Association of body fat with stress levels and dietary intakes in Indian women.

A cross-sectional study of 605 women (aged 18-50 years) conducted from January 2013 to June 2014 in Gujarat, India assessed stress, dietary intakes and body fat percentage (PBF), and the inter-relationship of PBF with stress, dietary fat, and carbohydrates. The population was categorized according to PBF cutoffs for Asians. A generalized linear regression model adjusted for age was performed to assess the relationship of stress, fat, and carbohydrate intakes with PBF. PBF had a significant positive association with stress level (p = .02) and carbohydrate intake (p = .008); fat intake was not significantly associated (p = .8). Women with moderate PBF consumed significantly less carbohydrates (mean = 152.3 ± 13.3 gm/1000 kcal/day, p < .05) and had lower stress scores (mean = 9.7 ± 4.2, p < .05) than women with high PBF (mean carbohydrate intake = 156.2 ± 10.8 gm/1000 kcal/day; mean stress score = 10.9 ± 4.4) and very high PBF (mean carbohydrate intake = 156.8 ± 11.6 gm/1000 kcal/day; mean stress score = 11.2 ± 4.2). We conclude that PBF has a positive association with stress and dietary carbohydrate; women with higher stress and carbohydrate intake are more likely to accumulate higher body fat as compared to women with less stress and low carbohydrate intake.

Impact of dietary nutrient intake and physical activity on body composition and growth in Indian children.

BackgroundTo investigate interrelationships of dietary composition and physical activity (PA) with growth and body composition (BC) in urban Indian school children.MethodsA cross-sectional study was performed in 4,747 Indian school children (2,623 boys) aged 3-18 years. Weight, height, BC by body impedance analyzer, PA and dietary food intakes by questionnaire method were recorded.ResultsMean daily energy and protein intakes as recommended dietary allowance were significantly lower in both boys and girls (P<0.01) above 6 years, with 55% reduction in micronutrient intakes in older children. When compared with World Health Organization references, lower heights in pubertal boys and girls were related to dietary energy and protein intake. Multiple regression analysis showed positive association of height for age z-scores (HAZ) with midparental height z-scores (ß=0.45, P=0.0001) and protein density (ß=0.103, P=0.014). HAZ was negatively associated with inactivity (ß=-0.0001, P=0.049) in boys and girls (R2=0.104, P<0.01). Further, body fat percentage was negatively correlated with moderate or light activity and antioxidant intakes (P<0.01) but not with dietary fat intake. Percentage muscle mass was positively correlated with moderate activity and negatively with inactivity (P<0.05).ConclusionAdequacy of protein and antioxidant intakes, reducing inactivity and increasing moderate activity are essential for optimal growth and body composition in Indian children.

Dietary patterns with special reference to calcium intake in 2-16-year-old Urban Western Indian children.

BACKGROUND: It is important to establish good dietary practices in childhood that promote adequate calcium intake throughout life and reduce the risk of osteoporotic fractures in later life. OBJECTIVES: To assess dietary patterns of 2-16-year-old children with special reference to calcium and suggest strategies and develop recipes suitable to identified patterns to increase dietary calcium intake. METHODS: We studied 220 schoolchildren (2-16 years) around Pune city, India. The study duration was June 2013-July 2014. Height and weight were measured using standard protocols. Dietary intake was assessed by 24-h diet recall on 3 nonconsecutive days. Dietary patterns were derived by cluster analysis in two age groups; children (2-9 years) and adolescents (10-16 years). As per the dietary patterns, calcium-rich recipes were developed. RESULTS: Among children, "rice-pulse" (RP) and "wheat, milk, and milk products" (WM) patterns were observed. Among adolescents, RP, "wheat, milk, and bakery" (WMB), and "mixed food" patterns were observed. Children who consumed "WM" and "WMB" patterns had greater intake of calcium (P < 0.05) than children consuming other dietary patterns. The daily calcium intake of whole group was 53% of the recommended dietary allowance. From this, 30% calcium came from milk. Each serve of the developed recipe provided an average of 254 mg of calcium. CONCLUSION: Majority of children had cereal-pulse-based dietary patterns. By replacing foods from existing dietary patterns with calcium-rich foods, the dietary calcium content may be increased in a sustainable manner.

