India bears a huge burden of hemoglobinopathies, and the most prevalent is thalassemia. The different types of thalassemia include minor, major and intermedia, based on the α/β-globin chain inequality. This review aimed to understand the current prevalence of thalassemia in different regions of India and communities affected by it, along with the management of β-thalassemia major (β-TM) and β-thalassemia (β-thal) minor patients. A comprehensive electronic search for relevant articles was conducted using two databases, i.e. PubMed and Science Direct. Articles published in English from India between January 2009 and September 2021 were included. Studies from other countries, genetic and molecular characterization studies, and articles published in other languages were excluded. The prevalence of β-thal trait in Central India ranged between 1.4 and 3.4%, while 0.94% β-TM was reported among the patients with anemia. In South India, the prevalence of β-thal trait was between 8.50 and 37.90% and β-TM was reported to be between 2.30 and 7.47%. Northern and Western Indian states had a higher thalassemic burden. In Eastern India, tribal populations had a higher prevalence of β-thal trait (0.00–30.50%), β-TM (0.36–13.20%) and other hemoglobinopathies [Hb E (HBB: c.79G>A)/β-thal] (0.04–15.45%) than nontribal populations. Additionally, scheduled castes, scheduled tribes and other backward classes of low socioeconomic status and low literacy rates were affected by β-thal. Almost all Indian states reported β-thal; however, it is mostly concentrated in eastern and western parts of the country. Well-integrated strategies and effective implementation are needed at State and National levels to minimize the burden of β-thal.

Background: The school-based food and nutrition guidelines approach has the potential to combat undernutrition, overnutrition and micronutrient deficiencies among children and adolescents and set the foundation for a healthy adult lifestyle. Aim: To critically compare the Nutrition Friendly School Initiative (NFSI) of the World Health Organization (WHO) with the Food Safety and Standards Authority of India (FSSAI) and the Indian Academy of Pediatrics (IAP) guidelines to gauge the strengths and limitations. Additionally, to summarize the existing studies on implementing school food and nutrition guidelines. Methods: Policy documents of the above guidelines were critically evaluated, and narrative analysis was conducted. An electronic search was conducted for full-text research articles published in the English language between January 2007 to September 2021 in Science Direct, PubMed, Web of Science, and SCOPUS databases. Results: Upon critical comparison of the three guidelines, it was found that the NFSI and FSSAI guidelines shared similarities in many components and the FSSAI guidelines, if implemented adequately, could improve the school food environment and combat the triple malnutrition burden in India. After screening the articles based on the eligibility criteria, 11 studies were included in the preparation of the review. Studies reported partial or inadequate implementation and poor compliance with the guidelines or approach. A few studies identified barriers to guideline implementation. Conclusion: Implementation of school food and nutrition guidelines could improve the nutritional outcomes in children and adolescents. To sustain the effective implementation, adequate resources and preparedness are essential in low-and middle-income countries, including India.

Background/Objectives: Cardiovascular diseases (CVDs) are a leading cause of mortality globally. Growing studies have been conducted to examine the diet–CVD association to alleviate the health and economic burdens associated with CVDs, but beneficial dietary factors may vary by study region and cohort. There was a need to identify the trends in diet–CVD research by study region and current emerging dietary exposures of interest, which could inform areas for future research and the regions where evidence is relatively limited. Methods: A comprehensive search of multiple databases was performed to identify eligible prospective cohorts examining diet–CVD associations published between 2019 and 2024. Trends in dietary exposure, including dietary patterns, food groups, and nutrients, were analyzed by publication year and geographical distribution. Results: A total of 298 studies were included in the review. While the United States continued to lead in the number of CVD–diet cohort studies, China has significantly increased its contributions over the past five years, increasing from 2.1% to 14.3%. The cohorts that contributed the most to the literature included the Nurses’ Health Study and the Danish Diet, Cancer, and Health cohort. Although food groups accounted for the highest number with respect to dietary exposure overall, there was a notable shift in diet–CVD cohort studies from a focus on nutrients to dietary patterns. Plant-based and Mediterranean diets were the most frequently investigated, while ultra-processed foods and country-specific dietary indices also gained prominence. Conclusions: This systematic review highlighted the shift towards dietary patterns in nutritional epidemiology, emphasizing the importance of understanding the role of nutrition in health through holistic dietary approaches. The observed trends in dietary exposure research suggested the need for future studies to delve deeper into the complexities of dietary patterns, including how cultural and socioeconomic elements defined the nuances of country-specific dietary patterns.

