Aravinda Meera Guntupalli

Maternal height and child growth patterns

Objective To examine associations between maternal height and child growth during 4 developmental periods: intrauterine, birth to age 2 years, age 2 years to mid-childhood (MC), and MC to adulthood. Study design Pooled analysis of maternal height and offspring growth using 7630 mother–child pairs from 5 birth cohorts (Brazil, Guatemala, India, the Philippines, and South Africa). We used conditional height measures that control for collinearity in height across periods. We estimated associations between maternal height and offspring growth using multivariate regression models adjusted for household income, child sex, birth order, and study site. Results Maternal height was associated with birth weight and with both height and conditional height at each age examined. The strongest associations with conditional heights were for adulthood and 2 years of age. A 1-cm increase in maternal height predicted a 0.024 (95% CI: 0.021-0.028) SD increase in offspring birth weight, a 0.037 (95% CI: 0.033-0.040) SD increase in conditional height at 2 years, a 0.025 (95% CI: 0.021-0.029 SD increase in conditional height in MC, and a 0.044 (95% CI: 0.040-0.048) SD increase in conditional height in adulthood. Short mothers (<150.1 cm) were more likely to have a child who was stunted at 2 years (prevalence ratio = 3.20 (95% CI: 2.80-3.60) and as an adult (prevalence ratio = 4.74, (95% CI: 4.13-5.44). There was no evidence of heterogeneity by site or sex. Conclusion Maternal height influences offspring linear growth over the growing period. These influences likely include genetic and non-genetic factors, including nutrition-related intergenerational influences on growth that prevent the attainment of genetic height potential in low- and middle-income countries.

Prediction of body-fat percentage from skinfold and bio-impedance measurements in Indian school children

Background/Objectives:Few equations for calculating body-fat percentage (BF%) from field methods have been developed in South-Asian children. The objective of this study was to assess agreement between BF% derived from primary reference methods and that from skinfold equations and bio-impedance analysis (BIA) in Indian children.Subjects/Methods:We measured BF% in two groups of Indian children. In Pune, 570 rural children aged 6–8 years underwent dual-energy X-ray absorptiometry (DXA) scans. In Mysore 18O in doubly labeled water was administered to 59 urban children aged 7–9 years. We conducted BIA at 50 kHz and anthropometry, including sub-scapular and triceps skinfold thicknesses. We used the published equations of Wickramasinghe, Shaikh, Slaughter and Dezenburg to calculate BF% from anthropometric data and the manufacturers equation for BIA measurements. We assessed agreement with values derived from DXA and doubly labeled water using Bland–Altman analysis.Results:Children were light and thin on average compared with international standards. There was poor agreement between the reference BF% values and those from all equations. Assumptions for Bland–Altman analysis were not met for Wickramasinghe, Shaikh and Slaughter equations. The Dezenberg equations under-predicted BF% for most children (mean difference in Pune −13.4, LOA −22.7, −4.0 and in Mysore −7.9, LOA (−13.7 and −2.2). The mean bias for the BIA equation in Pune was +5.0% and in Mysore +1.95%, and the limits of agreement were wide; −5.0, 15.0 and –7.8, 11.7 respectively.Conclusions:Currently available skinfold equations do not accurately predict BF% in Indian children. We recommend development of BIA equations in this population using a four-compartment model.

Diet patterns are associated with demographic factors and nutritional status in south Indian children

Abstract The burden of non‐communicable chronic disease (NCD) in India is increasing. Diet and body composition ‘track’ from childhood into adult life and contribute to the development of risk factors for NCD. Little is known about the diet patterns of Indian children. We aimed to identify diet patterns and study associations with body composition and socio‐demographic factors in the Mysore Parthenon Study cohort. We collected anthropometric and demographic data from children aged 9.5 years (n = 538). We also administered a food frequency questionnaire and measured fasting blood concentrations of folate and vitamin B12. Using principal component analysis, we identified two diet patterns. The ‘snack and fruit’ pattern was characterised by frequent intakes of snacks, fruit, sweetened drinks, rice and meat dishes and leavened breads. The ‘lacto‐vegetarian’ pattern was characterised by frequent intakes of finger millet, vegetarian rice dishes, yoghurt, vegetable dishes and infrequent meat consumption. Adherence to the ‘snack and fruit’ pattern was associated with season, being Muslim and urban dwelling. Adherence to the lacto‐vegetarian pattern was associated with being Hindu, rural dwelling and a lower maternal body mass index. The ‘snack and fruit’ pattern was negatively associated with the childs adiposity. The lacto‐vegetarian pattern was positively associated with blood folate concentration and negatively with vitamin B12 concentration. This study provides new information on correlates of diet patterns in Indian children and how diet relates to nutritional status. Follow‐up of these children will be important to determine the role of these differences in diet in the development of risk factors for NCD including body composition.