Linkages of biomarkers of zinc with cognitive performance and taste acuity in adolescent girls.

A cross-sectional study (n = 403) was conducted to examine the relationship of plasma zinc (PZ) and erythrocyte zinc (EZ) levels with cognitive performance and taste acuity for salt in Indian adolescent girls. PZ, EZ and hemoglobin were estimated in schoolgirls (10-16 years). Cognitive performance was assessed by simple-reaction-time (SRT), recognition-reaction-time (RRT), visual-memory, Raven's Progressive Matrices (RPM) test. Taste acuity was determined by recognition-thresholds-for-salt (RTS) using 10 different salt concentrations. Low PZ (<0.7 mg/l) and EZ (<8 µg/g of packed cells) were observed in 72% and 23.6% of girls, respectively. PZ and EZ were negatively associated with SRT (r = -0.41, -0.34), RRT (r = -0.49, -0.4), and positively with Memory (r = 0.43, 0.34) and RPM (r = 0.39, 0.31; p < 0.05) and remained significant after adjusting for socio-demographic factors and hemoglobin. RTS was impaired in 18.3% girls and significantly correlated with EZ (r = -0.31, p < 0.05). Zinc deficiency in adolescent girls was associated with poor cognition and taste function implying need for improving their dietary zinc intakes.

Metabolic risk factors and arterial stiffness in Indian children of parents with metabolic syndrome.

OBJECTIVE: To investigate the possible association between metabolic syndrome (MS) and arterial stiffness in Indian children with parental MS status. METHODS: A cross-sectional study was conducted in 140 overweight/obese and 60 normal-weight Indian children (mean age, 11.4 ± 2.8 years) along with one of their parents during 2008-2009. Data on weight, height, blood pressure, serum lipids, zinc, insulin, and glucose were collected. Intima media thickness (CIMT) and stiffness parameters were assessed in the right carotid artery. Physical activity and diet were assessed using structured questionnaires. Body composition was measured using dual-energy x-ray absorptiometry. RESULTS: A gradual increase in the percentage of MS children with an increasing number of MS components in parents was observed. Mean values for arterial stiffness, pulse wave velocity, and elastic modulus were significantly higher in MS children of MS parents than in MS children of normal parents (p < 0.05). A significant correlation was observed for lifestyle, metabolic, and arterial parameters among child-parent pairs (p < 0.05). Multiple logistic regression revealed that children's CIMT and arterial stiffness were significantly associated (p < 0.01) with their serum levels of triglycerides, high-density lipoprotein, and zinc, as well as with parental MS-CIMT. CONCLUSION: Parental MS status and lifestyle factors increase the risk of MS and arterial abnormalities in children.

Low bone status in Indian growth hormone-deficient children.

BACKGROUND: Growth hormone (GH) is critical for linear bone growth, skeletal maturation and mineralization during childhood. AIMS: The aim of this study is to examine the impact of bone size and lean body mass (LBM) adjusted less head (LH) total body bone mineral content (TBBMC) in 50 prepubertal GH-deficient children. RESULTS: The mean height (Ht) for age Z-score was -5.0±1.7. The mean total body less head (TBLH) BMC for Ht age Z-score after adjusting for TBLH LBM and TBLH BA was -3.27±0.27. The mean TBLH BMC Z-score remained below -2 even after adjustments for TBLH LBM, bone age, and Ht age, suggesting a deficit of BMC in spite of all adjustments. Applying the Molgaard approach, all children had "short bones," 86% had "narrow bones," and 72% had "light bones." When adjusted for LBM, 87% of the children had low LBM for Ht and 33% had low TBLH BMC for TBLH LBM. CONCLUSION: LH TBBMC of children remained low, even after adjustment for bone size and LBM.

