Living Environs and Nutritional Status of Children from an Urban Indian Slum: An Analysis of Associative Factors

Growing urbanization gives rise to slums, which are densely populated peri-urban areas housing underprivileged populations. The nutritional status of children in slum areas can be compromised due to poor living environs despite availability of many urban health care facilities. The present cross- sectional study was undertaken to determine the nutritional status of children residing in slum and analyze the various associative factors. The study area was Ghousianagar, a slum in city of Mysore from South India. A sample of 676 children (2-11 years of age, males, 310 and females, 366) from two schools was chosen for detailed anthropometry. Data were also collected on living conditions, economic and literacy levels of parents and nutritional status of mothers (n=200) through standard techniques. The results revealed that the living conditions of children were highly unhygienic. Only in 36% of families both parents were literate. Children from all age groups exhibited different degrees of malnutrition which worsened with increasing age. Only 8% of children were normal and the rest suffered with different degrees of undernutrition. Stunting and wasting were significantly influenced by age and gender of children. Under associative factors studied, weight for age of children was significantly associated with economic status of family and maternal BMI. Weight for height was associated with economic status, family size and maternal BMI. Height for age exhibited marginal association with family size. It can be said that adverse living environment and limited resources influenced the nutritional status of children adversely

Lack of Wdr13 Gene in Mice Leads to Enhanced Pancreatic Beta Cell Proliferation, Hyperinsulinemia and Mild Obesity

WD-repeat proteins are very diverse, yet these are structurally related proteins that participate in a wide range of cellular functions. WDR13, a member of this family, is conserved from fishes to humans and localizes into the nucleus. To understand the in vivo function(s) of Wdr13 gene, we have created and characterized a mutant mouse strain lacking this gene. The mutant mice had higher serum insulin levels and increased pancreatic islet mass as a result of enhanced beta cell proliferation. While a known cell cycle inhibitor, p21, was downregulated in the mutant islets, over expression of WDR13 in the pancreatic beta cell line (MIN6) resulted in upregulation of p21, accompanied by retardation of cell proliferation. We suggest that WDR13 is a novel negative regulator of the pancreatic beta cell proliferation. Given the higher insulin levels and better glucose clearance in Wdr13 gene deficient mice, we propose that this protein may be a potential candidate drug target for ameliorating impaired glucose metabolism in diabetes

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Dietary adequacy of indian children residing in an urban slum - analysis of proximal and distal determinants

The influences of proximal and distal determinants of dietary adequacy of children from an urban slum in India were analyzed. Children numbering 271 (5-14 years) and their mothers were enrolled for the study. Intake of all nutrients except protein was inadequate in the dietaries of children. Among distal determinants, associations were found between (i) calorie intake and maternal nutritional status; (ii) protein, iron and B-complex intakes and economic status, and (iii) retinol, calcium and fat intakes and family size. Literacy status was not associated with dietary adequacy. Age of children and economic status of family were important determinants of dietary adequacy of children from slum area

Dietary adequacy of indian children residing in an urban slum - analysis of proximal and distal determinants

The influences of proximal and distal determinants of dietary adequacy of children from an urban slum in India were analyzed. Children numbering 271 (5-14 years) and their mothers were enrolled for the study. Intake of all nutrients except protein was inadequate in the dietaries of children. Among distal determinants, associations were found between (i) calorie intake and maternal nutritional status; (ii) protein, iron and B-complex intakes and economic status, and (iii) retinol, calcium and fat intakes and family size. Literacy status was not associated with dietary adequacy. Age of children and economic status of family were important determinants of dietary adequacy of children from slum area

Effect of different blanching treatments on ascorbic acidretention in green leafy vegetables

111-116Blanching is a prerequisite for preservation of green leafy vegetables. However, it may cause partial destruction of some nutrients like ascorbic acid which is highly oxidizable with time in the post harvest period on atmospheric exposure. The objective of the present study is to identify a suitable blanching treatment and conditions (temperature, time and media) for commonly consumed green leafy vegetables that ensures enzyme inactivation and maximum ascorbic acid retention. Ten commonly consumed leafy vegetables, viz. Amaranth (Amaranthus gangeticus Linn.), Ambat chuka (Rumex vesicarius Linn.), Bathua (Chenopodium album Linn.), Brahmi [Centella asiatica (Linn.) Urban], Drumstick (Moringa oleifera Linn.), Fenugreek (Trigonella foenum-graecum Linn.), Keerae (Amaranthus sp.), Kilkeerae (Amaranthus tricolor Linn.), Shepu (Anethum graveolens Linn. syn. Peucedanum graveolens Linn.), and Spinach (Spinacia oleracea Linn.) were blanched for 1, 2 and 4 min at 80, 90 and 98oC in water and chemical media, steamed for 5 and 10 min with and without chemical treatment and microwaved for 1 and 1.5 min, unblanched greens served as control. Retention of ascorbic acid was reduced as the blanching time and temperature increased in all greens. It was comparatively higher in chemically treated samples both in conventional and steam-blanched samples. Steam blanched samples (5 min) had a higher level of ascorbic acid than conventional blanched samples irrespective of blanching media. Ascorbic acid content of microwave blanched samples was better in some greens compared to conventionally blanched greens. Blanching at 80oC for 1 min, steaming for 5 min and microwaving for 1 min was sufficient to inactivate peroxidase in all except two green leafy vegetables irrespective of the blanching media. From the nutrition point of view, chemical blanching proved to be advantageous both in steam and conventional blanching for short period and it also ensured enzyme inactivation

