Body fat reference percentiles on healthy affluent Indian children and adolescents to screen for adiposity.

BACKGROUND: Indian children and adolescents have higher body fat percentage at a given body mass index than their Western counterparts. OBJECTIVE: To create gender-specific percentile curves for total body fat percentage (TBFP), total body fat mass (TBFM), fat mass index (FMI) and android:gynoid (A:G) ratio for screening adiposity in healthy Indian children. METHODS: Data on body composition by dual-energy X-ray absorptiometry were obtained from a cross-sectional study conducted from May 2006-July 2010 on 888 (462 boys) apparently healthy children from affluent area schools and colleges in Pune city, India. Reference percentile curves were derived for boys and girls for TBFP, TBFM, FMI and A:G ratio. These percentile curves were validated using data on metabolic syndrome risk components in separate sample of 332 (148 boys) children. RESULTS: The median TBFP increased little (4%) from 5 to 18 years of age in boys compared with that in girls (19%). TBFP percentiles showed plateau after 13 years of age in boys, whereas a steady increase was seen till 18 years in girls. The median TBFM increased less (7 kg) from 5 to 18 years in boys compared with that in girls (13.4 kg). The curve for median FMI in boys was relatively flat with FMI remaining near 3 kg m(-2) after 13 years of age, whereas in girls median FMI increased with age till about 15 years of age. A:G ratio curves increased with age in both boys and girls up to 18 years of age. In a separate sample of 332 children, according to percentiles developed in the current study, children with TBFP/TBFM/FMI percentiles between 85th and 95th or >95th percentile had significantly higher metabolic risk parameters as compared with those with <85th percentile (P<0.05). CONCLUSIONS: Percentile curves developed in the current study would be useful in assessment of adiposity and thus cardiometabolic risk in Indian children.

Vitamin B12 and homocysteine status in asymptomatic Indian toddlers.

Low serum vitamin B(12) (V B(12)) and hyperhomocysteinemia have been reported in asymptomatic Asian Indian men. We studied the prevalence of V B(12) deficiency and hyperhomocysteinemia in 51 asymptomatic toddlers, from Pune, India. V B(12) levels were low and total serum homocysteine was high in 14% and homocysteine levels were significantly higher in boys. Programming for cardiovascular risk in adulthood possibly starts at a very young age through the homocysteine axis.

Iron deficiency anemia in an urban slum.

OBJECTIVE: Of this pilot study was to assess the iron status and dietary intake of 1-3 year-old apparently healthy toddlers of the lower socio-economic class, and the effect of eight weeks intervention with liquid oral iron in an urban slum in Pune, India. METHODS: 50 toddlers (M= 25, F= 25) with mean age of 2.4 years (SD 0.82) were evaluated. Anthropometry, Food Frequency Questionnaire, a hemogram and ferritin were measured. Twenty mg of elemental iron was given to all toddlers. After 8 weeks clinical examination, anthropometry, hemoglobin (HGB) and Ferritin were measured. RESULTS: Prevalence of anemia was 66% (HGB <11 gm %) and ferritin (iron stores) were low (< 12 microgm/L) in 45 (90%). After therapy prevalence of anemia was 30%. There was a significant difference in the HGB and ferritin levels of children after eight weeks of therapy (p<0.001). CONCLUSION: The prevalence of anemia decreased from 66 to 30% after treatment with liquid iron. We propose that all concerned in the care of toddlers should join the fight against anemia and prescribe iron to all toddlers when they are seen for minor ailments.