Bone status of women over 40 years of age from two socioeconomic strata.

BACKGROUND: Literature reports examining the association of bone mineral density (BMD) and socioeconomic status suggest of an inconclusive relation. METHODS: We studied 58 and 54 women (mean age 49.5 ± 7.2 years) from upper socioeconomic class (USC) and lower socioeconomic class (LSC), respectively, for their BMD at lumber spine and total femur by Lunar DPX-PRO dual-energy X-ray absorptiometry. Socioeconomic, lifestyle and biochemical data were collected. RESULTS: Percent prevalence of osteoporosis in USC women was 12% and 0% at lumber spine and total femur, respectively, while it was 33% and 11%, respectively, in LSC women. When the mean BMD values were adjusted for the effect of body mass index, protein and calcium intake, physical activity, and sunlight exposure, only the total femoral BMD of USC premenopausal women was significantly greater. CONCLUSION: Our data suggest that bone health of our LSC women was poor possibly due to the influence of socioeconomic and lifestyle factors.

Galacto-fructo-oligosaccharide fortification of fermented non-dairy snack enhances calcium absorption in healthy adolescent girls.

To evaluate the effect of galacto-fructo-oligosaccharide (G-FOS) fortification of non-dairy snack on relative calcium absorption, 61 girls (15-18 years) were randomly allocated to three equal groups; (i) Group-P, fermented-malted finger-millet pancake with soy coconut dip (snack; 534 mg calcium/serving); (ii) Group-G, snack fortified with G-FOS (8 g); (iii) Group-C: low calcium rice-flakes snack with calcium carbonate (540 mg). Group-G snack had lower pH (5.9) and higher total fatty acid content than group-P. After a 12-h fast, serum ionized calcium (iCa), intact parathyroid hormone (PTH) were measured at 0, 1, 3, 5, 7, 9 h after the ingestion of snack. Increment in area under the curve over baseline (ΔAUC) in iCa was higher in group-G(9.1%), as compared to group-P(1.4%) (p < 0.05) and group-C(3.1%). PTH ΔAUC was 39.7% higher for group-G as compared to group-P (p>0.1) but lower than group-C. In conclusion, calcium absorption is enhanced by G-FOS fortification and fermentation, which may be mediated through increased fatty acid content of the snack.

Determinants of bone mineral content and bone area in Indian preschool children.

The objective of this study was to examine the lifestyle factors that influence total body bone mineral content (TB BMC) and total body bone area (TB BA) in Indian preschool children. TB BMC and TB BA were measured by dual-energy X-ray absorptiometry (Lunar DPX PRO) in 71 apparently healthy children aged 2-3 years. A fasting blood sample was analyzed for serum concentrations of ionized calcium (iCa), intact parathyroid hormone (iPTH), phosphorus (iP) and 25-hydroxyvitamin D(3) (25 OHD). Dietary intake of energy, protein, calcium and phosphorus was estimated from a 3-day diet recall. The daily physical activity and sunlight exposure were recorded by a questionnaire. The study children were shorter than their age-gender matched WHO counterparts with a mean height for age Z score of -1.3 ± 1.5. The mean dietary intake of calcium was 46% of the Indian recommended dietary intakes (RDI). Seventy-three percent of children had low iCa concentrations, and 57% were deficient in vitamin D. Generalized linear model analysis revealed that height, lean body mass, weight, activity, sunlight exposure in minutes and dietary intakes of calcium, zinc and iron were the significantly influencing factors (p < 0.05) of TB BMC and TB BA. In conclusion, attaining optimal height for age, achieving the goals of overall nutrition with adequate calcium, iron and zinc intakes as well as adequate physical activity and sunlight exposure play an important role in achieving better TB BMC and TB BA in preschool children.

