Legume consumption is associated with lower fasting glucose (FG) and insulin levels in nutrition trials and lower CVD mortality in large-scale epidemiological studies. In India, legumes are widely consumed in various preparations, yet no epidemiological study has evaluated the association of legumes with FG levels, insulin resistance and diabetes risk. The present study aimed to fill this gap.

Fasting blood samples, in-person interviews to obtain information on demographic/socio-economic factors, physical activity, alcohol and tobacco use, and anthropometric measurements were collected. Dietary intakes were assessed by an interviewer-administered, validated, semi-quantitative FFQ.

Lucknow, Nagpur, Hyderabad and Bangalore, India.

Men and women (n 6367) aged 15–76 years – urban residents, urban migrants and their rural siblings.

In multivariate random-effects models adjusted for age, BMI, total energy intake, macronutrients, physical activity and rural/migration status, daily legume consumption was not associated with FG (P-for-trend=0·78), insulin resistance (homeostasis model assessment score; P-for-trend=0·73) or the prevalence of type 2 diabetes mellitus (P-for-trend=0·41). Stratified analyses by vegetarian diet and migration status did not change the findings. Inverse associations between legumes and FG emerged for participants with lower BMI and higher carbohydrate, protein, fat and sugar intakes.

Although legumes are essential in traditional Indian diets, as well as in prudent and Mediterranean diets in the West, we did not find an association between legumes and markers of glycaemic control, insulin resistance or diabetes, except for subgroups based on BMI and macronutrient intake. The ubiquitous presence and complexity of legume preparations in Indian diets may contribute to these findings.

Obesity is a growing problem in India, the dietary determinants of which have been studied using an ‘individual food/nutrient’ approach. Examining dietary patterns may provide more coherent findings, but few studies in developing countries have adopted this approach. The present study aimed to identify dietary patterns in an Indian population and assess their relationship with anthropometric risk factors.

FFQ data from the cross-sectional sib-pair Indian Migration Study (IMS; n 7067) were used to identify dietary patterns using principal component analysis. Mixed-effects logistic regression was used to examine associations with obesity and central obesity.

The IMS was conducted at four factory locations across India: Lucknow, Nagpur, Hyderabad and Bangalore.

The participants were rural-to-urban migrant and urban non-migrant factory workers, their rural and urban resident siblings, and their co-resident spouses.

Three dietary patterns were identified: ‘cereals–savoury foods’ (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), ‘fruit–veg–sweets–snacks’ (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and ‘animal-food’ (red meat, poultry, fish/seafood, eggs). In adjusted analysis, positive graded associations were found between the ‘animal-food’ pattern and both anthropometric risk factors. Moderate intake of the ‘cereals–savoury foods’ pattern was associated with reduced odds of obesity and central obesity.

Distinct dietary patterns were identified in a large Indian sample, which were different from those identified in previous literature. A clear ‘plant food-based/animal food-based pattern’ dichotomy emerged, with the latter being associated with higher odds of anthropometric risk factors. Longitudinal studies are needed to further clarify this relationship in India.

India has proposed legislating an upper limit of trans fat in partially hydrogenated vegetable oils and mandating trans fat labelling in an effort to reduce intakes. The objective of the present study was to examine the complexities of regulating trans fat in India by examining the policy processes involved and the perceived implementation challenges.

Semi-structured interviews (n 18) were conducted with key informants from various sectors. Interviewees were asked about sources of trans fat in the food supply, existing policies that may influence trans fats and perceived challenges related to the proposed trans fat regulation, in addition to questions tailored to their area of expertise. Interview data were organised based on common themes.

Interviews were conducted in India.

Interviewees were key informants from various sectors including agriculture, trade, industry and health.

Several themes were identified related to the complexity of regulating trans fat in India. A lack of trans fat awareness, the large unorganised retail sector, a need for suitable alternative products that are both acceptable to consumers and affordable, and a need to build capacity were crucial factors affecting India's ability to successfully regulate trans fat. The limited number of food inspectors will create an additional challenge in terms of enforcement of trans fat regulation.

