1

Methods: Anthropometric survey of 760 school children in Army School, Pune, was carried out
and compared against the NCHS/WHO reference standards to determine their nutritional
status. Associations of nutritional status with socio-economic status, education status of
parents, mothers working status and family size were determined. Results: The prevalence of
stunting was 13.81%, wasting 6.71% and under nutrition 9.87%. Mothers’ educational level,
wasting, socio economic status and family size were significantly associated with the
nutritional status of the child. Conclusion: Maternal educational status, socio-economic status
and family size are important determinants of nutritional status of school children

2
We examined the effects of omitting breakfast on the cognitive functions of three groups of
children: stunted, nonstunted controls, and previously severely malnourished. They were
admitted to a metabolic ward twice. After an overnight fast half the children received breakfast
on their first visit and a cup of tea the second time. The treatment order was reversed for the
other half. When breakfast was omitted, both the stunted and previously malnourished groups
responded similarly. The malnourished groups had lower scores in fluency and coding whereas
the control group had higher scores in arithmetic. The children were divided into wasted and
nonwasted groups. Wasted children were adversely affected in the digit span backwards tests,
and wasted members of the malnourished groups were adversely affected in efficiency of
problem solving and those in the control group in digit span forwards. These results indicate
that cognitive functions are more vulnerable to missing breakfast in poorly nourished children.

3
The different dietary habits and nutritional status of Spanish schoolchildren have been
analyzed. Nutrition affects health throughout the life cycle, and it is best to begin to prevent
harm early on. Habits are formed early in life, and habits are a major determinant of food
choice in later life. Two trends in particular are worthy of mention in this regard: the
progressive globalisation of the food supply and the increase of food intake such as snacks, soft
drinks and fast food, wich tipically apport a significant part of daily diet. In Spain, young
people are abandoning the “Mediterranean Diet” in favour of industrial products, full of calories
and saturated fatty acids but low in nutritional components, wich is contributing to obesity
and rising cholesterol levels. Also, breakfast consumption has been identified as an important
factor in the nutritional status of children and in Spain we are observing that an increasing
percentage of children are omitting breakfast

4
Background : As in many other Asian countries, Sri Lanka is in the phase of a rapid
demographic, nutritional and epidemiological transition. As a result dietary habits and lifestyle
are changing. These have led to new health problems in the region. Childhood overweight and
obesity are examples of such problems. Objective: To provide information on the nutritional
status of 8–12 years old schoolchildren in an urban area of Sri Lanka. Subjects and methods :
Seven schools situated in the city of Colombo were randomly selected. They showed a fair
representation of children of all social levels. Fifty students from each grade (years 4, 5, 6, 7) of
each school were randomly selected. Their height was measured using a stadiometer to the
closest 0.1cm and weight measured using an electronic weighing scale (Seca®, France) to the
closest 100 g. Calibration was checked with a standard weight at each 25 measurements.
Information regarding behaviour, feeding practices and socioeconomic factors were obtained by
a questionnaire filled by the parent or the guardian. To define obesity and overweight, sex and
age specific body mass index (BMI) criteria recommended by the International Obesity Task
Force (IOTF) were used. The age and sex specific BMI 5th percentile from revised NCHS (2000)
growth charts were used to define thinness. Weight and height Z score of less than –2 from the
median of height for age and weight for age derived using the ANTHRO software (CDC, USA)
were used to define stunting and underweight respectively. Data were analysed using EpiInfo
2000 (CDC, USA) computer package. Results : Anthropometric data of 1 224 children (48%
boys), and feeding practices and behaviour pattern data of 1 102 children (44% boys) were
analysed. Obesity prevalence among boys (4.3%) was higher than in girls (3.1%). The
prevalence of thinness was 24.7% in boys and 23.1% in girls. 5.1% of boys and 5.2% of girls
were stunted. 7.0% of boys and 6.8% of girls were underweight. 66% of obese children and
43.5% of overweight children belonged to high-income category (monthly family income more
than Rs. 20 000). Apart from family income, behaviour patterns did not significantly influence
the nutritional status. Conclusions : Although the data are not representative of the entire
country, nutritional transition is evident in the city of Colombo. Obesity and overweight in
older children are some emerging nutritional problems that may be the consequence of
emerging patterns of the lifestyle and diet in response to social and cultural changes.