Modifiable factors associated with low bone mineral content in underprivileged premenarchal Indian girls.

Low adolescent peak bone mass is associated with bone problems in adulthood. Our aim was to assess underprivileged premenarchal Indian girls for low bone mineral content and to study the influence of anthropometric, lifestyle factors on bone health. Data on anthropometry, diet, lifestyle, total body bone mineral content (TBBMC), bone area, bone mineral density, and biochemical parameters [parathyroid hormone, vitamin D (25OH-D), calcium, and zinc] were assessed in 214 premenarchal girls (8-12 years). Compared with the Indian reference database, 15.6% girls had TBBMC for age Z-scores below -2 and 37.5% had Z-scores between -2 and -1. The TBBMC for total body bone area Z-scores were below -2 for one fifth of girls, indicating undermineralized bones. Mean rate of increase in TBBMC with age and Tanner stage was lower in our study population (11.6% and 20.7%, respectively) than reference database (14.2% and 33.4%, respectively). Low weight, 25OH-D, and intake of protein, calcium, and zinc adversely affected TBBMC (p < 0.05). Many underprivileged premenarchal Indian girls are at risk of achieving low bone mass. Steps to improve underweight, 25OH-D, intakes of protein, calcium, and zinc might improve bone health.

Evaluation of insulin-like growth factor-1 in Indian growth hormone-deficient children on growth hormone therapy.

OBJECTIVE: To evaluate the impact of recombinant human growth hormone therapy (GHT) on serum insulin-like growth factor 1 (IGF-1) concentrations in Indian children with growth hormone deficiency. METHODS: Data on anthropometry and serum IGF-1 concentrations were collected from 28 growth hormone-deficient prepubertal children (8.6 ± 2.9 years) on growth hormone therapy, 6 monthly over the period of 2 years. RESULTS: Height z-scores showed a steady increase from baseline to 24 months. However, IGF-1 z-scores showed a plateau after the first 6 months and then a small dip followed by a rise. The pattern of increase of IGF-1 z-scores was dissimilar to that of the height z-scores. CONCLUSION: The change in serum IGF-1 z-scores in response to GHT in Indian children may not be a good indicator for monitoring growth hormone responsiveness.

To study impact of treatment with Rosuvastatin versus Atorvastatin on 25 hydroxy Vitamin D concentrations among adult Indian men- a randomized control trial.

BACKGROUND: Dyslipidemias are on the rise and are increasingly being treated with statins. As the metabolism of cholecalciferol and cholesterol are interrelated, reduction in cholesterol synthesis by statins is likely to affect Vitamin D status. OBJECTIVES: (1) The aim is to study the effect of treatment with statins (Atorvastatin/Rosuvastatin) on 25-hydroxy-Vitamin-D (25OHD) among newly detected subjects with dyslipidemia for 6 months (2) To study the impact of 25OHD concentrations on the efficacy of statin treatment. MATERIALS AND METHODS: This was a prospective, balanced randomized (1:1), open-label, parallel-group study, in apparently healthy Indian adult men (south Asian, 40-60 years). At baseline, serum lipids and 25OHD concentrations were measured. Based on the Adult Treatment Panel III guidelines, subjects were divided as per lipid concentrations into controls (who did not require statin treatment) and intervention (who required statin treatment) groups. Random allocation of subjects was done in two groups for receiving intervention for 6 months: Atorvastatin group (n = 52, received Atorvastatin) or Rosuvastatin group (n = 52, received Rosuvastatin). Lipids and 25OHD concentrations were measured at the end line. RESULTS: Atorvastatin group presented significant reduction (P < 0.05) in 25OHD, total cholesterol (TC) and low-density-lipoprotein-cholesterol (LDL-C) concentrations at the end line. In the Rosuvastatin group, significant drop in TC, LDL-C and high-density lipoprotein cholesterol (concentrations (P < 0.05) was observed, while 25OHD concentrations showed no significant change. Mean 25OHD concentrations were significantly correlated with a reduction in LDL-C concentrations in Atorvastatin group. CONCLUSIONS: Treatment with Atorvastatin resulted in a reduction in 25OHD concentrations; further, its efficacy in reducing LDL-C concentrations was related to the 25OHD concentrations.

