Prevalence of hypovitaminosis D in India & way forward.

Deficiency of vitamin D or hypovitaminosis D is widespread irrespective of age, gender, race and geography and has emerged as an important area of research. Vitamin D deficiency may lead to osteoporosis (osteomalacia in adults and rickets in children) along with calcium deficiency. Its deficiency is linked with low bone mass, weakness of muscles and increased risk of fracture. However, further research is needed to link deficiency of vitamin D with extra-skeletal consequences such as cancer, cardiovascular disease, diabetes, infections and autoimmune disorders. The causes of vitamin D deficiency include length and timing of sun exposure, amount of skin exposed, latitude, season, level of pollution in atmosphere, clothing, skin pigmentation, application of sunscreen, dietary factors and genetic factors. The primary source is sunlight, and the dietary sources include animal products such as fatty fish, food items fortified with vitamin D and supplements. Different cut-offs have been used to define hypovitaminosis D and its severity in different studies. Based on the findings from some Indian studies, a high prevalence of hypovitaminosis D was observed among different age groups. Hypovitaminosis D ranged from 84.9 to 100 per cent among school-going children, 42 to 74 per cent among pregnant women, 44.3 to 66.7 per cent among infants, 70 to 81.1 per cent among lactating mothers and 30 to 91.2 per cent among adults. To tackle the problem of hypovitaminosis D in India, vitamin D fortification in staple foods, supplementation of vitamin D along with calcium, inclusion of local fortified food items in supplementary nutrition programmes launched by the government, cooperation from stakeholders from food industry and creating awareness among physicians and the general population may help in combating the problem to some extent.

A review of selected nutrition & health surveys in India.

Assessment of the status of health and nutrition of a population is imperative to design and implement sound public health policies and programmes. The various extensive national health and nutrition surveys provide national-level information on different domains of health. These provide vital information and statistics for the country, and the data generated are used to identify the prevalence and risk factors for the diseases and health challenges faced by a country. This review describes the various national health and nutrition surveys conducted in India and also compares the information generated by each of these surveys. These include the National Family Health Survey, District Level Household Survey, Annual Health Survey, National Nutrition Monitoring Bureau Survey, Rapid Survey on Children and Comprehensive National Nutrition Survey.

Contribution of indigenous foods towards nutrient intakes and nutritional status of women in the Santhal tribal community of Jharkhand, India.

OBJECTIVE: The indigenous food environment, dietary intake and nutritional status of women in the Santhal tribal community of Jharkhand were assessed. Contribution of indigenous foods to nutritional status and nutrient intakes was explored. DESIGN: Exploratory cross-sectional study with a longitudinal dietary intake assessment component. Household and dietary surveys were conducted to elicit information on socio-economic and demographic profile and food consumption patterns at household level. A 24 h dietary recall for two consecutive days (repeat surveys in two more seasons) and anthropometric assessments were carried out on one woman per household. SETTING: Households (n 151) with at least one woman of reproductive age in four villages of Godda district of Jharkhand, India. SUBJECTS: Women aged 15-49 years. RESULTS: Almost all households owned agricultural land and grew fruits and vegetables in backyards for household consumption. A wide variety of indigenous foods were reported but dietary recalls revealed low intake. Women consumed adequate energy and protein but micronutrient intake was inadequate (less than 66 % of recommended) in the majority (more than 50 %) for Ca, Fe, vitamin B2, folate and vitamin B12. Women consuming indigenous foods in the past 2 d had significantly higher intakes of Ca (P=0·008) and Fe (P=0·010) than those who did not. Varying degrees of underweight were observed in 50 % of women with no significant association between underweight and consumption of indigenous foods. CONCLUSIONS: Promotion of preferential cultivation of nutrient-dense indigenous food sources and effective nutrition education on their importance may facilitate better micronutrient intakes among women in Santhal community of Jharkhand.

Traditional Knowledge and Nutritive Value of Indigenous Foods in the Oraon Tribal Community of Jharkhand: An Exploratory Cross-sectional Study.

Traditional knowledge and nutritional value of indigenous foods of the Oraon tribal community in Jharkhand, India was explored. Focus group discussions were conducted with adult members to identify commonly consumed indigenous foods. Taxonomic classification and quantitative estimation of nutritive value were conducted in laboratories or utilized data from Indian food composition database. More than 130 varieties of indigenous foods were identified, many of which were rich sources of micronutrients like calcium, iron, vitamin A, and folic acid. Some were reported having medicinal properties. Utilization and ease of assimilation of indigenous foods into routine diets can be leveraged to address malnutrition in tribal communities.

Etomidate versus Propofol for Motor Seizure Duration during Modified Electroconvulsive Therapy.

