NUTRITION IN INDIA: FACTS AND INTERPRETATIONS

The Indian economy has recently grown at historically unprecedented rates and is now one of the fastest-growing economies in the world. Real GDP per head grew at 3.95 percent a year from 1980 to 2005, and at 5.4 percent a year from 2000 to 2005. Measured at international prices, real per capita income in India, which was two-thirds of Kenya’s in 1950, and about the same as Nigeria’s, is now two and a half times as large as per capita income in both countries. Real per capita consumption has also grown rapidly, at 2.2 percent a year in the 1980s, at 2.5 percent a year in the 1990s, and at 3.9 percent a year from 2000 to 2005. Although the household survey data show much slower rates of per capita consumption growth than do these national accounts estimates, even these slower growth rates are associated with a substantial decrease in poverty since the early 1980s, Deaton and Drèze (2002), Himanshu (2007). Yet, per capita calorie intake is declining, as is the intake of many other nutrients; indeed fats are the only major nutrient group whose per capita consumption is unambiguously increasing. Today, more than three quarters of the population live in households whose per capita calorie consumption is less than 2,100 in urban areas and 2,400 in rural areas – numbers that are often cited as “minimum requirements” in India. A related concern is that anthropometric indicators of nutrition in India, for both adults and children, are among the worst in the world. Furthermore, the improvement of these measures of nutrition appears to be slow relative to what might be expected in the light of international experience and of India’s recent high rates of economic growth. Indeed, according to the National Family Health Survey, the proportion of underweight children remained virtually unchanged between 1998-99 and 2005-06 (from 47 to 46 percent for the age group of 0-3 years). 2 Undernutrition levels in India remain higher even than for most countries of sub-Saharan Africa, even though those countries are currently much poorer than India, have grown much more slowly, and have much higher levels of infant and child mortality. In this paper, we do not attempt to provide a complete and fully documented story of poverty, nutrition and growth in India. In fact, we doubt that such an account is currently possible. Instead, our aim is to present the most important facts, to point to a number of unresolved puzzles, and to present an outline of a coherent story that is consistent with the facts. As far as the decline in per capita calorie consumption is concerned, our leading hypothesis, on which much work remains to be done, is that while real incomes and real wages have increased (leading to some nutritional improvement), there has been an offsetting reduction in calorie requirements, due to declining levels of physical activity and possibly also to various improvements in the health environment. The net effect has been a slow reduction in per capita calorie consumption. Whatever the explanation, there is historical evidence of related episodes in other countries, for example in Britain from 1775 to 1850, where in spite of rising real wages, there was no apparent increase in the real consumption of food, Clark et al (1995). Per capita calorie consumption also appears to have declined in contemporary China in the 1980s and 1990s (a period of rapid improvement in nutrition indicators such as height and weight), see Du, Lu, Zhai and Popkin (2002). One of our main points is that, just as there is no tight link between incomes and calorie consumption, there is no tight link between the numbers of calories consumed and nutritional or health status. Although the number of calories is important, so are other factors, such as a balanced diet containing a reasonable proportion of fruits, vegetables, and fats, not just calories from cereals, as are factors that affect the need for and retention of calories, such as activity 3 levels, clean water, sanitation, good hygiene practices, and vaccinations. Because of changes in these other factors, the fact that people are increasingly choosing away from a diet that is heavy in cereals does not imply that nutritional status will automatically get worse. Nor should a reduction in calories associated with lower activity levels be taken to mean that Indians are currently adequately nourished; nothing could be further from the truth. We start by documenting the decline in per capita calorie consumption (Section 2.1), as well as the state of malnutrition (Section 2.2). We then look at possible reasons for the reduction in calories (Section 3.1), and try to tease out how it fits into the general picture of economic growth and malnutrition in India (Section 3.2). Section 4 concludes. We emphasize at the outset that our analysis covers the period up to 2006, so that we do not discuss what has happened to calorie consumption or to nutritional status in the subsequent two years, during which there has been a marked increase in the price of food, both in India and around the world.