Zinc supplementation improved cognitive performance and taste acuity in Indian adolescent girls.

OBJECTIVE: To test the efficacy of zinc supplementation through diet or ayurvedic zinc tablet on cognitive function and taste acuity in adolescent girls. METHODS: Using zinc-rich food items, snacks were prepared by adopting food-processing methods that enhance zinc bioavailability. Ayurvedic zinc tablet (jasad bhasma) was chosen as a natural elemental zinc supplement. Efficacy of snacks and the tablet was assessed in 180 schoolgirls (12.5 +/- 0.85 years) from Pune City, India, who were randomly allocated to any of the 3 groups: (1) ayurvedic zinc tablet-J, (2) zinc-rich snacks-D, or (3) Control-C. Supplementation was given on every school day (6 days/wk) for 10 weeks. All measurements were recorded at baseline and at the end of the study period. Food intake was recorded by 24-hour diet recall on 3 random days. Hemoglobin, serum ferritin, and plasma zinc were estimated on a fasting blood sample. Cognitive assessment was done on each participant using tests for simple reaction time (SRT), recognition reaction time (RRT), visual memory, and Raven's Progressive Matrices (RPM). Taste acuity was determined by recognition thresholds for salt (RTS) over a range of 10 different salt concentrations. RESULTS: A higher increase in plasma zinc (61.3%) was observed in the J group than in the D group (9.9%) (p < 0.01), whereas plasma zinc declined in the control group (-2.2%) over baseline (p > 0.1). Hemoglobin showed no change in all 3 groups (p > 0.1). Percent increment in scores for memory and RPM was significantly more in the D and J groups (24.5%-29.6%) than in the C group (6.5%) (p < 0.05). Mean SRT and RRT were reduced more in the D and J groups (5%-16%) than in the C group (1.6%) (p < 0.05). A significant fall in median RTS from 5 to 2.5 mmol/L was noted after both diet and zinc supplementation (p < 0.01); however, it remained the same at 5 mmol/L in the Control group after 10 weeks. CONCLUSION: Supplementation of ayurvedic zinc and zinc-rich foods are effective in improving cognitive performance and the recognition threshold for salt of adolescent girls.

Influence of dietary and socio-demographic factors on the iron status of married adolescent girls from Indian urban slums.

To explore the influence of dietary factors of iron bioavailability and socio-demographic conditions on blood iron status of married adolescent girls (MAG), a cross-sectional study was conducted in 173 MAG (15-19 years old) from urban slums near Pune city, India. Diet was assessed by two random 24-h recalls. The age, weight, height, education, family size, income, physical work, and number of days of menstrual loss were recorded. Fasting blood was analyzed for hemoglobin and serum ferritin. Mean intakes of micronutrients were 40-75% less than the recommended dietary intakes for Indian adolescent girls. High intake of phytates (171+/-6 mg/day) and low intakes of vitamin C (25+/-1 mg/day) resulted in low bioavailable iron intakes. The mean bioavailable iron intake was 0.76+/-0.3 mg/day, which is one-half of the basal iron requirement of adolescent girls. The prevalence of iron deficiency (serum ferritin<12 microg/l) was 25.1%, and anemia (hemoglobin <12 g/l) was seen in 46.4% of MAG. A multiple regression model adjusted for energy intake indicated that intakes of beta-carotene and riboflavin were associated with hemoglobin (P<0.001) and those of zinc, riboflavin and thiamin associated with serum ferritin (P<0.01). Multiple regressions including socio-demographic factors revealed that the family size, number of menstrual days lost and total bioavailable iron intake were the influencing factors for low iron status. In conclusion, there is a need to increase intakes of vitamin C and other micronutrients of the MAGs and to improve iron bioavailability through diet modifications.

