Adolescence appears to be the next available critical period to improve inadequacies in nutrition, growth, and development from childhood. In this analysis, we describe the dietary and nondietary determinants of nutritional status among adolescent girls and adult women residing in rural areas of India. We used data pertaining to 3930 adolescents (10–19 years) and 11,058 adult women (20–49 years) from the National Nutrition Monitoring Bureau Survey, 2011–2012 database. Logistic regression analysis was conducted to understand the effects of various individual‐ and household‐level determinants of thinness and underweight among adolescents and adult women, respectively. Almost one‐third of the adolescents and adult women were undernourished. Factors other than dietary adequacy and diversity had a greater impact on undernutrition in both the adolescents and adult women. The nondietary determinants (e.g., higher age group, higher household wealth status, access to improved water, better maternal work status, and living in better type of houses) predicted good nutritional status in the adolescent girls. In addition, the women's own higher education and household occupation status and better sanitation facilities improved undernutrition in adult women. Therefore, India needs multipronged strategies along with dietary interventions and effective implementation programs to achieve good health and well‐being of adolescents and adult women.

Multiple micronutrient deficiencies (MNDs) co‐exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6–17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B 12 and C‐reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B 12 deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B 12 remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes.

Fortification of rice with micronutrients using extrusion technology is considered a sustainable strategy to prevent nutritional deficiencies in general population. The objective of the present study is to assess the retention, stability and iron bioavailability from indigenously developed triple fortified rice (iron, folic acid and vitamin B 12 ) during rinsing and different cooking methods. Further, we also assessed the acceptability of fortified rice in adult human volunteers. The retention of iron during rinsing with excess water was ≥90%, whereas folic acid and vitamin B 12 levels were reduced by ~25% during rinsing. Watertight cooking of rice (in electric cooker or on flame) had no additional effect on the nutrient levels as compared with rinsed rice, implying their stability during cooking. However, cooking with excess water followed by decanting led to loss of 45% iron and ≥70% folic acid and vitamin B 12 . The dialyzable iron and ferritin synthesis in Caco‐2 cells was significantly ( P < .01) higher from fortified rice compared with unfortified rice. In addition, inclusion of ascorbic acid significantly ( P < .01) increased the iron bioavailability from the fortified rice. Triangle tests in adult human subjects revealed that there are no significant sensory differences among fortified and unfortified rice. Further, fortified rice consumption appears to bridge the gaps in dietary iron intake deficits in children and women of reproductive age. These results suggest that the iron‐, folic acid‐ and vitamin B 12 ‐fortified rice has higher retention and stability of fortified nutrients and is acceptable for consumption in adult human volunteers.

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