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ObjectiveTo identify correlates of anaemia during the first trimester of pregnancy among 366 urban South Indian pregnant women.DesignCross-sectional study evaluating demographic, socio-economic, anthropometric and dietary intake data on haematological outcomes.SettingA government maternity health-care centre catering predominantly to the needs of pregnant women from the lower socio-economic strata of urban Bangalore.SubjectsPregnant women (n 366) aged ≥18 and ≤40 years, who registered for antenatal screening at ≤14 weeks of gestation.ResultsMean age was 22·6 (sd 3·4) years, mean BMI was 20·4 (sd 3·3) kg/m2 and 236 (64·5 %) of the pregnant women were primiparous. The prevalence of anaemia (Hb <11·0 g/dl) was 30·3 % and of microcytic anaemia (anaemia with mean corpuscular volume <80 fl) 20·2 %. Mean dietary intakes of energy, Ca, Fe and folate were well below the Indian RDA. In multivariable log-binomial regression analysis, anaemia was independently associated with high dietary intakes of Ca (relative risk; 95 % CI: 1·79; 1·16, 2·76) and P (1·96; 1·31, 2·96) and high intake of meat, fish and poultry (1·94; 1·29, 2·91).ConclusionsLow dietary intake of multiple micronutrients, but higher intakes of nutrients that inhibit Fe absorption such as Ca and P, may help explain high rates of maternal anaemia in India. [ABSTRACT FROM PUBLISHER]

Objectives: To identify important factors (linked to lifestyle, eating and sedentary behaviors) relating to waist circumference among urban South Indian children aged 3 to 16 years. Design: Cross sectional. Setting: Urban schools of Bangalore, from August 2008 to January 2010. Participants: 8444 children; 4707 children aged 3-10 years and 3737 children aged 10-16 years. Methods: Data were collected on the frequency of consumption of certain foods, physical activity patterns, sedentary habits at home, sleep duration and behaviors such as habits of snacking, skipping breakfast, eating in front of television and frequency of eating out. Simple linear regression analysis of waist circumference on various food items, physical activity, behavior and parental BMI were performed. A path model was developed to identify potential causal pathways to increase in waist circumference. Results: Increased consumption of bakery items, non vegetarian foods, increased television viewing, decreased sleep duration, eating while watching television, snacking between meals, family meals, skipping breakfast (in older children), and parental BMI were found to be related to waist circumference. Older children possibly underreported their intake of "unhealthy" foods, but not behaviors. Conclusions: This study identified potential behaviors related to waist circumference in urban school children in India. Longitudinal studies with better measures of morbidity and adiposity are warranted in order to derive casual relationships between various determinants and waist circumference. [ABSTRACT FROM AUTHOR]

Folate and vitamin B-12 are essential for normal brain development. Few studies have examined the relationship of maternal folate and vitamin B-12 status during pregnancy and offspring cognitive function. To test the hypothesis that lower maternal plasma folate and vitamin B-12 concentrations and higher plasma homocysteine concentrations during pregnancy are associated with poorer neurodevelopment, 536 children (aged 9-10 y) from the Mysore Parthenon birth cohort underwent cognitive function assessment during 2007-2008 using 3 core tests from the Kaufman Assessment Battery, and additional tests measuring learning, long-term storage/retrieval, attention and concentration, and visuo-spatial and verbal abilities. Maternal folate, vitamin B-12, and homocysteine concentrations were measured at 30 ± 2 wk gestation. During pregnancy, 4% of mothers had low folate concentrations 1<7 nmol/L), 42.5% had low vitamin B-12 concentrations (<150 pmol/L), and 3% had hyperhomocysteinemia (>10 μmol/L). The children's cognitive test scores increased by 0.1-0.2 SD per SD increase across the entire range of maternal folate concentrations (P < 0.001 for all), with no apparent associations at the deficiency level. The associations with learning, long-term storage/retrieval, visuo-spatial ability, attention, and concentration were independent of the parents' education, socioeconomic status, religion, and the child's sex, age, current size, and folate and vitamin 8-12 concentrations. There were no consistent associations of maternal vitamin B-12 and homocysteine concentrations with childhood cognitive performance. In this Indian population, higher maternal folate, but not vitamin B-12, concentrations during pregnancy predicted better childhood cognitive ability. It also suggests that, in terms of neurodevelopment, the concentration used to define folate deficiency may be set too low. [ABSTRACT FROM AUTHOR]

Objective: To validate questionnaire-based physical activity level (PAL) against accelerometry and a 24 h physical activity diary (24 h AD) as reference methods (Protocol 2), after validating these reference methods against the heart rate- oxygen consumption (HRVO2) method (Protocol 1). Design: Cross-sectional study. Setting: Two villages in Andhra Pradesh state and Bangalore city, South India. Subjects: Ninety-four participants (fifty males, forty-four females) for Protocol 2; thirteen males for Protocol 1. Results: In Protocol 2, mean PAL derived from the questionnaire (1·72 (SD 0·20)) was comparable to that from the 24 h AD (1·78 (SD 0·20)) but significantly higher than the mean PAL derived from accelerometry (1·36 (SD 0·20); P<0·001). Mean bias of PAL from the questionnaire was larger against the accelerometer (0·36) than against the 24 h AD (20·06), but with large limits of agreement against both. Correlations of PAL from the questionnaire with that of the accelerometer (r=0·28; P=0·01) and the 24 h AD (r50·30; P=0·006) were modest. In Protocol 1, mean PAL from the 24 h AD (1·65 (SD 0·18)) was comparable, while that from the accelerometer (1·51 (SD 0·23)) was significantly lower (P<0·001), than mean PAL obtained from the HRVO2 method (1·69 (SD 0·21)). Conclusions: The questionnaire showed acceptable validity with the reference methods in a group with a wide range of physical activity levels. The accelerometer underestimated PAL in comparison with the HRVO2 method. [ABSTRACT FROM AUTHOR]