Prevalence of Osteoporosis in Apparently Healthy Adults above 40 Years of Age in Pune City, India.

PURPOSE: The aim of study was to assess the prevalence of osteoporosis and changes in bone mass with increasing age and compare bone health status of apparently healthy men, premenopausal and postmenopausal women. METHODS: Data were collected on anthropometric and sociodemographic factors in 421 apparently healthy Indian adults (women = 228), 40-75 years of age, in a cross-sectional study in Pune city, India. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at two sites-lumbar spine (LS) and left femur. Individuals were classified as having osteoporosis or osteopenia based on the World Health Organization criteria of T-scores. RESULTS: Mean age of study population was 53.3 ± 8.4 years. Of the total women, 44.3% were postmenopausal with 49.2 ± 3.5 years as mean age at menopause. Postmenopausal women showed a rapid decline in BMD with age till 50 years while men showed a gradual decline. Premenopausal women showed no significant decline in BMD with age (P > 0.1). Significantly lower T-scores were observed at LS in men compared to premenopausal (P < 0.05). At left femur, T-scores were lower in men compared to premenopausal women (P < 0.05) but not postmenopausal women (P > 0.1). The prevalence of osteoporosis in men at LS was lower than postmenopausal women but higher than premenopausal women. CONCLUSION: In Indian men, a low T-score compared to women indicates higher susceptibility to osteoporosis. In women, menopause causes a rapid decline in BMD. Therefore, both Indian men and postmenopausal women require adequate measures to prevent osteoporosis during later years in life.

Duration of Casual Sunlight Exposure Necessary for Adequate Vitamin D Status in Indian Men.

OBJECTIVES: To investigate the duration of casual sunlight ultraviolet-B (UVB) exposure required to maintain optimal Vitamin D status (25-hydroxyvitamin-D [25(OH)D]) >50 nmol/L in urban Indian men, using polysulfone (PSU) dosimeters and a sunlight exposure questionnaire. METHODS: In healthy men (aged 40-60 years) from Pune (18.52° N, 73.86° E), India, serum 25(OH)D was measured using enzyme-linked immunosorbent assay. Sunlight exposure was assessed using PSU dosimeter and by questionnaire. RESULTS: Of 160 men (48.3 ± 5.6 years), 26.8% were deficient and 40.6% had insufficient Vitamin D concentrations. A hyperbolic function for the relationship between PSU measured sunlight exposure in standard erythema dose (SED) and serum 25(OH)D concentrations (r = 0.87, P < 0.01) revealed that daily exposure of 1 SED was sufficient to maintain serum 25(OH)D concentrations over 50 nmol/L. The curve plateaued around 5 SED (80 nmol/L) and extrapolation of the curve (>5 SED) did not increase 25(OH)D concentrations above 90 nmol/L. Receiver operating curve analysis confirmed that 1 SED-UV exposure was sufficient to maintain 25(OH)D concentrations over 50 nmol/L. Based on the questionnaire data, >1 h of midday casual sunlight exposure was required to maintain serum 25(OH)D concentrations above 50 nmol/L. Duration of sunlight exposure assessed by questionnaire and PSU dosimeter showed a significant correlation (r = 0.517, P < 0.01). CONCLUSION: In urban Indian men, >1 h of casual midday sunlight exposure daily was required to maintain serum 25(OH)D concentrations above 50 nmol/L, and >2 h of casual sunlight exposure was needed to maintain 25(OH)D concentrations above 75 nmol/L. Excess sunlight did not increase 25(OH)D linearly. The sunlight exposure questionnaire was validated for use in clinical studies and surveys.

