A critical comparison of the Indian school food and nutrition guidelines with the WHO-nutrition friendly school initiative and the review of existing implementation scenario.

Background: The school-based food and nutrition guidelines approach has the potential to combat undernutrition, overnutrition and micronutrient deficiencies among children and adolescents and set the foundation for a healthy adult lifestyle. Aim: To critically compare the Nutrition Friendly School Initiative (NFSI) of the World Health Organization (WHO) with the Food Safety and Standards Authority of India (FSSAI) and the Indian Academy of Pediatrics (IAP) guidelines to gauge the strengths and limitations. Additionally, to summarize the existing studies on implementing school food and nutrition guidelines. Methods: Policy documents of the above guidelines were critically evaluated, and narrative analysis was conducted. An electronic search was conducted for full-text research articles published in the English language between January 2007 to September 2021 in Science Direct, PubMed, Web of Science, and SCOPUS databases. Results: Upon critical comparison of the three guidelines, it was found that the NFSI and FSSAI guidelines shared similarities in many components and the FSSAI guidelines, if implemented adequately, could improve the school food environment and combat the triple malnutrition burden in India. After screening the articles based on the eligibility criteria, 11 studies were included in the preparation of the review. Studies reported partial or inadequate implementation and poor compliance with the guidelines or approach. A few studies identified barriers to guideline implementation. Conclusion: Implementation of school food and nutrition guidelines could improve the nutritional outcomes in children and adolescents. To sustain the effective implementation, adequate resources and preparedness are essential in low-and middle-income countries, including India.

Alterations in reproductive hormone levels among farm women and their children occupationally exposed to organophosphate pesticides.

Exposure to organophosphorus pesticides may lead to reproductive hormone dysfunction. Even among children of pubertal age, the exposure may disrupt growth, development, and maturation. The present study was conducted to assess the alterations in the reproductive hormone levels, among farm women (24-45 years, n = 129) and their children (9-12 years, n = 66 and 13-15 years, n = 63) and compare them with age and gender-matched control group [women (n = 134) and their children (9-12 years, n = 69 and 13-15 years, n = 65)] belonging to villages of Ranga Reddy District, Telangana, India. Blood pesticide residues and reproductive hormone (follicle-stimulating hormone-FSH, luteinizing hormone-LH, estradiol, and testosterone) levels were analyzed. The detected pesticide residues (ng/mL) were chlorpyrifos, diazinon, malathion, and monocrotophos among the farm women, while the farm children of 9-12 years age groups were detected with residues of chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone. The farm children of 13-15 years age group were detected with residues of chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone. However, no residues were detected among the samples of women and children of control groups. Significantly lower levels of FSH (in follicular phase) were observed among the farm women than the control group. Significant alterations in FSH and LH levels of farm women were observed with a significant correlation between the chlorpyrifos residue levels and estradiol hormone. While no such significant change in hormone levels was observed among the farm children of both age groups of both genders. Though the present study showed pesticide-induced alterations in hormone levels among the farm women, research is needed to elucidate the critical windows during which exposure may adversely affect the reproductive system in children at the pubertal stage and women at reproductive age and subsequently their progeny's health at a later stage of life.

Impact of Maternal Essential Fatty Acid Intake on the Birth Weight of Infants.

BACKGROUND: Increased uptake of essential fatty acids during pregnancy through seafood and supplementation has been shown to positively correlate with gestational age and increased infant birth weight. We aimed to evaluate the effect of maternal dietary intake of essential fatty acids, supplementation on gestational period and infant birth weight. MATERIALS: A literature search with the help of various databases such as PubMed, Google Scholar, Web of Science and Scopus was conducted. METHODS: Original research articles and intervention-based studies, which involve an association between dietary intake and supplementation of essential fatty acids during full-term pregnancy on human infant birth outcomes and published from 2011 to 2021, were included. RESULTS: In total, there were 21 intervention-based studies, including full-term pregnant women with or without existing comorbidities, which compared essential fatty acids in the form of dietary sources and supplementation with dietary counseling and with or without placebo. The intervention trials included in this review were conducted in developed and developing countries. Half of the pregnant women who enrolled in the study had comorbidities such as diabetes and hypertension, which might increase their risk of adverse maternal and infant birth outcomes. Most of the studies included in the review have reported a positive association between improvised dietary and supplementation intake of essential fatty acids with increased length of gestation, infant birth weight and other parameters such as head circumference, infant birth length and growth velocity. CONCLUSION: Positive correlations were found between increased consumption of essential fatty acids in food sources and supplements with improvised infant birth weight and gestational period.