Excellent intra and inter-observer reproducibility of wrist circumference measurements in obese children and adolescents

In a previous study, we found that wrist circumference, in particular its bone component,was associated with insulin resistance in a population of overweight/obese children. Theaim of the present study was to evaluate the intra- and inter-operator variability in wrist cir-cumference measurement in a population of obese children and adolescents. One hundredand two (54 male and 48 female) obese children and adolescents were consecutivelyenrolled. In all subjects wrist circumferences were measured by two different operators twotimes to assess intra- and inter-operator variability. Statistical analysis was performed usingSAS v.9.4 and JMP v.12. Measurements of wrist circumference showed excellent inter-operator reliability with Intra class Correlation Coefficients (ICC) of 0.96 and ICC of 0.97 forthe first and the second measurement, respectively. The intra-operator reliability was, also,very strong with a Concordance Correlation Coefficient (CCC) of 0.98 for both operators.The high reproducibility demonstrated in our results suggests that wrist circumference mea-surement, being safe, non-invasive and repeatable can be easily used in out-patient set-tings to identify youths with increased risk of insulin-resistance. This can avoid testing theentire population of overweight/obese children for insulin resistance parameter

Indonesian anthropometry update for special populations incorporating Drillis and Contini revisited

Nowadays, research on anthropometry becomes more essential, and yet, it is critical due to its implication and contribution to product and system design. Since it deals with human capability and limitation on physical activities, its role becomes more important, especially, when it comes to the needs for special populations. This study provides a comparative study between elderly and children anthropometry using Drillis and Contini approach incorporating Chinese and non-Chinese ethnic groups. More than 1000 subjects involved in this study. After the data refinement process, there were 498 valid data for children (i.e., 98 Chinese male, 136 non-Chinese male, 134 Chinese female, and 130 non-Chinese female), and 556 valid data for elderly (i.e., 186 Chinese male, 148 non-Chinese male, 115 Chinese female, and 107 non-Chinese female). In general, the finding shows that elderly (both male and female, both Chinese and non-Chinese) tends to have similar size and pattern with adult. Whilst, male and female children of 6e9 years sub-group (both Chinese and non-Chinese sub-group) tend to have higher weight ratio, compared to elderly and the children of 10e12 years sub-group. It was easily recognized that the children tend to have higher rate for limb segments compared to other body dimensions. At all sample groups, the eye height and shoulder height were found to be highly correlated with stature. Moreover, related to body weight, all samples show that thigh thickness and abdominal depth were deemed to be significant measures to be associated with. The expected contribution of this study is that to update the Indonesian special population anthropometry and to identify which measures are significantly associated with stature and weight, respectively with regard to different special population and given limited anthropometric data. Practically, given the data of stature and body weight, product designer can predict the anthropometric characteristics for special population

Anthropometric measurement of the lip-nose complex among young adults in Kuala Lumpur, Malaysia.

The lip-nose complex is an important aesthetic subunit of the mid and lower face. To date, there is no published data on lip-nose complex anthropometry for the Malaysian population. This cross sectional descriptive study aims to establish the norms of the lip-nose complex among Malaysian Malays, Chinese and Indians and to compare the transgender and transethnic variation between them. Seven parameters of the lip-nose complex namely mouth width, cupids bow width, columellar width, nasal width, lip height, columellar height and dome height were measured using standard anthropometric measurement tools. Three hundred sixteen-year-olds were randomly selected from three schools in Kuala Lumpur, with equal gender and ethnic distribution. Results obtained showed that all seven parameters the lip-nose complex in Malay, Chinese and Indian males were consistently larger than their respective female counterparts (p0.05). Malays and Chinese differed in all parameters except cupids bow width. Malays and Indians only differed in mouth width and nasal width. Chinese and Indians differed in lip height and dome height. Malays and Chinese show differences in their lip-nose complex profile despite having originated from the East Asian continent. Malays and Indians differed in width measures, while the Chinese and Indians differed in height measures. The variation of anthropological measurements among the three ethnic groups reinforces the need to have individualized norms. These findings form a baseline for future studies that are age based which would then serve as an invaluable guide to the reconstructive surgeon especially when dealing with unilateral and bilateral cleft lip repairs

Nasal Morphology of the Chinese: Three-Dimensional Reference Values for Rhinoplasty

