SubbaRao M. Gavaravarapu

Thiamine (vitamin B1) deficiency, once considered controlled in India, has re‐emerged in parts of Northeast India, raising concern for maternal and infant health. We conducted a community‐based cross‐sectional study during 2023–2024 to estimate its prevalence and dietary determinants among pregnant and lactating women in the Barak Valley of Assam and adjoining districts of Tripura. Using multistage cluster sampling, women were recruited from 120 villages with documented beriberi clusters. Thiamine status was assessed by determining the erythrocyte transketolase activation coefficient (ETKAC), a functional marker, and whole‐blood thiamine diphosphate (ThDP), a biochemical marker measured by high‐performance liquid chromatography. Of 1329 women, 1083 were analyzed. Both markers gave similar estimates of suboptimal status: 20.1% by ThDP (95% CI: 17.8−22.6; deficient: 4.9%, marginal: 15.2%) and 20.6% by ETKAC (95% CI: 18.3−23.1; severe: 8.5%, marginal: 12.1%), higher among pregnant than lactating women. Diets were rice‐based with low diversity. As the functional marker ETKAC was more sensitive to dietary context, we focused on its determinants: stored rice, washing rice repeatedly before cooking, and drinking salted tea were each associated with higher odds of ETKAC‐defined suboptimal status. Socioeconomic disadvantage further increased risk. This substantial, subclinical, preventable burden driven by dietary monotony and thiamine‐depleting rice practices underscores the need for targeted maternal nutrition strategies.

Low diet diversity is the major contributor to micronutrient inadequacy among children, underscoring a need for a rapid assessment tool to assess micronutrient adequacy. This study aimed to (i) develop a context-specific diet diversity score (DDS) tool (ii) evaluate the performance of the DDS scoring system against mean probability of adequacy for 10 micronutrients, 5 biomarkers of micronutrient status and (iii) identify an optimal DDS cut-off by applying minimum portion size threshold to support its potential use as a practical screening tool. A cross-sectional study was conducted among 6-10-year-old children (n = 76) in two villages of Ghatkesar sub-district, Telangana. Portion sizes of commonly consumed fruits and vegetables were standardized. Data on household demographics, anthropometry, and biomarkers of micronutrient status were collected using a pretested questionnaire and standardized protocols. Three non-consecutive 24-hour-dietary-recalls were obtained using the weighment method. DDS was developed based on the nutrient content of consumed foods; minimum intake thresholds of 0.1 g, 5 g and 10 g was applied while scoring. Mean probability of adequacy (MPA) for 10 micronutrients was estimated using ICMR-EAR values. Correlations of DDS with MPA and biomarkers were examined, and sensitivity and specificity were assessed using ROC curves, considering MPA ≥ 70% as adequate. The DDS included 13 food groups. Mean DDS (5 g threshold) was 8.67 ± 1.50 and correlated significantly with MPA (r = 0.58), and hemoglobin (t = 2.07). A DDS-5 g cut-off of ≥10 predicted MPA > 70%, with an AUC of 0.89. The DDS showed good predictive performance for micronutrient adequacy, but requires further field validation before programmatic use.

Background: Hypertension is being increasingly observed among young adults in urban India, alongside rapid dietary transitions and rising consumption of ultra-processed foods (UPFs). The current study aimed to assess the frequency and patterns of UPF consumption and examine their association with high blood pressure among urban college students. Methods: A cross-sectional study was conducted among 311 undergraduate students aged 18–24 years from three colleges in Hyderabad, India. Our study used a validated automated device to measure blood pressure. Dietary intake over the previous month was assessed using a 24-item food frequency questionnaire capturing commonly consumed UPFs. After adjusting for age, sex, and socioeconomic variables, multivariable logistic regression was performed to assess the relationships between UPF consumption categories and high blood pressure. Ninety-five percent confidence intervals (CIs) for adjusted odds ratios (AORs) were reported. Results: Overall, 12.5% of participants had high BP (≥140/90 mmHg). The prevalence was higher among males and those aged >20 years. In the adjusted analyses, males had significantly higher odds of having high BP (AOR: 4.96; 95% CI: 1.64–15.01), as did students from higher-income households (AOR: 3.22; 95% CI: 1.07–9.66). Consumption of high-fat and/or high-salt UPFs at or above the median was independently associated with high BP (AOR: 2.85; 95% CI: 1.16–6.99). Taste, availability, and low cost were common drivers of UPF intake. Conclusions: Higher consumption of high-fat and/or high-salt ultra-processed foods was associated with higher odds of elevated blood pressure among urban young adults. These findings warrant further longitudinal investigation and may help inform the development of targeted dietary awareness and food environment interventions in college settings.