5
Nutritional assessment in the community is essential for accurate planning and
implementation of intervention programmes to reduce morbidity and mortality associated with
under-nutrition. The study was, therefore, carried out to determine and compare the
nutritional status of children attending urban and rural public primary schools in Ife Central
Local Government Area (ICLGA) of Nigeria. The schools were stratified into urban and rural,
and studied schools were selected by balloting. Information obtained on each pupil was entered
into a pre-designed proforma. The weight and height were recorded for each pupil, and
converted to nutritional indices (weight for age, weight for height, height for age). A total of 749
pupils (366 and 383 children from the rural and urban communities, respectively) were
studied. The overall prevalent rates of underweight, wasting and stunting were 61.2, 16.8 and
27.6%, respectively. In the rural area these were 70.5, 17.8 and 35.8%, while in the urban they
were 52.2, 15.9 and 19.8%, respectively. The mean nutritional indices (Weight for Age, Weight
for Height and Height for Age) were found to be significantly lower among the rural pupils than
urban pupils (P < 0.001 in each case). The present study shows that malnutrition
(underweight, wasting and stunting) constituted major health problems among school children
in Nigeria. This is particularly so in the rural areas. Therefore, prevention of malnutrition
should be given a high priority in the implementation of the ongoing primary health care
programmes with particular attention paid to the rural population.

6
Objective: Clinical assessment of nutritional status of neonate using CAN score and
comparison with other methods of determining intrauterine growth. Design: Cross sectional
study. Setting: Tertiary care hospital. Subjects: 637 consecutive, liveborn singleton neonates
with known gestational age and no major congenital malformation. Methods: Birth weight,
length, midterm circumference and head circumference recorded in newborns. Ponderal index
and mid arm to head circumference ratio was calculated. Clinical assessment of nutritional
status was done on the basis of CAN score and compared with other methods. Results: CAN
score < 25 separated 60% of the babies as well nourished and 40% as malnourished. Weight
for age and Ponderal Index classified 70-75% of babies as well nourished (AGA) and 25-30% as
malnourished. Also MAC/HC classified nearly half the babies as well nourished and half as
malnourished. Conclusion: CAN score may be a simple clinical index for identifying fetal
malnutrition and for prediction of neonatal morbidity associated with it, without the aid of any
sophisticated equipments.

7
Objective: To validate a revision of the Mini Nutritional Assessment short-form (MNA®-SF)
against the full MNA, a standard tool for nutritional evaluation. Methods: A literature search
identified studies that used the MNA for nutritional screening in geriatric patients. The
contacted authors submitted original datasets that were merged into a single database. Various
combinations of the questions on the current MNA-SF were tested using this database through
combination analysis and ROC based derivation of classification thresholds. Results: Twenty-
seven datasets (n=6257 participants) were initially processed from which twelve were used in
the current analysis on a sample of 2032 study participants (mean age 82.3y) with complete
information on all MNA items. The original MNA-SF was a combination of six questions from
the full MNA. A revised MNA-SF included calf circumference (CC) substituted for BMI
performed equally well. A revised three-category scoring classification for this revised MNA-SF,
using BMI and/or CC, had good sensitivity compared to the full MNA. Conclusion: The newly
revised MNA-SF is a valid nutritional screening tool applicable to geriatric health care
professionals with the option of using CC when BMI cannot be calculated. This revised MNA-SF
increases the applicability of this rapid screening tool in clinical practice through the inclusion
of a “malnourished” category.

