To assess the impact of an intervention modifying dietary habits for the prevention of anaemia in rural India.

Intervention study with data on anthropometric (weight, height) measurements, Hb and diet pattern. As per the cut-off for Hb in the government programme, women with Hb <11 g/dl had to be given Fe tablets and formed the supplemented group while those with Hb > 11 g/dl formed the non-supplemented group.

Three villages near Pune city, Maharashtra, India.

Rural non-pregnant women (n 317) of childbearing age (15–35 years).

After 1 year of intervention, mean Hb increased (from 10·94 (sd 1·22) g/dl to 11·59 (sd 1·11) g/dl) significantly (P < 0·01) with a consequent reduction in the prevalence of anaemia (from 82·0 % to 55·4 %) as well as Fe-deficiency anaemia (from 30·3 % to 10·8 %). Gain in Hb was inversely associated with the initial level of Hb. Significant gain in Hb (0·57 g/dl) was observed among women attending >50 % of the meetings or repeating >50 % of the recipes at home (0·45 g/dl) in the non-supplemented group and was smaller than that observed in the supplemented group. Consumption of green leafy vegetables more than twice weekly increased substantially from 44·7 % to 60·6 %, as did consumption of seasonal fruits. Logistic regression showed that women with lower participation in the intervention had three times higher risk (OR = 3·08; 95 % CI 1·04, 9·13; P = 0·04) for no gain in Hb compared with those having high participation.

Developing action programmes for improving nutritional awareness to enhance the consumption of Fe-rich foods has great potential for preventing anaemia in rural India.

To examine various sociodemographic aspects related to consumption of micronutrient-rich foods like green leafy vegetables (GLV), which will be helpful in modifying dietary habits, a strategy that merits consideration for prevention of anaemia.

Cross-sectional study for collecting data on socio-economic and anthropometric (weight, height) variables, Hb, dietary pattern (FFQ) and peripheral smear examination for classifying nutritional and iron-deficiency anaemia (IDA).

Three villages near Pune city, Maharashtra, India.

Rural women (n 418) of childbearing age (15–35 years).

Mean Hb was 11·07 g/dl. Seventy-seven per cent of the women were anaemic (Hb < 12 g/dl) and 28 % had IDA, indicating that a large proportion of the women had nutritional anaemia. Higher prevalence of IDA was associated with several sociodemographic and maternal parameters, but multiple logistic regression analysis showed significant (P < 0·05) risk of IDA with lower body weight (<40 kg), short maternal height (<145 cm), younger age at marriage (<19 years) and higher parity (≥2). Various socio-cultural reasons associated with low consumption of GLV included non-cultivation of GLV, priority for selling them rather than home consumption, dislike of GLV by husband and children, and lack of awareness about different recipes for GLV.

Our findings highlight that low consumption of GLV, which are treasures of micronutrients including Fe, is associated with genuine social reasons. This indicates a need for developing action programmes to improve nutritional knowledge and awareness leading to enhanced consumption of Fe-rich foods for preventing anaemia in rural India.

In view of the fact that height differences between socio-economic groups are apparent early in childhood, it is of interest to examine whether skeletal growth is reflective of the social class gradient in CVD risk. The present study examined blood pressure levels, adiposity and growth of adolescent boys from high and low social classes.

In a cross-sectional study, skeletal growth (height and sitting height), adiposity (weight, BMI and body fat) and blood pressure levels of the adolescents were measured.

Pune, India.

Adolescent schoolboys (9–16 years) from high socio-economic (HSE; n 1146) and low socio-economic (LSE; n 932) class.

LSE boys were thin, short and undernourished (mean BMI: 15·5 kg/m2v. 19·3 kg/m2 in HSE boys, P = 0·00). Social gradient was revealed in differing health risks. The prevalence of high systolic blood pressure (HSBP) was high in HSE class (10·5 % v. 2·7 % in LSE class, P = 0·00) and was associated with adiposity, while the prevalence of high diastolic blood pressure (HDBP) was high in LSE class (9·8 % v. 7·0 % in HSE class, P = 0·00) and had only a weak association with adiposity. Despite this, lower ratio of leg length to height was associated with significantly higher respective health risks, i.e. for HDBP in LSE class (OR = 1·99, 95 % CI 1·14, 3·47) and for HSBP in HSE class (OR = 1·69, 95 % CI 1·02, 2·77).

As stunting in childhood is a major problem in India and Asia, the leg length to height indicator needs to be validated in different populations to understand CVD risks.

In view of the paucity of data on energy costs, the present study aimed to estimate these for typical daily activities performed by women in rural India.

A cross-sectional study covering 26 different activities was done by indirect calorimetry using the Oxylog™ instrument (Morgan).

Villages about 30–40 km from Pune city, Maharashtra, India.

Energy costs were measured on 22 rural Indian women aged 18–45 years.

Irrespective of whether an activity was domestic or farming, energy cost was lower when performed in sitting position (cleaning grains 5.24 kJ min−1, plucking leafy vegetables 5.76 kJ min−1) and increased considerably with the extent of muscular movement (carrying two water containers 14.77 kJ min−1, chopping firewood 14.5 kJ min−1), indicating the importance of the postural details of the activity. Physical activity ratio computed using the Food and Agriculture Organization/World Health Organization/United Nations University equation (PARw) was lower for all activities compared with that (PARm) based on measured basal metabolic rate, indicating the need for a population-specific equation. Furthermore, PARw identified more activities as belonging to the ‘very light’ category (nine out of 26 activities), in contrast to the perception of rural women which was supported with empirical evidence. Estimated daily energy expenditure of the women was 7.69 ± 0.63 MJ (1837 ± 150 kcal) and identified their daily activity pattern as ‘moderate’ based on PALw (1.65 ± 0.16) while PALm (2.04 ± 0.18) identified it as ‘heavy’.

Our results highlight the importance of qualitative descriptions of the various activities. The energy costs for several daily activities reported in this study could potentially be used for estimating daily energy expenditure of women from similar rural settings.