A field tool for prediction of body fat in Sri Lankan women: skinfold thickness equation

Background: Valid skinfold thickness (SFT) equations for the prediction of body fat are currently unavailable for South Asian women and would be a potentially robust field tool. Our aim was to assess the validity of existing SFT equations against deuterium (2H2O) dilution and, if invalid, to develop and validate an SFT equation for % fat mass (%FM) in Sri Lankan women. Methods: H2O dilution was used with Fourier transform infrared (FTIR) spectroscopy as the criterion method for the assessment of %FM in urban Sri Lankan women (30\u201345 years). This data was used to assess the validity of available SFT equations and to generate and validate a new SFT equation for the prediction of %FM against the criterion method. Women (n = 164) were divided into validation and cross-validation groups for the development and validation of the new equation. The level of agreement between the %FM calculated by the final derived prediction equation and the %FM obtained by 2H2O dilution was assessed using Pearson\u2019s correlation coefficient (R) and Bland Altman plots. Student\u2019s t test was used to assess over- or underestimation, and significance was set at p < 0.05. Results: Existing equations significantly (p < 0.001) underestimated %FM compared with the 2H2O dilution method. The final equation obtained was %FM= 19.621 + (0.237*weight) + (0.259*triceps). When compared with 2H2O dilution, %FM by the equation was not significantly different. There was a significant (p < 0.001) correlation between %FM by the reference method and %FM by the equation. The limit of agreement by Bland Altman plot was narrow with a small mean positive bias. Conclusions: Existing SFT equations were not applicable to this population. The new equation derived was valid. We report a new SFT equation to predict %FM in women of South Asian ancestry suitable for field use

Prevalence of Vitamin A Deficiency in South Asia: Causes, Outcomes, and Possible Remedies

Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot\u2019s spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stern efforts are needed to address this issue of publichealth significance at local and international level in lower- and middle-income countries of South Asia

Sedentary behaviour and physical activity in South Asian women: time to review current recommendations?

OBJECTIVE: Our aims were to describe activity and sedentary behaviours in urban Asian women, with dysglycaemia (diagnosed at recruitment), and without dysglycaemia and examine the relative contribution of these parameters to their glycaemic status. METHODS: 2800 urban women (30-45 years) were selected by random cluster sampling and screened for dysglycaemia for a final sample of 272 newly diagnosed, drug naive dysglycaemic and 345 normoglycaemic women. Physical activity and sedentary behaviours were assessed by the International Physical Activity Questionnaire (IPAQ). Demographic data, diet and anthropometry were recorded. Logistic regression analysis assessed contribution of all parameters to dysglycaemia and exposure attributable fractions were calculated. RESULTS: The mean energy expenditure on walking (2648.5±1023.7 MET-min/week) and on moderate and vigorous physical activity (4342.3±1768.1 MET-min/week) for normoglycemic women and dysglycaemic women (walking;1046.4±728.4 MET-min/week, moderate and vigorous physical activity; 1086.7±1184.4 MET-min/week) was above the recommended amount of physical activity per week. 94.3% of women spent >1000 MET-minutes/week on activity. Mean sitting and TV time for normoglycaemic and dysglycaemic women were 154.3±62.8, 38.4±31.9, 312.6±116.7 and 140.2±56.5 minutes per day respectively. Physical activity and sedentary behaviour contributed to dysglycaemia after adjustment for family history, diet, systolic blood pressure and Body Mass Index. Exposure attributable fractions for dysglycaemia were; lower physical activity: 78%, higher waist circumference: 94%, and TV viewing time: 85%. CONCLUSIONS: Urban South Asian women are at risk of dysglycaemia at lower levels of sedentary behaviour and greater physical activity than western populations, indicating the need for re-visiting current physical activity guidelines for South Asians

Prevalence of Vitamin A Deficiency in South Asia: Causes, Outcomes, and Possible Remedies

Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot’s spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stern efforts are needed to address this issue of publichealth significance at local and international level in lower- and middle-income countries of South Asia

Selected characteristics of the study population.

<p>Continuous data are presented as mean (SD).</p>a<p>Significantly different (p<0.001) from normoglycaemics.</p>b<p>Conversion Rate 1 LKR = 0.0075 U.S Dollars.</p

Receiver Operating Characteristics curve cut off values for dysglycaemia with sensitivity and specificity.

<p>AUC – area under the curve.</p

Correlation of HbA1c with risk factors of dysglycaemia and physical activity.

<p>Correlation of HbA1c with risk factors of dysglycaemia and physical activity.</p