Although India will face challenges in regulating trans fat, legislating an upper limit of trans fat in partially hydrogenated vegetable oils will likely be the most effective approach to reducing it in the food supply. Ongoing engagement with industry, agriculture, trade and processing sectors will prove essential in terms of product reformulation.

India spans the spectrum of under- and overnutrition disorders and does so in generous proportions. India also tops the charts globally in the prevalence of risk factors for several chronic diseases. Although Public Health Nutrition (PHN) – both as an academic field as well as a means to improved health – has been around for two centuries in developed countries, it is only now coming to the fore as a conduit for tackling nutrition-related disorders in developing countries. In the light of these issues, we undertook an exercise to map the existing educational initiatives for nutrition, and in particular PHN, in India.

This situational analysis of PHN across India was conducted using a combination of Internet search, telephone calls as well as interviews with experts. Information collected was pooled and tabulated using a snowball approach.

India.

Not applicable.

Currently, there are nearly 190 institutes in India that offer one or more nutrition courses, with the majority offering full-time courses. Of these, PHN was offered in less than five institutes across India and opportunities were confined to specialization options/modules.

This situational analysis reveals the huge gap in existing nutrition ventures and points towards the urgent need to undertake newer academic initiatives especially in the field of PHN in India. Reforms in the education and employment sector need to be brought in which may include working towards making the field of nutrition attractive for career pursuit. The focus of this discipline needs to be broadened to, but not limited to, span the entire spectrum from dietetics to research and teaching. Strong synergistic collaborations and academic partnerships with other developed countries should be encouraged to catalyse finding solutions to emerging and/or existing threats to public health problems.

To study the impact of migration on food consumption among Indian factory workers and their siblings and spouses.

A cross-sectional study was conducted to assess diet using an interviewer-administered semi-quantitative FFQ from which intake of 184 commonly consumed food items was obtained.

Participants recruited from factory sites in Bangalore, Lucknow, Nagpur and Hyderabad.

The sample comprised 7049 participants (41·6 % female), and included urban, migrant and rural groups.

Thirteen food items were eaten by the greatest proportion of individuals on a daily basis. These were all indigenous foods. The proportion of people consuming tandoori roti, dal with vegetables, potato and ghee on a daily basis was highest in the urban sample, intermediate in the migrant group and lowest in the rural group (P ≤ 0·01). The proportion of individuals consuming Western food on a weekly basis followed a similar trend.

The diet of this sample is predominantly indigenous in nature, irrespective of migration status, with the prevalence of daily Western food consumption being minimal.

To validate questionnaire-based physical activity level (PAL) against accelerometry and a 24 h physical activity diary (24 h AD) as reference methods (Protocol 2), after validating these reference methods against the heart rate–oxygen consumption (HRVO2) method (Protocol 1).

Cross-sectional study.

Two villages in Andhra Pradesh state and Bangalore city, South India.

Ninety-four participants (fifty males, forty-four females) for Protocol 2; thirteen males for Protocol 1.

In Protocol 2, mean PAL derived from the questionnaire (1·72 (sd 0·20)) was comparable to that from the 24 h AD (1·78 (sd 0·20)) but significantly higher than the mean PAL derived from accelerometry (1·36 (sd 0·20); P < 0·001). Mean bias of PAL from the questionnaire was larger against the accelerometer (0·36) than against the 24 h AD (−0·06), but with large limits of agreement against both. Correlations of PAL from the questionnaire with that of the accelerometer (r = 0·28; P = 0·01) and the 24 h AD (r = 0·30; P = 0·006) were modest. In Protocol 1, mean PAL from the 24 h AD (1·65 (sd 0·18)) was comparable, while that from the accelerometer (1·51 (sd 0·23)) was significantly lower (P < 0·001), than mean PAL obtained from the HRVO2 method (1·69 (sd 0·21)).

The questionnaire showed acceptable validity with the reference methods in a group with a wide range of physical activity levels. The accelerometer underestimated PAL in comparison with the HRVO2 method.