Parental childhood growth and offspring birthweight: pooled analyses from four birth cohorts in low and middle income countries.

Associations between parental and offspring size at birth are well established, but the relative importance of parental growth at different ages as predictors of offspring birthweight is less certain. Here we model parental birthweight and postnatal conditional growth in specific age periods as predictors of offspring birthweight.

Modeling The Effects Of Immunizations Timing On Child Health Outcomes In India

Timely vaccinations of children in developing countries are important for reducing morbidity and mortality, which are Millennium Development Goals. However, a majority of children do not possess vaccination cards compiling information on timing. We investigated the benefits of vaccination cards for the uptake of immunizations against diphtheria, pertussis and tetanus (DPT), polio, tuberculosis (BCG), and measles using data on over 200,000 Indian children from the District Level Health and Facility Survey 3. Methodological issues such as whether parents of children with higher morbidity levels may have them vaccinated were investigated. The results from the models for DPT, polio, measles, and BCG vaccinations showed significant beneficial effects of maternal education, household possessions, and access to health care facilities. Moreover, models for childrens ages at the time of vaccination showed significant interactions between maternal education and access to and availability of health care facilities. Finally, models for child morbidity due to diarrhea, cough, and fever showed that timely vaccinations against DPT, access to piped water, and cooking with electricity or natural gas were associated with lower morbidity. Overall, issuing paper or electronic vaccination cards to children is likely to enhance timely uptake of various immunizations thereby reducing child morbidity.

Health care utilization, socioeconomic factors and child health in India

This paper models the proximate determinants of height, weight and haemoglobin concentration of over 25,000 Indian children using data from the National Family Health Survey-3. The effects of public and private health care service utilization, food consumption patterns and maternal health status on child health were investigated in a multidisciplinary framework. Methodological issues such as potential endogeneity of explanatory variables and the appropriateness of combining height and weight as the body mass index were tackled. The results from models for childrens heights and weight showed beneficial effects of child vaccinations against DPT, polio and measles, and negative effects of not utilizing government health facilities. The models for childrens haemoglobin concentration indicated beneficial effects of food consumption patterns and treatment against intestinal parasites. The results provide several insights for improving child health in India.

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET‐DD) study, a collaborative study carried out in 14 countries

To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries.

Heights Across the Last 2000 Years in England

Abstract This paper uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the ‘Dark Ages’ in the early medieval period. At the turn of the first millennium heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialisation. The data show that average heights in England in the early nineteenth century were shorter than those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. The paper also discusses the ssociation of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains.

Socio-demographic differences of disability prevalence among the population aged 60 years and over in Bangladesh

ABSTRACT This study aims to delineate the sociodemographic differences in disability prevalence across the population aged 60 years and over in Bangladesh, and to investigate the association of factors with reporting disability in later life. A microdata sample for those aged 60 years or over from the Census of Bangladesh 2011 was used where disability was assessed with a self-reported single response question. Logistic regression models were performed separately for men and women. Results reveal that the disability prevalence rate increased sharply with age, and it was higher among older women (5.2 per cent) compared to men (4.8 per cent). Physical and vision disabilities were the two categories with the highest prevalence of reported disabilities, with a higher prevalence of physical disability among men and vision disability among women. Being older, female, currently not in marital partnership, and having a lower educational attainment, not being employed, living alone, and residing in the rural areas were significantly associated with reporting disability in later life. The higher prevalence of disability among older women, those who are illiterate, and those residing in rural areas highlights the need for policies prioritising these groups. Special attention should also be given to those who are currently not in marital partnership, particularly women who are living alone.

Active Ageing Index (AAI) in India: Is the Approach Used in European Countries Applicable to Developing Countries?

One of the questions the chapter asked is whether the AAI (Active Ageing Index), a widely popular policy tool in Europe, can be applied in India. We conclude that the AAI will help to understand the contribution of older adults in India, by including social and economic components. We believe that one of the strengths is the critical evaluation of employment and social engagement domains. In India, employment in later life could not always be interpreted as an active engagement, due to lack of formal support and prevailing ageism in the labour market. Despite poor scoring in the employment domain, India has similar scores to the EU due to higher social participation rate. We recommend that in-depth analysis has to be carried out to draw policy conclusions based on AAI in developing countries.