Reema Kumari

Elucidation of Dietary Risk Factors in Osteoarthritis Knee—A Case-Control Study

Background and Objective: Nutritional imbalance, combined with endocrine abnormalities, may be involved in the pathogenesis of osteoarthritis (OA). This study was conducted to determine the association of OA with dietary factors, such as quantity and quality of nutrient intake. Methods: This case-control study enrolled 180 knee osteoarthritis (KOA) subjects who met the American College of Rheumatology definition of KOA, with an equal number of matched controls. Outcome measures, such as dietary nutrient intake and its frequency, were recorded using a food frequency questionnaire. Results: Compared to controls, cases were older individuals with a higher body mass index (BMI). Physical activity scores were lower in female cases compared to male cases and controls. A significantly higher intake of phosphorus and fat was observed in overall cases (fat in females only). A significantly lower intake of vitamin C and vitamin D was observed in overall cases and the significance of vitamin D persisted on gender-wise bifurcation. On multiple logistic regression analysis, the intake of vitamin D (odds ratio [OR] = 0.79) and vitamin C (OR = 0.97) was inversely associated with the presence of KOA in the observation group, especially in females. Generally, the intake of food servings/day, green leafy vegetables (GLVs), and fats/oils was higher, whereas the intake of fruits, milk/milk products, and meat/poultry was lower in cases compared to controls. Conclusion: Low intake of vitamin D and vitamin C is a possible risk factor for KOA. Certain food groups, such as fruits, milk/milk products, and meat/poultry are beneficial for KOA. Further studies are needed to elucidate the associations between diet and KOA.

The association of anthropometric measures and osteoarthritis knee in non-obese subjects: a cross sectional study

OBJECTIVE: Body mass index (BMI) and knee osteoarthritis have a strong association, but other anthropometric measures lack such associations. To date, no study has evaluated non‐obese knee osteoarthritis to negate the systemic and metabolic effects of obesity. This study examines the validity of the contention that BMI and other anthropometric measures have a significant relationship with knee osteoarthritis. METHODS: In total, 180 subjects with a diagnosis of knee osteoarthritis were recruited and classified according to Kellgren‐Lawrence (KL) grades. Body mass index, mid‐upper arm circumference, waist‐hip ratio and triceps‐skinfold thickness were recorded by standard procedures. Osteoarthritis outcome scores (WOMAC) were evaluated. RESULTS: (1) In both genders, the BMI was significantly higher for KL grade 4 than for grade 2; triceps‐skinfold thickness was positively correlated with the joint space width of the tibial medial compartment. (2) In males, triceps‐skinfold thickness significantly increased as the KL grades moved from 2 to 4; the significantly higher BMI found in varus aligned knees was positively correlated with WOMAC scores. (3) In females, the waist‐hip ratio was significantly higher for KL grade 4 than for grade 2; a significant correlation was found between BMI and WOMAC scores. The waist‐hip ratio was significantly associated with varus aligned knees and it positively correlated with WOMAC scores and with the joint space width of the tibial medial compartment. The mid‐upper arm circumference demonstrated no correlation with knee osteoarthritis. CONCLUSION: This study validates the contention that BMI and other anthropometric measures have a significant association with knee osteoarthritis. Contrary to common belief, the triceps‐skinfold thickness (peripheral fat) in males and the waist‐hip ratio (central fat) in females were more strongly associated with knee osteoarthritis than BMI.

Social Determinants and its Influence on the Prevalence of Morbidity among Adolescent Girls.

Background: The adolescent girls are more vulnerable, particularly in developing countries including India, due to various adverse socio-cultural and economic reasons. Majority of the health problems affecting adolescent girls are preventable by promotion of hygienic practices through proper health education by the teachers. Aim: This study was designed to examine the various factors influencing the prevalence of morbidity among school-going adolescent girls of Lucknow district in north India. Materials and Methods: A cross-sectional study was carried out in urban and rural schools of Lucknow district from 2008 to 2009. Multistage random sampling was used to select the requisite number of girls. A total of 847 adolescent girls between 10 and 19 years of age were interviewed, and information regarding their socio-demographic characteristics was collected and clinical examination was carried out. Statistical analyses were done using percentage and Chi-square test. Results: Of 847 adolescent girls, around 64.8% were found to be sick at the time of the study. Significant association of morbidity was observed with caste, birth order, type of family, socioeconomic status (SES), living status with parents/guardian, and general personal hygiene (P<0.05). Conclusion: This study reveals a high prevalence of morbidity. A strong need exists for planning and programming intervention activities for health needs in the area.

Nutritional status of school going adolescent girls in Lucknow District

Objectives: To study the nutritional status of school going adolescent girls in Lucknow district, Uttar Pradesh, India. Materials and Methods: A cross-sectional descriptive study was carried out in urban as well as rural schools of Lucknow district from October 2008 to September 2009. Multistage random sampling was used to select the requisite number of girls. A total of 847 school going adolescent girls between 10 and 19 years of age were interviewed and anthropometric measurements were recorded for assessing the nutritional status. Results and Conclusions: The mean weight in all age groups in both urban and rural schools showed significant difference with the ICMR mean weight for respective ages except in ages 18 and 19 years in urban school girls and in ages 10 and 19 years in rural school girls. The mean height in all age groups in both urban and rural schools showed significant difference with the ICMR mean height for respective ages except in ages 18 and 19 years in urban schools and in ages 16, 17, 18, and 19 years in rural schools. Overall prevalence of thinness was found to be 17.0% and 11.4% (BMI 85th percentile according to NCHS-CDC reference) among urban and rural school going adolescent girls, respectively.