Comparative analysis of influence of promoters and inhibitors on in vitro available iron using two methods

The investigation was undertaken with the objective of comparing two in vitro techniques, measuring dialyzable iron (method A) and measuring ionizable iron (method B), for iron bioavailability in a model system. The effect of the time of introduction of the additives on the available iron was also determined. FeSO4 solution was used as the reference source of iron, to which a series of enhancers (ascorbic acid, citric acid, maleic acid and tartaric acid) and inhibitors (tannic acid, calcium oxalate, oxalic acid, calcium carbonate and sodium phytate) were added individually at various concentrations, and available iron was estimated. From FeSO4 solution, 0.1% (method A) and 3.9% (method B) of iron was available. The addition of ascorbic acid, citric acid and tartaric acid increased this by 33 - 50%, 28 - 57% and 23 - 90%, respectively, for method A and by 15 - 89%, 24 - 78% and 24 - 93% for method B. Tannic acid, sodium phytate and calcium oxalate exhibited an inhibitory effect irrespective of the concentrations, while oxalic acid and calcium carbonate exhibited a dose-dependent inhibitory pattern. The iron availability analyzed by both methods showed a positive correlation with seven out of nine additives. An inverse relation was seen between the inhibitory effect of calcium carbonate and calcium oxalate and their time of introduction into the system. The overall observations showed that although absolute values varied widely, a positive correlation existed between the methods

In vitro bioavailability of calcium and iron from selected green leafy vegetables

Abstract The objective of the present investigation was to analyze the relative influence of oxalic acid, phytic acid, tannin and dietary fiber on in vitro availability of iron and calcium from green leafy vegetables (GLV). Thirteen GLV were selected and analyzed for iron, calcium, oxalic acid, phytic acid, tannin and dietary fiber contents using standard methods. The bioavailability of calcium and iron in the GLV was estimated by equilibrium dialysis. Oxalic acid content was less than 1 g kg−1 in four greens and ranged between 1.22 to 11.98 g kg−1 in the remaining. Dietary fiber ranged from 19.5 to 113.7 g kg−1. Tannin content ranged between 0.6138 and 2.1159 g kg−1 with the exception of two GLV that had 0.1332 and 14.8619 g kg−1. Four GLV were found to have approximately 40% bioavailable iron, while the others were in the range of 6–30%. In vitro available calcium was less than or equal to 25% in eight GLV and between 34% and 52% in five GLV. Multiple regression analysis revealed that these factors together accounted for 53% (r2 = 0.53) and 45% (r2 = 0.45) inhibition of iron and calcium absorption, respectively. These findings infer that calcium and iron availability is influenced by the constituents present in the GLV. Copyright © 2006 Society of Chemical Industr

Antioxidant properties of fresh and processed Citrus aurantium fruit

Edible components of Citrus aurantium (bitter orange) fruit i.e. whole fruit, separated peel and pulp, and processed preserved products, namely salt pickle, chilli pickle, and sweet preserve were analyzed for antioxidant potential by various in vitro assays. The antioxidants components were extracted in different media and freeze dried. Methanol and aqueous media were comparatively more effective in extracting the antioxidant components. The total phenol content of the extracts ranged from 2.5 to 22.5 mg/g and 5.0 to 45.0 mg/g of pulp and peel fragments, respectively. The fruit components exhibited proton radical, oxyradical, and hydroxyl radical scavenging abilities and were effective in preventing lipid peroxidation. Regression analysis showed positive association between total phenolics and different antioxidant assays. In processed products, there was an initial decrease in antioxidant capacity, which showed an increase on storage. In conclusion, bitter orange exhibited high antioxidant capacity which was retained even in processed and stored products

Dietary adequacy of Indian rural preschool children-influencing factors

The dietary adequacy (qualitative and quantitative) of preschool children residing in rural areas near Mysore (a district in south India) was assessed by the ‘Food frequency method’ and ‘24-h recall method’. Food intake assessed in three different seasons revealed that their diets were predominantly cereal based with negligible quantity of protective foods. The overall nutrient intake was found to be inadequate, irrespective of the seasons. The adequacy level of the nutrients (cereal dependence) was found to be comparatively better in monsoon and winter seasons because of better labour opportunities and availability. Food consumption pattern showed no gender differences. The nutrient adequacy also varied by the age of the children. The influence of ‘food expenditure’ on the nutrient adequacy was not statistically significant. Nutritional status was found to be a factor influencing nutrient intake. Apart from age, nutritional status and food availability, feeding practices may also influence the nutrient intake of the preschool children