Prevalence of Metabolic Syndrome Markers among Women at 1-year Postpartum as per Prepregnancy Body Mass Index Status: A Longitudinal Study.

INTRODUCTION: Maternal body composition (BC) changes during lactation. Increased prepregnancy obesity is associated with poor obstetric outcomes. The aim was to study changes in maternal BC postpartum (PP) to 1-year PP with reference to their prepregnancy body mass index (BMI) status. METHODS: The study design was a 1-year follow-up study. Sixty-five apparently healthy primiparous women (28.6 ± 3.4 years delivered full-term infants) were randomly selected from December 2010 to June 2013 and postclassified on the basis of their prepregnancy BMI status. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, and BC at total body (dual energy X-ray absorptiometry, GE, Lunar DPX) were collected using standardized protocols. RESULTS: Forty-one women were classified in Group A with normal prepregnancy BMI (20.4 ± 2.0 kg/m2) and 24 women in Group B with overweight/obese (OW/OB) prepregnancy BMI (26.1 ± 1.9 kg/m2). At 1 year, 75% of women returned to normal BMI in Group A, whereas all 100% of women from Group B remained in OW category at 1-year PP. Nearly 43% of Group B women showed the presence of at least two metabolic syndrome risk factors as compared to 36% in Group A at 1 year. CONCLUSION: Women with OW/OB prepregnancy BMI accumulated higher visceral fat with a higher prevalence of metabolic risk factors at 1-year PP. Our study underlines the importance of maintaining BMI status in reference range in reproductive years.

Randomized Control Trial Assessing Impact of Increased Sunlight Exposure versus Vitamin D Supplementation on Lipid Profile in Indian Vitamin D Deficient Men.

BACKGROUND: Despite abundance of sunshine in India, Vitamin D deficiency is common and therefore there is an increasing trend toward taking Vitamin D supplements either as prescription medicine or as a nutritional supplement. Studies have suggested that duration of sun exposure may influence serum lipid profile. OBJECTIVES: To study the effect of increased sunlight exposure versus Vitamin D supplementation on Vitamin D status and lipid profile in individuals with Vitamin D deficiency (25-hydroxyvitamin-D [25OHD] <50 nmol/L). DESIGN: A prospective, randomized open-label trial was carried out in apparently healthy Indian men (40-60 years). Based on 25OHD concentrations, individuals were divided into control (>50 nmol/L, n = 50) and intervention (<50 nmol/L, n = 100) groups. Individuals from intervention group were randomly allocated to two groups; either "increased sunlight exposure group" (n = 50, received at least 20 min sunlight exposure to forearms and face between 11 a.m. and 3 p.m. over and above their current exposure) or "cholecalciferol supplement group" (n = 50, received oral cholecalciferol 1000 IU/day). RESULTS: Significant increase in 25OHD concentrations was seen in both intervention groups (P < 0.01). Significant decrease in total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), and low-density-lipoprotein cholesterol (LDL-C) was seen in individuals with increased sunlight exposure (P < 0.05). Cholecalciferol supplement group showed a significant increase in TC and HDL-C (P < 0.05) and insignificant increase in LDL-C. CONCLUSIONS: Increase in Vitamin D concentrations through sunlight exposure significantly reduced TC, LDL-C, and HDL-C concentrations, and cholecalciferol supplementation increased TC and HDL-C concentrations.

Interrelationship between serum 25-hydroxyvitamin D3 concentration and lipid profiles in premenopausal Indian women.