OBJECTIVE: To determine normative nasal measurements for Chinese young adults, conditioned on demographics. STUDY DESIGN: A cross-sectional descriptive study. SETTING: A university hospital. SUBJECTS AND METHODS: Three-dimensional (3D) photographs were captured from 103 Chinese subjects between 18 and 35 years of age using a commercial stereophotographic system. Anthropometric landmarks were identified on these 3D surface images, and measurements suitable for nasal analysis were performed and contrasted against established Caucasian norms. Gender differences in anthropometric dimensions were also analyzed. RESULTS: Normative data for these measurements are made available. Linear nasal measurements, except those for mid-columella length, were significantly larger in men than in women; further, the nasal tip angle and nasofrontal angle were significantly larger in Chinese women. Contrasts of these new data against published Caucasian norms revealed dimensions that differ for these 2 groups. The Chinese normative mean values for morphological nose width, nasal tip angle, nasofrontal angle, and alar slope angle exceeded those reported for North American Caucasians. CONCLUSIONS: Gender-specific normative data for the Chinese nose were established in this study to provide a useful tool for surgeons in dealing with rhinoplasty. Moreover, the Chinese nasal anthropometric measurements in this study are broader and flatter than those reported for North American Caucasians. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.postprin

Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study

INTRODUCTION: To characterise the nutritional status in children with obesity or wasting conditions, European anthropometric reference values for body composition measures beyond the body mass index (BMI) are needed. Differentiated assessment of body composition in children has long been hampered by the lack of appropriate references. OBJECTIVES: The aim of our study is to provide percentiles for body composition indices in normal weight European children, based on the IDEFICS cohort (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS). METHODS: Overall 18 745 2.0-10.9-year-old children from eight countries participated in the study. Children classified as overweight/obese or underweight according to IOTF (N = 5915) were excluded from the analysis. Anthropometric measurements (BMI (N = 12 830); triceps, subscapular, fat mass and fat mass index (N = 11 845-11 901); biceps, suprailiac skinfolds, sum of skinfolds calculated from skinfold thicknesses (N = 8129-8205), neck circumference (N = 12 241); waist circumference and waist-to-height ratio (N = 12 381)) were analysed stratified by sex and smoothed 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile curves were calculated using GAMLSS. RESULTS: Percentile values of the most important anthropometric measures related to the degree of adiposity are depicted for European girls and boys. Age-and sex-specific differences were investigated for all measures. As an example, the 50th and 99th percentile values of waist circumference ranged from 50.7-59.2 cm and from 51.3-58.7 cm in 4.5-to < 5.0-year-old girls and boys, respectively, to 60.6-74.5 cm in girls and to 59.9-76.7 cm in boys at the age of 10.5-10.9 years. CONCLUSION: The presented percentile curves may aid a differentiated assessment of total and abdominal adiposity in European children

Ophthalmic Anthropometry among Rural Dwellers in Mashonaland Central Province, Zimbabwe

Introduction The measures of ophthalmic anthropometric parameters may vary among races and ethnic groups but are of immense importance in clinical diagnosis and management of oculo-visual defects. There is paucity of data on these measures among the Zimbabwean population. Purpose &nbsp;The aim was to determine ophthalmic anthropometric parameters among rural dwellers in Zimbabwe. Methods Six ophthalmic anthropometric parameters including interpupillary distance (IPD), head width (HW), temple width (TW), length to bend (LTB), and apical radius were measured using a pupillometer, PD rule, Head width calipers, Fairbank facial gauge, and ABDO frame rule. Results A total of 471 participants aged 18 to 100 years (mean age = 55.13; SD± 17.33 years). Of the 471 participants, 206 (43.7%) were males and 265 (56.3%) were females. A mean interpupillary distance at far was 65.57 ± 4.80 mm, mean temple width of 12.49 ± 1.53 cm, mean head width of 13.61 ± 1.39 cm and a side length to bend of 10.24 ± 1.20 cm and the apical radius was 9.94 ± 1.37. There was a significant (P &lt; 0.05) difference between the ophthalmic anthropometric parameters of males and females except for temple width and apical radius. Conclusion A narrower interpupillary distance but a wider temple width was observed among adult Zimbabweans. A significant difference in ophthalmic anthropometric parameters between males and females were observed except for temple width and apical radius. This should inform eyewear manufacturers and importers of frames on the facial and ocular parameters of Zimbabweans to improve the aesthetics and ensure a comfortable vision for wearers of already-made near vision spectacles for presbyopes. Rwanda J Med Health Sci 2021;4(1):99-11

