Raghavendra Pandurangi

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.

Background: Excess dietary sodium intake is a major modifiable risk factor for hypertension and cardiovascular disease (CVD) globally. Potassium-Enriched Low-Sodium Salt Substitutes (LSSS), which partially replace sodium chloride with potassium chloride, are recommended as a population-level sodium-reduction strategy. However, sensory acceptability remains a key barrier to their adoption, particularly in India where discretionary salt use predominates. Objective: To assess whether potassium-enriched low-sodium salt substitutes (15% and 30% potassium chloride) differ from regular salt in perceived saltiness intensity when added to commonly consumed Indian food matrices. Methods: A controlled taste perception assessment was conducted using a screened analytical panel (N = 25) selected according to ISO 8586:2012 standards. Three salt formulations (100% NaCl, 85% NaCl & 15% KCl, and 70 % NaCl+30% KCl) were evaluated across three food matrices representing liquid (buttermilk), semi-solid (dal with roti), and surface-salted (French fries) foods. Saltiness intensity was rated on a five-point ordinal scale. Differences were analysed using Friedman’s test. Results: Across all three food matrices, no statistically significant differences in saltiness intensity were observed between regular salt and potassium-enriched formulations (p > 0.05). Although minor numerical variations in mean ratings and distribution patterns were noted, these differences were inconsistent and did not indicate systematic changes in perceived saltiness. Conclusions: Potassium-enriched LSSS containing up to 30% potassium chloride produced similar saltiness perception to regular salt across representative Indian food matrices when evaluated by trained assessors. These findings support the sensory feasibility of LSSS as a strategy for population-level sodium reduction in India.

Introduction: As there was little literature available about gender disparities in undernutrition within household, this secondary analysis was performed on a large representative data with an objective to evaluate the Z-score differences, viz., Weight-for-age Z-score (WAZ), Height-for-age Z-score (HAZ), Weight-for-height Z-score (WHZ) and BMI-for-age Z-score (BAZ) of the Indian female under-5 children with their male siblings within same household. Methods: Individual data of 19083 pairs of siblings was analysed from the NFHS -5 data. Differences in the Z-scores of the siblings was calculated as male’s Z-score minus female’s Z-score and factors influencing them were studied. Results: The mean HAZ and WAZ scores were less than -1.4 Standard deviations (SD) for both genders – while the means of WHZ and BAZ scores were ranging between -0.67 to -0.83. The differences in Z scores were more or less distributed equally on both sides of zero, implying no disadvantage to any of the genders. The mean differences in the Z scores were minimal (-0.07 in HAZ, -0.04 in WAZ, -0.06 in WHZ and 0.01 in BAZ). Conclusion: There was little or no difference in the mean z scores of females and male siblings and did not indicate any gender advantage or disadvantage.

On 4th December 2020, a sudden outbreak, with neurological symptoms like seizures, loss of consciousness etc., was reported in a town from south India. By 3^rdday about 400 people were involved. A multi disciplinary team from our institute visited the site to investigate the outbreak. Based on the case history and clinical examination of the patients, the team suspected a probable diagnosis of an acute pesticide, heavy metal and/or mycotoxin exposure for which, biological samples (blood, urine) were collected from those who reported the symptoms as well as from a few who did not report symptoms (controls). To identify the source, water and food samples were collected. The samples were subjected to ICP-MS for heavy metal analysis, LC-MS/MS for pesticide analysis, microbiological analysis and ELISA-Kit method for aflatoxins if any. Clinical and dietary details were collected from a total of 112 participants, of which, 103 cases (77 active cases at Hospital and 26 recovered cases from community) and 9 were controls. A total of 109 biological samples, 36 water samples and food samples were collected. The mean age of the study participants was 29.2 years. Among cases, Seizures were seen in 84%, loss of consciousness in 66%, mental confusion in 35%, pinpoint pupil in 11%. Triazophos (organophosphate) pesticide was present in 74% of Blood samples and its metabolites were present in 98% of the urine samples collected from the cases. All the ten heavy metals investigated including lead, mercury and nickel were found to be within permissible limits except for a few samples. No presence of mycotoxins was observed in Food samples. Water samples which included Head pump and reservoir were free from pesticides; however, all water samples from households of cases had triazophos pesticide with a mean concentration of 1.00 ug/L. Thus, it was concluded that, the probable cause of outbreak was Triazophos (Organophosphate) pesticide contamination in water at the Household level. Regular surveillance for the presence of residual pesticides in soil, water and food with heightened vigour is recommended to prevent future outbreaks.