CONTEXT: Vitamin D deficiency is prevalent worldwide, and observational studies have associated it with an atherogenic lipid profile. AIM: To determine the interrelationship between Vitamin D and lipid profile in apparently healthy premenopausal Indian women, considering confounding factors such as lifestyle that independently influence lipids. SETTING AND DESIGN: Cross-sectional study. SUBJECTS AND METHODS: One hundred and twenty healthy premenopausal women (20-45 year) were recruited from Gujarat, India. Data were collected on anthropometry, physical activity, sunlight exposure, and diet. Fasting blood samples were collected for the measurement of serum 25-hydroxyvitamin D3 (25[OH]D), parathyroid hormone, and lipid profile. STATISTICAL ANALYSIS: Pearson's correlation coefficient was used to derive correlation between serum 25[OH]D concentrations and serum lipids. RESULTS: Ninety-three percent women showed Vitamin D deficiency (serum 25[OH]D < 20 ng/ml). Serum 25(OH)D concentrations showed significant inverse correlation with total cholesterol (TC) (r = -0.202, P = 0.027), triglycerides (TG) (r = -0.284, P = 0.002), and low-density lipoprotein-cholesterol (LDL-C) (r = -0.184, P = 0.044) and positive correlation with high-density lipoprotein-cholesterol (HDL-C) (r = 0.250, P = 0.006). On dichotomizing the population according to median 25(OH)D concentration (11.1 ng/dl), no significant differences were observed between the groups for anthropometry, sunlight exposure, and lifestyle. Serum lipid profiles were significantly different, above median serum 25(OH)D concentration group showed favorable serum lipids (TC: 179.3 ± 30 vs. 191.8 ± 31.7 mg/dl; TG: 140 ± 39.1 vs. 165.5 ± 53.4 mg/dl; LDL-C: 100 ± 30.2 vs. 112 ± 32 mg/dl; HDL-C: 53 ± 14 vs. 47.6 ± 9.3 mg/dl)(P < 0.05). CONCLUSIONS: This study demonstrates that association of 25(OH)D concentrations with lipid profile even after considering lifestyle factors which independently influence lipids. Intervention trials would be required to prove this association to be causation.

Association of dental and skeletal fluorosis with calcium intake and serum vitamin D concentration in adolescents from a region endemic for fluorosis.

CONTEXT: Fluorosis is controlled by the duration of fluoride exposure and calcium and Vitamin D nutrition status. AIM: To examine (a) prevalence of dental and skeletal fluorosis in adolescents from upper, middle, and lower socioeconomic strata (SES) and (b) association of fluorosis with calcium intake and Vitamin D status. SETTINGS AND DESIGN: A cross-sectional study conducted in 10-13.9 years apparently healthy adolescents (n = 90), from different SES of Patan (Gujarat, India). MATERIALS AND METHODS: Dental fluorosis was graded as mild, moderate, and severe. Radiographs of the right hand and wrist were examined and graded. Serum 25 hydroxyvitamin D3 (25OHD) and parathyroid hormone concentrations were measured. Diet was recorded (24 h recall) and calcium intake was computed (C-diet V-2.1, 2013, Xenios Technologies Pvt. Ltd). STATISTICAL ANALYSIS: Generalized linear model was used to analyze relationships between fluorosis, SES, serum 25OHD concentration, and calcium intake. RESULTS: Fluorosis was predominant in lower SES (17% had both dental and radiological features whereas 73% had dental fluorosis); no skeletal deformities were observed. Mean 25OHD concentrations and dietary calcium were 26.3 ± 4.9, 23.4 ± 4.7, and 18.6 ± 4 ng/ml and 441.2 ± 227.6, 484.3 ± 160.9, and 749.2 ± 245.4 mg/day, respectively, for lower, middle, and upper SES (P < 0.05). Fluorosis and SES showed a significant association (exponential ß = 2.5, P = 0.01) as compared to upper SES, middle SES adolescents were at 1.3 times while lower SES adolescents were at 2.5 times higher risk. Serum 25OHD concentrations (P = 0.937) and dietary calcium intake (P = 0.825) did not show a significant association with fluorosis. CONCLUSION: Fluorosis was more common in lower SES adolescents, probably due to the lack of access to bottled water. Relatively adequate calcium intake and serum 25OHD concentrations may have increased the efficiency of dietary calcium absorption, thus preventing severe fluorosis.