The UN Sustainable Development Goal aims at a 50% reduction of anemia in women of reproductive age (WRA) by 2030. Several nutrition-specific and sensitive interventions are targeted across LMICs to reduce anemia. The meta-review comprehensively assessed the effectiveness of nutrition-specific and sensitive interventions on hemoglobin (Hb) and serum ferritin (SF) concentrations, the prevalence of iron deficiency and anemia among WRA, pregnant women and lactating women from LMICs. The preparation of the present meta-review followed a double-blinded synthesis process with three stages- screening, quality appraisal and data extraction in Eppi Reviewer. Earlier, a well-designed peer-reviewed protocol was published (1). A comprehensive search was performed for systematic reviews (SRs) published between January 2000 and May 2022 using 21 international, national, and regional databases. The methodological quality appraisal of included studies was conducted using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. A total of 23 SRs evaluated the effects of various nutrition-specific interventions included in the final synthesis. The included SRs on nutrition-specific interventions such as supplementation of nutrients iron (n = 7), iron and folic acid (n = 4), vitamin A (n = 3), calcium (n = 2), multiple micronutrients (n = 7) and intravenous iron sucrose (n = 2). Also, SRs on fortification of nutrients included multiple micronutrients (n = 6), iron and folic acid (n = 4) and iron (n = 4). Of the 23 SRs, 22 were of high quality. Iron with or without folic acid supplementation and fortification and vitamin A supplementation consistently showed positive effects on either reduction in the prevalence of anemia or iron deficiency and in improving the Hb concentrations or SF concentrations in WRA and pregnant women from LMICs. The comprehensive meta-review reported the beneficial effects of iron with or without folic acid, multiple micronutrient supplementation/fortification, and vitamin A supplementation in reducing the prevalence of anemia or iron deficiency and increase in Hb or SF concentrations in WRA from LMICs.

Growing popularity of restrictive dietary practices exists among young women; however, their effects on health and factors driving adoption of restrictive dietary practices among young Indian women remain underexplored. The study assessed prevalence, awareness, and effects of perceived restrictive dietary practices among young adult Indian women (18-30 years). A cross-sectional pilot study using online survey was performed pan-India using a pre-tested questionnaire. A total of 230 young women who provided consent and met eligibility criteria completed the study. Information on socio-demographics, nutrition knowledge, dietary habits, and perceived effects of restrictive dietary practices were collected. Descriptive statistics and chi-square/Fisher's exact tests were performed to investigate associations between age, education attainment status, and outcomes. The study reported a prevalence of adoption of restrictive dietary practices was 20.9%, with higher adoption rates among women > 23 years of age (31.7%). The ketogenic diet was the most popular perceived restrictive dietary practice; however, intermittent fasting was the most widely practiced (65.6%). Personal factors, especially physical appearance, predominantly motivated the adoption of restrictive dietary practices (96.3%). Postgraduate participants demonstrated significantly higher nutrition knowledge and healthier dietary practices (p < 0.05) than graduates. Younger women and postgraduates reported significantly lower perceived negative physical and psychological effects of restrictive dieting. The prevalence of restrictive dieting among young adult Indian women, primarily driven by personal factors rather than social pressures. Age and education shape awareness, adoption, and perceived effects. Enhancing nutrition education, formal nutrition education, and digital literacy strategies is imperative to mitigate misconceptions and promote evidence-based dietary practices. Further larger studies with objective assessments of nutritional status and nutritional adequacy are recommended. No level of evidence, Basic Science.

Cardiovascular diseases (CVD) remain a leading cause of death, with diet as a key modifiable risk factor. While prospective cohort studies using food frequency questionnaires (FFQs) underpin dietary guidelines, FFQs are prone to measurement errors that typically attenuate true associations. Characterizing the degree of error through validation is essential to properly interpret and adjust observed diet-disease relationships. It remains unclear whether FFQ validation evidence adequately supports the specific dietary exposures analyzed in recent CVD research. Therefore, this meta-research study aimed to evaluate this gap by examining discrepancies between validated dietary factors and those used in association analyses. A systematic search of multiple databases identified cohort studies published between 2019 and 2024 using keywords related to cohort studies, CVDs, and FFQs (PROSPERO: CRD42024589050). The proportion of cohorts with discrepancies was examined, defined as cases in which the dietary variables examined in association analyses lacked direct validation in the referenced FFQ validation paper. A total of 298 cohort studies from over 50 countries were included, with 88.3% using validated FFQs (against reference methods such as 24-hour dietary recalls, dietary records or biomarkers) for dietary assessment. A total of 93 unique validation papers were referenced across all included studies. However, at the acceptable correlation threshold ( r > 0.3), discrepancies were identified in 80.6% of studies, indicating that the dietary variables examined in association analyses lacked direct validation in the referenced FFQ validation paper. Correlation analysis was the most commonly used validation metric (92.5% of validation studies), with 41.9% relying solely on correlation analyses. This research highlighted a significant FFQ validation gap in diet-CVD association research. Future research should clearly report FFQ validation metrics, especially de-attenuated correlation coefficients, and ensure that the dietary exposures of interest are covered in the referenced validation study. For dietary pattern studies, whenever feasible, researchers should directly validate dietary pattern scores against reference methods, so that these assessments are supported by direct evidence of validity. PROSPERO registry number: CRD42024589050