Body Fat Indices for Identifying Risk of Hypertension in Indian Children.

Background: High adiposity is major risk factor for hypertension. Various anthropometric indices are used to assess excess fatness. Objectives: (1) To examine relationship of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), triceps skin fold thickness (TSFT) and wrist measurements with blood pressure in children and adolescents 2) to suggest age- and gender-specific cutoffs for these indices in Indian children. Methods: Cross-sectional school-based study on a random sample of 6380 children (6-18 yr old, 3501 boys) from five major cities in India. Height, weight, waist and wrist circumference, TSFT, and blood pressure were recorded. Children with systolic blood pressure (BP) and/or Diastolic BP >95th percentile were classified as hypertensive. Results: Prevalence of overweight and obesity was 23.5% and 9.7%, respectively. Hypertension was observed in 5.6%. Multiple logistic regression (adjustments: age, gender) indicated double risk of hypertension for overweight and 7 times higher odds for obese than normal-weight children. Children with TSFT >95th centile for US children showed three times risk and with TSFT from 85th to 95th double risk of hypertension. Higher WC and WHtR exhibited 1.5 times risk and larger Wrist 1.3 times higher risk of hypertension (P<0.001). Receiver operating curve (ROC) analysis provided age-gender specific cut offs for the five indices to detect the risk of high BP. Area under ROC curves (AUC) for five indices were similar and greater in older age groups indicating equal sensitivity and specificity. Conclusion: Using age- and gender-specific cutoffs for BMI, TSFT, WC or WHtR may offer putative markers for early detection of hypertension.

Body Mass Index Cut-offs for Screening for Childhood Overweight and Obesity in Indian Children.

Objective: To develop age and sex specific cut- offs for BMI to screen for overweight and obesity in Indian children linked to an adult BMI of 23 and 28 kg/m2 respectively, using contemporary Indian data. Design: Cross-sectional. Setting: Multicentric, School based. Participants: 19834 children were measured from 11 affluent schools from five major geographical regions of India. Data were analyzed using the LMS method, which constructs growth reference percentiles adjusted for skewness. Results: Compared to the cut-offs suggested for European populations and those by the Indian Academy of Pediatrics 2007 Guidelines, the age and sex specific cut off points for body mass index for overweight and obesity for Indian children suggested by this study are lower. Conclusions: Contemporary cross-sectional age and sex specific BMI cut-offs for Indian children linked to Asian cutoffs of 23 and 28 kg/m2 for the assessment of risk of overweight and obesity, respectively are presented.

Growth Performance of Affluent Indian Preschool Children: A Comparison with the New WHO Growth Standard.

This study was conducted to evaluate the nutritional status of 2-5 year old affluent, urban children using the new WHO 2006 standards. A cross-sectional, multicentric preschool-based study was conducted on 1493 children (727 boys). Mean Z scores for height, weight, body mass index and weight for height (-0.75(1.1), - 0.59(1.1), –0.19(1.22) and -0.26(1.18), respectively) were below the WHO standard median.

Sunlight exposure and development of rickets in indian toddlers.

Objective. To study the role of sunlight exposure in determining the vitamin D status of underprivileged toddlers. Methods. Height and weight were measured, clinical examination was performed, Food Frequency Questionnaire was administered and history of sunlight exposure was obtained in all (61) toddlers attending daytime crèche (Group B). Ionised calcium (iCa), inorganic Phosphorous (iP), alkaline phosphatase activity (ALP), serum parathyroid hormone (PTH) and 25 Hydroxy vitamin D (25OHD) were measured. Data were compared with results of a survey measuring similar parameters in 51 (of 251 eligible) toddlers from the same slum (Group A). Results. 111 children (mean age 2.6 yr (0.7), boys 56) were studied. Prevalence of hypovitaminosis D was 77% in group B toddlers (46 of 60) and 16.4% (10 of 61) had rickets, while none of the group A toddlers had 25OHD levels below 30nmol/L. Four children (7.8%) from Group A as against 24 (42.9%) from Group B, had sunshine exposure of < 30 minutes per day. Conclusion. Underprivileged toddlers who were deprived of sunlight had a much greater incidence of hypovitaminosis D and frank rickets. The study has important public health implications and underscores the necessity for sunlight exposure in young children.

Effect of microbial activities on stored raw buffalo hide.