Breastfeeding Patterns and Stress Among Lactating Women in Pune During the COVID-19 Pandemic.

Lactating mothers (n=126) residing in Pune, Maharashtra were interviewed to assess the prevalence of stress, rate of exclusive breastfeeding (EBF), and its association with different demographic factors.  75.4% mothers were found to be moderately stressed. Rate of EBF was 62.7%. Moderate stress and testing positive for COVID-19 were significantly negatively associated with EBF (P<0.001).

Impact of Micronutrient Supplementation on Pesticide Residual, Acetylcholinesterase Activity, and Oxidative Stress Among Farm Children Exposed to Pesticides.

The present interventional study aimed to assess the impact of micronutrient supplementation on pesticide-residues concentrations, vitamins, minerals, acetylcholinesterase activity and oxidative stress among 129 farm children (9-12 years, n = 66 and 13-15 years, n = 63) involved in farming activities in Ranga Reddy district, Telangana, India. Our data showed the presence of five organophosphorus pesticide residues (chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone) among children before-supplementation (both age-groups); while post-supplementation, only two pesticide residues (chlorpyrifos and diazinon) were detected indicating improved metabolic rate. Vitamin E, copper, magnesium and zinc levels were also improved in both the age-groups and manganese levels were significantly increased only among children of 13-15 years age group. Further, post-supplementation also showed an improvement in acetylcholinesterase activity and a decrease in lipid peroxidation among both the age groups of children. However, further research for ascertaining the ameliorating effect of micronutrients in preventing adverse effects of organophosphorus pesticides must be conducted.

Organophosphate pesticide exposure among farm women and children: Status of micronutrients, acetylcholinesterase activity, and oxidative stress.

Nutritional status plays a major role in determining the possible adverse health outcomes due to pesticide toxicity. The objective of the present study was to assess the organophosphorus pesticide residue levels among farm women (FW) (24-45years) and farm children (FC) (9-12 and 13-15years) belonging to the Rangareddy district (Telangana, India) along with their micronutrient status, inhibition of acetylcholinesterase activity, and oxidative stress levels. Residues of Chlorpyrifos, Diazinon, Malathion, Monocrotophos and Phosalone were found in the serum samples of FW and FC along with significantly low levels of vitamins and minerals. Inhibition of AChE activity was observed in FW and FC and altered oxidative stress parameters among FW. Correlation studies have found significant associations between the pesticide residues, micronutrients and antioxidant enzymes. The study suggests an association between pesticide exposure coupled with micronutrient deficiency, induced AChE inhibition, and oxidative stress.

Effect of organophosphorus pesticide exposure on the immune cell phenotypes among farm women and their children.