In India, the rising risk of overweight and obesity among adolescents is a significant public health concern, primarily associated with their frequent consumption of nutrient-poor snacks, sugar-sweetened beverages, and fast foods. Identifying the determinants of their food choices is crucial for developing effective nutrition promotion strategies. This study aimed to identify the determinants of food choices among adolescents in two metro cities in North and South India using a cross-sectional, mixed-methods approach. The study involved adolescents (n = 869) studying in 8^th and 9^th grades from randomly selected government and private schools, utilizing a pre-tested questionnaire and virtual food preference flip cards (quantitative phase), along with in-depth interviews with adolescents, teachers, and parents (n = 11) (qualitative phase). A four-level socio-ecological model was adopted to categorize the determinants associated with adolescent’s food choices. The findings revealed that taste (51%) was the primary determinant driving adolescents to choose outside foods, followed by peer influence (31%) and trendy foods (27%). In-depth interviews further highlighted the impact of social media, parental influence, celebrity endorsements, popular food trends, and marketing incentives such as toys and coupons on adolescents’ food choices. The study provides a springboard for future research into the development of a nutrition-friendly choice architecture to encourage adolescents to make healthy food choices. Public health policy should utilize these determinants to transform the existing food environment of adolescents.

Over the past few years, there has been a global shift in the food consumption pattern from traditional home cooked meals to ultra-processed packaged foods (UPFs). Adolescents are the most avid consumers of UPFs, with these foods comprising nearly 16.2% of total daily energy intake among Indian adolescents. Adolescence is a critical period for establishing autonomous dietary choices and habits, which often persist into adulthood and are strongly linked to long-term health outcomes, including obesity, diabetes, and cardiovascular disease. Therefore, empowering adolescents to make informed food choices is critical for both immediate and future public health. Globally, the implementation of user-friendly food labelling has been proven to improve consumer understanding and is recognized as an effective public health strategy for promoting healthier food choices. This review aimed to assess the extent (volume of literature available) and range (the variety of research done) of evidence available on promoting food label literacy and/or healthy food choices among adolescents through education-based interventions. An extensive literature search was conducted to select relevant research articles using a predetermined inclusion criterion. The literature search was done across different databases like PubMed, Scopus, Embase and Google scholar. The databases were searched for records published between the time frame 2000 to 2024. A total of 4,380 articles were manually screened, yielding 221 titles for further review. Of these, 169 abstracts and subsequently 44 full-text articles were assessed for eligibility using software. Ultimately, 11 full-text articles met the inclusion criteria and were incorporated into the scoping review. The findings of the selected 11 studies were synthesized to highlight methods that promote food label reading and healthy food choices among adolescents. This review identified effective educational interventions for improving food label literacy and healthy food choices among adolescents commonly utilized behaviour change models, tailored content, and participatory approaches. Most interventions were school based, delivered through lectures or interactive activities, with some incorporating digital media and real food label analysis. Statistically significant improvements in food label knowledge were reported in the majority of studies, with positive impacts also observed on label use practices and food choices. These findings highlight the importance of context-specific, engaging, and theory-driven strategies in adolescent nutrition education. The study concluded that such educational interventions have been primarily conducted in schools (mode), using educational materials and food models (as media) through lecture-based delivery (method). Invariably this approach enhances food label knowledge of adolescents, however, challenges remain in translating this knowledge into long term practices and healthy food choices.