‘Keeping qualities’ of hides are dependent on the total microbial flora associated with the hides and the biochemical changes brought about by these microorganisms during short-term storage at ambient temperature (28±2 oC). It was evident that within first 24 hr of hide’s ambient storage, bacterial load was raised to 8.8 log cfu g-1 hide from 6.1 log cfu g-1 hide. Nonlinear parabolic increase in release of hydroxyproline and tyrosine from stored hide was observed starting from 0 hr and confirming proteolytic activities. Continuous release of CO2 from the stored hide suggested its mineralization. Exponential release of free fatty acids during storage indicated simultaneous lipolysis. Thus the process of biodegradation during the course of ambient storage of hide piece was found to progress steadily and seems to be interrelated as well as very complex. During the storage period, the liquefaction of hide piece was also observed visually within 96 hr. Present studies of assessment of bacterial activities on hide with respect to total bacterial load, release of amino acids, free fatty acids and evolved CO2 provide data that can be used to formulate and evaluate hide curing agent(s) other than salt, thus rendering leather industry a platform to design bio-based technologies for efficient and ecofriendly preservation of raw materials.

Zinc, copper & iron contents in cooked foods & estimates of their daily intakes in young hostel residents.

Dietary zinc, copper and iron intakes of 19 men and 11 women (aged 18-25 yr) were determined during three periods of five consecutive days each, using, weighment method and atomic absorption analysis of food samples. Daily zinc, copper and iron intakes of men ranged from 13.1 +/- 1.2 to 15.3 +/- 1.4 mg/d, 1.62 +/- 0.15 to 1.84 +/- 0.17 mg/d and 20.5 +/- 2.8 to 29.1 +/- 4.5 mg/d and of women 8.8 +/- 2.0 to 9.0 +/- 1.6, 1.42 +/- 0.23 to 1.69 +/- 0.62, and 10.0 +/- 2.4 to 14.7 +/- 2.6 mg/d respectively. Cereals provided 67.7 per cent of dietary zinc, 47.7 per cent copper and 62 per cent iron in men and 60 per cent of Zn, 44 per cent of Cu and 59 per cent of Fe in women, suggesting lower contribution of cereals to Cu intakes than Zn and Fe. Men had mineral intakes close to the recommended allowances for Indians, whereas the intakes of women were 30 to 60 per cent lower. When expressed as mg/1000 kcal, lower calorie intakes of women were responsible for their low mineral intakes. Intra-individual variation in mineral intakes was higher (18.39%) than that of energy intakes (14-17%) in both men and women. Phytate: Zn molar ratios were > 15 indicating risk of zinc deficiency in these students.

Energy intake & resting metabolic rate of young Indian men & women.

Energy intake, body weight and resting metabolic rate (RMR) were measured on seven days consecutively, in 20 men and 14 women on ad libitum food intake under free-living conditions. These measurements were repeated in 8 men and 9 women twice with an interval of two months. Mean energy intake (EI) as measured by 'Weightment' method, was 2820 +/- 577 kcal/d in men and 1611 +/- 147 kcal/d in women. EI showed significant differences between weeks (P less than 0.01, CV = 13.1% in men and 9.5% in women) and between subjects (P less than 0.05, CV = 13.7% in men and 9.8% in women). Intra individual variance contributed up to 60 to 70 per cent of the total variance in EI in both the groups. RMR measured by using Oxylog, varied between the three periods (CV = 6% in men and 5.9% in women) and between subjects (CV = 5.7% in men and 12.3% in women). Mean RMR of both men and women was lower than the predicted value by FAO/WHO/UNU equation. Estimate of mean 24 h energy expenditure, using activity diary and factorial method, in the first round was 2458 +/- 144 kcal in men and 1655 +/- 172 in women, resulting in an energy balance of 308 kcal in men and -44 kcal/d in women. The pattern of activity remained the same in the three rounds for both groups. There were no significant changes in weight (CV-1.6%) or per cent body fat during the study period (P greater than 0.1).

Intra-individual variation in energy intake in adult males in training.

Variability of energy intake was examined using data for 73 adult males (17-21 yr) for two different levels of training. The subjects were put on hard physical training costing about 1850 kcal/d (phase I: heavy activity) for the first five months and trades' training involving light physical work equivalent to 900 kcal/d (phase II: moderate activity) in the next five months. All the subjects were observed for five consecutive days of their training for dietary intake, weight, and daily activity pattern in the middle of each activity level. A subsample of nine subjects was also surveyed for five consecutive days every second month during the entire training period to get an estimate of week to week variation within subjects. 'Weigh as you eat' method in combination with proximate analysis was used to determine the habitual energy intake of the subjects. Analysis of variance for intake data showed that a substantial part (55 to 60%) of the total variance was contributed by intra-individual variation. Inter subject variation was found to have a cv of 10 per cent in both the levels of activity. Moreover data of the subsample indicated that variation in mean intake from week to week was significantly larger than the daily variance suggesting nonrandomness of daily energy intake.