Global success case analyses have identified factors supporting reductions in stunting across countries; less is known about successes at the subnational levels. We studied four states in India, assessing contributors to reductions in stunting between 2006 and 2016. Using public datasets, literature review, policy analyses and stakeholder interviews, we interpreted changes in the context of policies, programs and enabling environment. Primary contributors to stunting reduction were improvements in coverage of health and nutrition interventions (ranged between 11 to 23% among different states), household conditions (22–47%), and maternal factors (15–30%). Political and bureaucratic leadership engaged civil society and development partners facilitated change. Policy and program actions to address the multidimensional determinants of stunting reduction occur in sectors addressing poverty, food security, education, health services and nutrition programs. Therefore, for stunting reduction, focus should be on implementing multisectoral actions with equity, quality, and intensity with assured convergence on the same geographies and households.

IFA supplementation with or without vitamin B12 is an effective measure to cure anaemia. Although addition of vitamin B12 had similar impact on improving haemoglobin status as IFA alone, it resulted in better ferritin status. Hence, more multi-centre studies with a longer duration of supplementation or higher dose of vitamin B12 may be undertaken to assess the possible impact of vitamin B12 on improving haemoglobin levels in the population.

Anemia among adolescent girls is one of the major challenges faced by India. The present study was undertaken to assess the prevalence of anemia and status of other hematological parameters among adolescent girls (11 - 18 years) residing in an urban slum of Delhi. A total of 794 adolescent girls were recruited for the study. The prevalence of anemia was estimated using the cyanmethemoglobin method. Serum levels of ferritin, folic acid and vitamin B12 were estimated for anemic subjects. The prevalence of anemia was reported as 58.7 %, with 31.6 %, 25.7 % and 1.4 % of subjects being mild, moderate and severely anemic. Hemoglobin levels of subjects who had attained menarche were found to be significantly lower than those who had not attained menarche. The prevalence of serum ferritin, folic acid and vitamin B12 deficiency among those who were anemic was reported as 41.1 %, 5.0 % and 63.3 % respectively. A total of 23.5 % anemic subjects had concomitant micronutrient deficiencies of serum vitamin B12 and ferritin. The results indicate that supplemental iron and vitamin B12 may better address the burden of anemia in adolescent girls in Delhi.

This analysis on key nutrition indicators from successive rounds of the NFHS (4 and 5) is based on all-India and State/UT level factsheet released by Ministry of Health and Family Welfare (MoHFW). The analysis includes: 1. National level trends from NFHS-3 (2005-06), NFHS-4 (2015-16) and NFHS-5 (2019-21) data for 44 indicators including outcomes, service delivery and key determinants of nutrition. 2. State level trends of same indicators- number of states showing improvement / worsening (± 0.1 percent point change), /no change for these indicators, spatial maps based on change in prevalence for these indicators; and charting State performance with respect to achieving Sustainable Development Goals (SDG 2030) targets. This presentation will be useful for policy makers, State administrators, public health experts, research scholars and research institutes in the area of maternal and child health & Nutrition.

This paper answers research questions on screening and management of severe thinness in pregnancy, approaches that may potentially work in India, and what more is needed for implementing these approaches at scale. A desk review of studies in the last decade in South Asian countries was carried out collating evidence on six sets of strategies like balanced energy supplementation (BEP) alone and in combination with other interventions like nutrition education. Policies and guidelines from South Asian countries were reviewed to understand the approaches being used. A 10‐point grid covering public health dimensions covered by World Health Organization and others was created for discussion with policymakers and implementers, and review of government documents sourced from Ministry of Health and Family Welfare. Eighteen studies were shortlisted covering Bangladesh, India, Nepal, and Pakistan. BEP for longer duration, preconception initiation of supplementation, and better pre‐supplementation body mass index (BMI) positively influenced birthweight. Multiple micronutrient supplementation was more effective in improving gestational weight gain among women with better pre‐supplementation BMI. Behavior change communication and nutrition education showed positive outcomes on dietary practices like higher dietary diversity. Among South Asian countries, Sri Lanka and Nepal are the only two countries to have management of maternal thinness in their country guidelines. India has at least nine variations of supplementary foods and three variations of full meals for pregnant women, which can be modified to meet additional nutritional needs of those severely thin. Under the National Nutrition Mission, almost all of the globally recommended maternal nutrition interventions are covered, but the challenge of reaching, identifying, and managing cases of maternal severe thinness persists. This paper provides four actions for addressing maternal severe thinness through available public health programs, infrastructure, and human resources.

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Dietary diversity is a measure of the number of individual foods or food groups consumed in a given period of time. Consumption of more diverse diets is one of the many approaches to improve the nutrition situation. Malnutrition is linked with quality and quantity of dietary intake. A higher dietary diversity has been associated with better nutritional status in an individual. The present study was designed to assess the dietary diversity of the mother and her child, their nutritional status, and any association between these. The sample comprised of mothers (n=100) and their children aged, 2-5 years (n=100), residing in Shakurpur, an urban slum of Delhi, India.  Data on background information, obstetric history, household characteristics, and hygienic practices followed by the mother for herself and for her child, morbidity profile of mother and child, immunization, child feeding practices and birth information, were collected. Anthropometric measurements were taken for both mother and child and were analysed using Anthro plus software MDD-W (2016). Moderate wasting, underweight, and stunting were observed in 5%, 18%, and 20% of children respectively, as compared to severe wasting (4%), severe underweight (4%), and severe stunting (10%). No significant difference was observed in the height and weight of boys and girls.  A greater proportion of mothers of pre-schoolers were either pre-obese (20%) or obese (9%) than underweight (3%) as per WHO classification, while a little over half (68%) the mothers were of normal weight. The mother’s nutritional status was significantly associated with all the indicators of her child’s nutritional status (p=0.00). More than 50% of the study population (both mothers and children) were consuming ≥5 food groups. Inadequacy in dietary diversity was more in mothers (49%) than children (42%). An association between maternal dietary diversity and child dietary diversity (χ2= 14.577, p=0.000) was observed. However, no association was found between dietary diversity of either the child or the mother and the nutritional status of the children (p>0.05). Thus, the present study showed that the diet of the mother and her child as well as the nutritional status of a mother and her child are associated. This re- emphasizes the fact that a mother and child are very closely related.

Abstract:The inactivation of rice bran lipase was studied in vitro and in vivo using metal ions in methanol or HCI. Lipase was extracted from rice bran in 0.1 M potassium phosphate buffer, pH 7.0 and purified by ammonium sulphate fractionation. The 25-55 % ammonium sulphate fraction was subjected to DEAEcellulose ion exchange chromatography and the fraction (F6) eluted at V,/ V, of 14.37 was purified about 333-fold. In-vitro studies on F6 lipase showed that Fe3+ and Ni2+ completely inhibited the lipase activity at 5 x M concentration, while Zn2+ and Cu2+ did so at 2.5 x M. The results on in-vivo inactivation of rice bran lipase showed that Fe3+ and Ni2+ at 200 pg g-' significantly checked the release of free fatty acids (FFA) from rice bran for 6 days of storage when compared with using concentrated HCl (2 %, v/w) only. The triglyceride content of oil was also maximum with Fe3+ and Ni2+ treatment at 200 pg g-l. The present results suggest that Fe3+ and Ni2+ could be effectively used to arrest the release of FFA in rice bran and thus contribute to improving the edible quality of rice bran oil.