status and provision of good health care facilities also play a key role. Growth pattern in children with CP Cerebral palsy is a disorder of posture and movement. [15] These children grow poorly throughout their lives. [2,16,17] They have significantly lower mean height, [18-20] weight, [7,18-20] skinfold thickness, [7,19] and mid upper arm circumference (MUAC) [7,18] as compared to general population. Communitybased cross-sectional surveys in Philippines, [21] Nigeria, [22] Bangladesh, [15] and India [19] have also reported similar findings [Table 1]. Overweight and obesity have also been reported by various researches conducted mostly in developed countries [Table 2]. Prevalence of overweight found to vary from 2% in Nigeria [18] to 16% in Norway. [9] Overweight and obesity are more prevalent among spastic bilateral CP than spastic unilateral CP. [9] This could be because children with spastic unilateral CP are more mobile as compared to those with spastic bilateral CP, and they have less feeding problems due to which they have a greater chance of gaining weight. The objective of this work was to review the studies conducted among developing and developed countries to assess the growth pattern and nutritional status of children with cerebral palsy. It also aimed at summarizing the key factors responsible for high prevalence of undernutrition among them. Significant reductions in the anthropometric parameters were found in children with cerebral palsy as compared to their nondisabled counterparts. This deviation from normal growth can be attributed to inadequate dietary intake, feeding problems, decreased weight bearing, and several nonnutritional factors including abnormal endocrine function, socioeconomic status, disease severity, and age. Also, it was seen that undernutrition was more prevalent among developing countries as compared to developed countries. Besides undernutrition, various studies conducted among developed countries have reported a high prevalence of overweight and obesity among this population. This could be attributed to a decrease in the motor function because of the underlying condition and an increase in the gastrostomy feeding owing to availability of better health care facilities.
The emergence of modernization coupled with sedentary lifestyle has resulted in the shift from the prevalence of diseases only due to under nutrition, to those caused by over nutrition. The augmentation of non-communicable diseases, thus, imposes double burden of disease, impeding the health of a nation. This upsurge has led to increase in prevalence and incidence of Metabolic syndrome which is a cluster of inter-related factors characterized by high fasting blood glucose, increased level of triglycerides, low levels of high density cholesterol, elevated blood pressure and abdominal obesity. The best way to combat this syndrome is to reduce the atherosclerotic risk, which can be carried out by modification in the diet and lifestyle – the first line of treatment of the syndrome. Thus, the present review was undertaken to understand the already existing as well as the current scenario specifically regarding the dietary and lifestyle interventions being carried out to overcome Metabolic syndrome. Of the randomized control trials reviewed, all except one reported improvement in Metabolic syndrome following intervention in diet and/or lifestyle modification either in certain components or overall syndrome within a period of 2 weeks–1 year. These interventions to alter diet and lifestyle focus on weight reduction, promotion of regular physical activity, reduction of substance abuse, effectiveness of specific food items along with regulation of genes and various inflammatory markers. They have the potential to succeed only if they are executed early, and thus, offer enough evidence to develop appropriate public policies. However, the issue that is of utmost significance is of sustainability and compliance, which eventually decides the long-term success or failure of an intervention.
FMI was a better predictor of generalized obesity compared to BMI and BF%. Considering abdominal obesity as an independent risk factor for insulin resistance, both WC and WC/ht ratio were able to predict central obesity better than WHR. Finally, the study presents ranges for FFMI and FMI for various BMI categories.
Metabolic syndrome is a constellation of risk factors that has the potential of developing into cardiovascular disease or increase the susceptibility to it. It is present worldwide with now even developing countries getting overwhelmed by its burden. With a shift towards unhealthy diet coupled with sedentary lifestyle, development of metabolic syndrome is on the rise even among young adults. One of the main causes of this problem is faulty diet, so any means to reduce the incidence of the syndrome involves the modification of the existing diets rich in saturated fat, sodium and cholesterol. This review focusses on efficacy of different dietary patterns for combating the syndrome along with other lifestyle risk factors. It also highlights newer advancements in the field of Metabolic Syndrome, which can serve as potential strategies to combat it. Public health interventions targeting adults, therefore, should center on prevention through education, modification of diet and lifestyle, and focusing on environment, so that these changes are acceptable and sustainable.
Metabolic Syndrome (MetS) is a complicated disorder that increases a person's risk to cardiovascular disease and diabetes mellitus and therefore, needs to be diagnosed early. Young adults in business process outsourcing industry (BPO) may be more susceptible to the syndrome owing to the sedentary nature of their work and other lifestyle factors. This study aimed at assessing the prevalence of MetS among young business process outsourcing industry employees (21-30 years). In this cross-sectional study conducted in the National Capital Region of India, MetS was diagnosed using the Adult Treatment Pattern III (NCEP ATPIII, 2001) and International Diabetes Federation (IDF, 2005) (ethnicity specific) criteria among 415 business process outsourcing employees (274 males; 141 females) working at the calling level. Prevalence of MetS was 11.8% according to ATPIII criteria (14.6% males; 6.4% females) and 18.3% according to IDF criteria (22.3% males; 10.6% females) and was significantly higher in males compared to females (ATPIII p = 0.014; 95% CI 0.02, 0.14; IDF:p = 0.004; 95% CI 0.05, 0.19). As per the ATPIII criteria, highest proportion of the employees had low levels of HDL cholesterol (48.2%) whereas as per the IDF criteria, they had high waist circumference (58.6%). MetS was significantly associated with being single (ATPIII p=0.003; IDF p=0.012), having monthly income more than 20,000 INR (ATPIII p=0.009), having waist to height ratio ≥ 0.5 (ATPIII p=0.002; IDF p=0.000) and BMI ≥ 23kg/m<sup>2</sup> (ATPIII p=0.000; IDF p=0.000). With nearly 1/5th of the BPO employees having MetS at a young age (21-30 years), there is an urgent need to initiate appropriate workplace screening and intervention strategies to prevent and reverse the syndrome among them.
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