Epidemiological studies suggest suppression of the lymphocytes function through cholinergic stimulation due to organophosphorus pesticide exposure. The study aimed to assess the alteration in the levels of immune cell phenotypes among farm women (FW) and farm children (FC) who were occupationally exposed to pesticides and age/gender-matched control subjects belonging to Rangareddy district (Telangana, India). A total of 129 FW, 129 FC and 268 age/gender-matched controls were recruited. Blood samples were collected from the selected subjects to estimate the levels of nine organophosphorus pesticide residues and CD (CD3+, CD4+, CD8+, CD16+ and CD19+) cell markers using LC-MS/MS and flow cytometry, respectively. Independent t-test analysis was conducted to compare the immune cell phenotypes between exposed and control groups. Spearman's rank correlation test was further carried out to identify any possible correlation between the pesticide residues and CD markers. The mean percentage for CD4+, CD8+ and CD16+ was found to be significantly low, while for CD19 + itwas significantly high in the FW as compared to the CW group (p < 0.01). Further, the residues of chlorpyrifos and monocrotophos among FW were found to be significantly correlating with the mean percentages of CD19+ and CD8+ markers, respectively. The cell marker subsets of CD4+ and CD8+ were significantly low in FC children 9-12 years and 13-15 years age groups, respectively (p < 0.05). Also, these levels were significantly correlating with the residues of malathion and monocrotophos. The present study could indicate an alteration in the lymphocytes' subpopulations, which may thereby infer the toxicity in the first phase assessment of immunotoxicity. Therefore, further studies may be conducted to understand the suspected pesticides' mechanism along with various other factors in causing immune suppression coupled with nutritional and other related disorders.

Assessment of dermal exposure to pesticides among farmers using dosimeter and hand washing methods.

Inappropriate use of pesticides followed by unsafe handling practices to control the insect infestation among the farming groups in developing countries has resulted in a high exposure risk. The use of personal protective equipment is also negligible among Indian farmers due to their affordability to access the same. Very little research has been conducted to establish an exposure assessment procedure through dermal penetration of pesticide residues. Therefore, to quantify the contamination of pesticide residues through dermal exposure along with detailed field observations and pesticide management practices, a field study was conducted in Rangareddy district, Telangana, Southern India, to assess the dermal exposure based on dosimeter and hand washing methods. The analytical method was modified and validated in-house for performance parameters such as limit of detection, quantification, linear range, recovery, and precision. The potential dermal exposure values ranged from 0.15 to 13.45 µg, while a reduction was found in exposure levels as actual dermal exposure values ranged from 0 to 0.629 µg. Contamination through hand washing was the major contributor to overall dermal exposure. Statistical analysis revealed a significant difference in the exposed dermal regions of the leg and torso after the use of PPE. Penetration factor for each anatomical region and risk evaluation in terms of the Margin of Safety implies unsafe handling of pesticides. The findings of the present study confirm the increased exposure to organophosphate pesticides among operators and highlight the importance of the use of protective measures, especially among those that focus on dermal exposure mitigation.

Predominant role of antioxidants in ameliorating the oxidative stress induced by pesticides.

Oxidative stress has been reported as one of the adverse effects caused due to pesticides, which is the main mechanism of the toxicity in humans and animals and is a useful parameter in monitoring studies. It involves an imbalance in the equilibrium state of ROS and antioxidant defenses leading to alterations in various antioxidant enzyme levels and lipid peroxidation. The objective of the current paper is to present a review of the potential role and protective mechanism action of the antioxidant micronutrient supplementation to ameliorate the oxidative stress induced by pesticides. Studies in animal models and human were retrieved through the relevant search of the literature and categorized. Various animal studies were categorized according to the type of supplementation. Animal studies provide evidence to conclude the potential protective role of antioxidants in ameliorating the adverse effects of pesticides. Similar studies in humans are meager suggesting for further comprehensive research.

Pesticide handling practices and self-reported morbidity symptoms among farmers.

Amid growing concern about the adverse effects of pesticides, a questionnaire-based cross-sectional study was conducted to evaluate farmers' knowledge on pesticides handling. Results of in-depth surveys (n = 217) with field observations revealed that participants had a mean 18 years of farming experience and knapsack-sprays were used for spraying. About 99% were not using any personal-protective-equipments during mixing, loading, application operations. Over 80% reentered the treated farms within two-days of application without following safety protocols and 39% admitted unsafe disposal of empty containers of pesticides. Statistical-analysis revealed a significant association between participant's pesticide handling practices and self-reported morbidity symptoms (p < 0.05). Despite awareness of toxicity, participants were mishandling the pesticides. Training on safe handling practices and incentives in form of personal-protective-equipments could be productive to ensure safety at work.