommendations for the prevention of NCDs. Methods: The dietary profiles of 6907 adults aged ≥ 20 yr, from a cluster of 42 villages in Kancheepuram district of Tamil Nadu State in southern India, were assessed using a validated food frequency questionnaire. Results: The prevalence of general obesity was 27.4 per cent and that of abdominal obesity, 14.0 per cent among this rural population. The median daily energy intake of the population was 2034 (IQR 543) kcals. More than 3/4th of the calories (78.1%) were provided by carbohydrates. Refined cereals, mainly polished rice, was the major contributor to total calories. About 45 per cent of the population did not meet WHO recommendation for protein due to low intake of pulses, flesh foods and dairy products and more than half (57.1%) exceeded the limit of salt intake; 99 per cent of the population did not meet WHO recommendations for fruits and vegetables and 100 per cent did not meet the requirement of n-3 poly unsaturated fatty acids. Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action. [ABSTRACT FROM AUTHOR]

Background & objectives: Pre-clinical toxicology evaluation of biotechnology products is a challenge to the toxicologist. The present investigation is an attempt to evaluate the safety profile of the first indigenously developed recombinant DNA anti-rabies vaccine [DRV (100 µg)] and combination rabies vaccine [CRV (100 µg DRV and 1.25 IU of cell culture-derived inactivated rabies virus vaccine)], which are intended for clinical use by intramuscular route in Rhesus monkeys. Methods: As per the regulatory requirements, the study was designed for acute (single dose - 14 days), sub-chronic (repeat dose - 28 days) and chronic (intended clinical dose - 120 days) toxicity tests using three dose levels, viz. therapeutic, average (2x therapeutic dose) and highest dose (10 x therapeutic dose) exposure in monkeys. The selection of the model i.e. monkey was based on affinity and rapid higher antibody response during the efficacy studies. An attempt was made to evaluate all parameters which included physical, physiological, clinical, haematological and histopathological profiles of all target organs, as well as Tiers I, II, III immunotoxicity parameters. Results: In acute toxicity there was no mortality in spite of exposing the monkeys to 10XDRV. In sub chronic and chronic toxicity studies there were no abnormalities in physical, physiological, neurological, clinical parameters, after administration of test compound in intended and 10 times of clinical dosage schedule of DRV and CRV under the experimental conditions. Clinical chemistry, haematology, organ weights and histopathology studies were essentially unremarkable except the presence of residual DNA in femtogram level at site of injection in animal which received 10X DRV in chronic toxicity study. No Observational Adverse Effects Level (NOAEL) of DRV is 1000 ug/dose (10 times of therapeutic dose) if administered on 0, 4, 7, 14, 28th day. Interpretation & conclusions: The information generated by this study not only draws attention to the need for national and international regulatory agencies in formulating guidelines for pre-clinical safety evaluation of biotech products but also facilitates the development of biopharmaceuticals as safe potential therapeutic agents. [ABSTRACT FROM AUTHOR]