BACKGROUND: Certain anesthetic agents on account of their anticonvulsant property have a negative impact on motor seizure duration. Etomidate and propofol being devoid of the strong anticonvulsant property may be beneficial for use in electroconvulsive therapy (ECT). ECT requires sedation with a short-term anesthetic agent that does not interfere with seizure activity and has rapid onset and recovery to facilitate fast-tracking. AIMS: The primary objective of this study was to compare motor seizure duration, and the secondary objective was to compare induction time, hemodynamic parameters, recovery time, and adverse effects between propofol and etomidate in modified ECT. SETTINGS AND DESIGN: This is a prospective, double- blind, randomized, controlled study conducted in the Department of Anesthesia and Intensive care in a tertiary care hospital during 2018-2019. MATERIALS AND METHODS: After ethical clearance from institutional ethics committee and written informed consent, a total of 70 patients, aged 18-65 years were randomly allocated using computer generated random number list into two groups - Group A - Propofol (1%) - 1.0 mg.kg-1 and Group B - Etomidate 0.2 mg.kg-1 as an intravenous induction agent. Intraoperatively, motor seizure duration, induction time, and hemodynamic parameters and at the end of procedure recovery parameters were assessed. STATISTICAL ANALYSIS USED: Data were described in terms of number (%) and mean ± standard deviation. Comparison of quantitative variables between the study groups was done using Student t-test and Mann Whitney U test for parametric and nonparametric variables respectively. For comparing categorical data, Chi -square (χ2) test was performed. RESULTS: Mean motor seizure duration with etomidate (55.17 ± 19.06 s) was longer as compared to propofol (27.80 ± 17.33 s), and the difference was highly significant (P < 0.001). Among hemodynamic parameters, there was a significant increase in heart rate (P = 0.016) and significant fall in mean arterial pressure (P = 0.005) after induction with propofol as compared to etomidate. CONCLUSION: Etomidate has the advantage of longer seizure duration and stable hemodynamics. It can be a useful alternative in patients achieving suboptimal therapeutic responses to ECT or where seizure duration is too short.

Estimates of Indigenous Food Consumption and Their Contribution to Nutrient Intake in Oraon Tribal Women of Jharkhand, India.

INTRODUCTION: Oraon tribes of India have high levels of undernutrition. Dietary diversification is one of the food-based interventions to ameliorate malnutrition. OBJECTIVES: This study assessed the awareness and availability of indigenous foods and estimated dietary intakes and nutritional status with emphasis on indigenous food consumption among women in the Oraon tribal community in Jharkhand, India. DESIGN: A cross-sectional study with a longitudinal component on dietary intake assessment to capture seasonality. SETTING: Selected villages in Raidih block of Gumla district of Jharkhand. PARTICIPANTS: Reproductive-age Oraon tribal women (N =143). METHODS: Household and dietary surveys were conducted. A 24-hour dietary recall for 2 consecutive days (repeat surveys in 2 other seasons) and food frequency questionnaire were adminsitered on 1 woman per household. Anthropometric assessments were also carried out. OUTCOMES: Socioeconomic status, awareness about indigenous foods, dietary intake pattern, and contribution of indigenous food to nutrient intake of Oraon tribal women in the reproductive age-group. RESULTS: Comprehensive awareness about indigenous food resources was present. However, household food security and actual intake of indigenous foods were low. Higher intake of key micronutrients, calcium and iron, was observed among those who consumed indigenous foods. About 40% of the woman had various degrees of chronic energy deficiency. CONCLUSION: Despite rich knowledge, nutrient-rich indigenous food resources remain underutilized in the Oraon tribal community of Jharkhand, India. Identifying strategies to promote dietary diversity via optimum indigenous food intake could contribute to both food and nutrition security.

Exploring the Potential of Indigenous Foods to Address Hidden Hunger: Nutritive Value of Indigenous Foods of Santhal Tribal Community of Jharkhand, India.

Traditional foods of indigenous communities can be explored as a sustainable means of addressing undernutrition. Our study aimed at identifying indigenous foods of the Santhal tribal community of Godda district of Jharkhand, India, assessing their nutritive value, and appraising their potential role in addressing hidden hunger. A cross-sectional survey using qualitative methods like focus group discussions with women of childbearing age (15-49 years), adult males, and elderly people was conducted for food identification. This was followed by taxonomic classification and quantitative estimate of nutritive value of the identified foods either in a certified laboratory or from secondary data. The community was well aware of the indigenous food resources in their environment. More than 100 different types of indigenous foods including a number of green leafy vegetables were identified. Taxonomic classification was available for 25 food items and an additional 26 food items were sent for taxonomic classification. Many indigenous foods (more than 50% of which were green leafy vegetables) were found to be rich sources of micronutrients like calcium, iron, vitamin A as beta carotene, and folate. Maximizing utilization of indigenous foods can be an important and sustainable dietary diversification strategy for addressing hidden hunger in this indigenous community.