The Reliability Of Facial Soft Tissue Landmarks With Photogrammetry

Introduction:With attention being given to the deleterious effects of radiation exposure from dental radiographs and inaccuracies in cephalometric soft tissue measurements, an alternative method of facial analysis with sufficiently reliable soft tissue landmarks should be developed. The goals of this study were threefold: (1) to define a new, low-cost method for capturing standardized frontal and sagittal facial images, (2) to determine on which photographic view that landmarks can be more reliably located, and (3) to determine which landmarks are appropriate for quantitative facial analysis. Materials and Methods:Simultaneous frontal and right sagittal facial images of 10 male and 10 female dental student subjects were captured using high-definition webcams as part of a low-cost set-up. Seventeen identical predefined facial soft tissue landmarks were located by 5 examiners on both types of images and were recorded as coordinate values. These coordinate values were used to calculate the best estimate of the true value for each landmark, mean deviation from this best estimate, and reliability in the X- and Y-axes using the Shrout-Fleiss intraclass correlation coefficient with corresponding 95% confidence intervals. Two examiners repeated the landmark location to evaluate intra-examiner reliability. Results:With a 95% confidence interval range of \u3e0.950, nose and mouth landmarks were among the most reliable landmarks on frontal and sagittal facial images. Converselyright soft tissue gonionwas one of the least reliable landmarks located in this study. In general, landmarks located by a single examiner showed greater reliability than when there were multiple examiners. Conclusions:This low-cost method yielded frontal and sagittal images sufficient for landmark identification. The magnitude of error varies between landmarks, is largest for poorly demarcated landmarks, and most had a non-circular envelope of error. Certain landmarks were more reliable on sagittal images and others were more reliable on frontal images. All landmarks had greater reliability and less mean deviation when located by a single examiner

Age-related gait standards for healthy children and young people: the GOS-ICH paediatric gait centiles

Objective To develop paediatric gait standards in healthy children and young people. Methods This observational study builds on earlier work to address the lack of population standards for gait measurements in children. Analysing gait in children affected by neurological or musculoskeletal conditions is an important component of paediatric assessment but is often confounded by developmental changes. The standards presented here do not require clinician expertise to interpret and offer an alternative to developmental tables of normalised gait data. Healthy children aged 1-19 years were recruited from community settings in London and Hertfordshire, U.K. The GAITRite ® walkway was used to record measurements for each child for velocity, cadence, step length, base of support, and stance, single and double support (as percentage of gait cycle). We fitted generalized linear additive models for location, scale and shape (gamlss). Results We constructed percentile charts for seven gait variables measured on 624 (321 males) contemporary healthy children using gamlss package in R. A clinical application of gait standards was explored. Conclusion Age-related, gender-specific standards for seven gait variables were developed and are presented here. They have a familiar format and can be used clinically to aid diagnoses, and to monitor change over time for both medical therapy and natural history of the condition. The clinical example demonstrates the potential of the GOS-ICH Paediatric Gait Centiles (GOS-ICH PGC) to enable meaningful interpretation of change in an individual’s performance, and describes characteristic features of gait from a specific population throughout childhood.Peer reviewedFinal Accepted Versio

Dimensional Changes in the Skulls of Ancient Children with Age in Xinjiang, China

Many scholars have conducted research on the growth patterns of children’s skulls in terms of skull size, head circumference, cranial cavity volume, and so forth. This study compared and analyzed 20 skull measurement indexes of different ages from 38 children’s skulls (aged 2–15) and 87 adult female skulls (aged 20–40) at the Zaghunluq cemetery in Xinjiang, China, in an attempt to figure out how the size Children’s of ancient children’s skulls changed with age. Analysis of variance (ANOVA) showed that there were significant differences between the six age groups (2 years, 3–5 years, 6–8 years, 9–11 years, 12–15 years, and adults) in terms of metrical cranial traits, cranial area, and cranial cavity volume. The study indicated that the skull kept growing from ages 3 to 5, 12 to 15, and 15 to adulthood, implying that the skull sizes of ancient children in Xinjiang continued to increase with age. In addition, the study revealed that children aged 12 to 15 had skulls that were significantly smaller than those of adults. This finding showed that the skulls of ancient children in Xinjiang were not fully developed at the age of 15. It is also important to note that differences existed between age groups in both the developmental traits of the cranium and the rate at which the skull changes