Purpose: To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. Procedure: 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90 % of variance to total energy intake. Nutrient and food group intakes were compared using an independent t-test. Main Findings: The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. Conclusions: In Indian populations with diverse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using standard methods to match foods can be adopted. [ABSTRACT FROM AUTHOR]

Background & objectives: There is no published literature on the extent of vitamin B12 deficiency in elderly Indians as determined by plasma vitamin B12 levels and methylmalonic acid (MMA) levels. Vitamin B12 deficiency is expected to be higher in elderly Indians due to vegetarianism, varied socio-economic strata and high prevalence of Helicobacter pylori infection. We therefore, studied the dietary habits of south Indian urban elderly population and measured vitamin B12, MMA red cell folate and homocysteine (Hcy) levels. Methods: Healthy elderly urban subjects (175, >60 yr) were recruited. Detailed history, physical examination and neurological assessment were carried out. Food Frequency Questionnaire (FFQ) for dietary analysis for daily intake of calories, vitamin 12, folate and detailed psychological assessment for cognitive functions was carried out. Blood samples were analyzed for routine haematology and biochemistry, vitamin B12, red cell folate, MMA and Hcy. Results: The mean age of the study population was 66.3 yr. Median values for daily dietary intake of vitamin B12 and folate were 2.4 and 349.2 µg/day respectively. Sixty two (35%) participants consumed multivitamin supplements. Plasma vitamin B12 level and the dietary intake of vitamin B12 was significantly correlated (P=-0.157). Plasma vitamin B12 and Hcy were inversely correlated (P= -0.509). Red cell folate was inversely correlated with Hcy (P= -0.550). Significant negative correlation was observed between plasma vitamin B12 and MMA in the entire study population (P= -0.220). Subjects consuming vitamin supplements (n=62) had significantly higher plasma vitamin B12 levels, lower MMA levels and lower Hcy levels. There was no significant correlation between plasma vitamin B12, MMA, Hcy and red cell folate and any of the 10 cognitive tests including Hindi Mental Status Examination (HMSE). Interpretation & conclusions: Our study is indicative of higher vitamin B12 (2.4 µg/day) intakes in urban south Indian population. Thirty five per cent of the study population consumed multivitamin supplements and therefore, low plasma vitamin B12 levels were seen only in 16 per cent of the study subjects. However, MMA was elevated in 55 per cent and Hcy in 13 per cent of the subjects. [ABSTRACT FROM AUTHOR]

In recent years there is growing interest on the role of long chain ω-3 polyunsaturated fatty acids (ω-3 LC-PUFA) in pregnancy and the growth and development of the offspring. We aim to characterize and provide baseline data on the intake of LCPUFA (ω-3 and ω-6) in a prospective cohort of 829 pregnant Indian women and report associations between LCPUFA intake and erythrocyte membrane phospholipid fatty acid concentration in a subgroup at baseline (1st trimester), the 2nd and 3rd trimesters of pregnancy. The dietary intake of all the macronutrients and of α-linolenic acid(ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) significantly increased over the 3 trimesters of pregnancy while that of ω-6 fatty acids (FA) remained unchanged. Median ω-3 FA intakes of ALA, EPA and DHA, however, were on average low at 0.56, 0.003 and 0.011 g/d, respectively while LA was 14.6 g/d during pregnancy. Consequently, the intake ratio of ALA to LA in the women in the present study was very low at 1:26. A significant decline in erythrocyte membrane arachidonic acid (AA) concentration but not of DHA was observed throughout pregnancy. This might be due to increased efficiency in terms of elongation of parent ω-3 FA. Dietary methods for improving the consumption of ω-3 FA need to be considered in the diets of young women as well as during pregnancy. As newborns primarily depend on placental transfer of ω-3 FA there is need to examine the ω-3 LC-PUFA concentration in infants of mother's with low intakes of ω-3 FA. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a physical activity assessment questionnaire for use in poorly educated and low socio-economic rural communities in developing countries and assess the repeatability of the measurements over a one-year duration. Physical Activity Level, as a composite measure of daily physical activity (PAL - estimated 24 hour energy expenditure / estimated basal metabolic rate) was derived from the semipictorial, interviewer based questionnaire assessing physical activity over the previous I week. PAL of both men and women was unchanged across the different seasons of the year. Correlations between the first physical activity questionnaire and the mean of at least 4 questionnaires administered during the course of one year were generally high (males: PAL 'r' = 0.69, individual domains 'r' between 0.57 and 0.82; females: PAL 'r' 0.7. individual domains 'r' between 0.41 and 0.76, all p < 0.05). Within- individual % coefficient variations (CV) across 4 physical activity questionnaires were low for sleep duration and PAL (< 14%) but high for the other domains of physical activity (77-100%). The data, at least in this community, suggest that while within-individual variations in specific domains of physical activity may be considerable, the questionnaire that we designed can rank individuals in terms of their PAL or individual domains of physical activity fairly consistently. A single physical activity assessment using this instrument may therefore be adequate to rank individuals. [ABSTRACT FROM AUTHOR]