8
A cause-and-effect relation between protein-energy malnutrition and poor outcome in acute
stroke patients has not been definitively established. To measure the effect of the nutritional
status of hospitalized stroke patients on clinical outcome, a prospective, observational study
was performed. Acute stroke patients admitted to Leicester General Hospital from June 1994 to
October 1995 had their nutritional status assessed with anthropometric, hematologic, and
biochemical methods within 48 h of admission and after 2 and 4 wk. Outcome measures
including disability, handicap, length of stay, morbidity (infective complications), discharge
destination, and mortality were recorded during the hospital stay and at 3 mo. Nutritional
status deteriorated significantly during the study period, but only serum albumin
concentrations showed a significant association with various outcome measures. Stroke
patients with hypoalbuminemia had a greater risk of infective complications (P<0.0001) and
poor functional outcome during hospitalization than those with normal or higher serum
albumin concentrations. Serum albumin concentrations were good predictors of the degree of
disability and handicap during the hospital stay. After prognostic indicators of poor outcome
were adjusted for, serum albumin concentration in the hospital was a strong and independent
predictor of mortality at 3 mo after acute stroke [hazard ratio 0.91 (95% CI: 0.84, 0.99) for a 1-
g/L higher serum albumin concentration]. Whether nutritional supplementation removes or
mitigates the hazard of poor outcome associated with undernutrition after acute stroke needs
to be determined.
9
The present study was designed to evaluate to the effect of dietary supplements on clinical
outcome and nutritional status in a large group of geriatric patients (n = 501). The patients
were randomised into an experimental group which received nutritional supplementation (400
kcal) as well as a standard hospital diet, and a control group on hospital diet alone. The
nutritional state was measured on admission and after 8 and 26 weeks by anthropometry,
serum protein analysis and a delayed hypersensitivity skin test. Protein energy malnutrition
was defined as the presence of three or more abnormal parameters. 28.5% of patients showed
evidence of malnutrition on admission. Hospitalisation itself resulted in a gradual deterioration
in nutritional status. Nutritional supplementation generally improved nutritional state. Among
those patients who were well nourished on admission, and subsequently receiving dietary
supplementation, 8.3% fulfilled malnutrition criteria after 26 weeks, while 21.1% were
considered malnourished in the control group (p < 0.05). The improvement observed in
transport proteins was probably related to nutritional support and not just to the reversal of
inflammation. In the initially well nourished group of more than 300 patients, the mortality
rate was 8.6% in those given nutritional support compared to 18.6% in the control group (p <
0.02).

10
Objective: To evaluate the antioxidant activity of aqueous extract of Moringa oleifera (M.
oleifera) young leaves by in vivo as well as in vitro assays. Methods: In vitro study included
estimation of total phenolic, total flavonol, total flavonoid and total antioxidant power (FRAP
assay). In addition, in vivo study was done with the identified most effective dose of 200 mg/kg
of its lyophilized powder on normal and diabetic rats. Its effect on different oxidative free
radical scavenging enzymes, viz, superoxide dismutase (SOD), catalase (CAT), glutathione-S-
transferase (GST), lipid peroxide (LPO) contents were measured. Results: Significant increase
in activities of SOD, CAT, GST while, a decrease in LPO content was observed. Whereas, total
phenolic, flavonoid and flavonol contents in the extract were found to be 120 mg/g of GAE,
40.5 mg/g of QE and 12.12 mg/g of QE, respectively. On the other hand, FRAP assay results of
M. oleifera leaves was (85.00 依 5.00) 毺 M of Fe ++/g of extract powder. Conclusions: The
significant antioxidant activities of M. oleifera leaves from both in vivo as well as in vitro
studies suggests that the regular intake of its leaves through diet can protect normal as well as
diabetic patients against oxidative damag
The present study was designed to investigate clinically the hypoglycemic effect of seeds of
Moringa oleifera and Azadirachta indica in Type 2 Diabetes Mellitus. About 55 type-2 diabetes
(36 men and 19 women) in the age group of 30-60 years were selected from the Hospital of
Acharya Nagarjuna University and Diabetic Care hospital, Guntur and divided into two
Experimental (n=46) and control group (n=9). The first two experimental were administered
Moringa oleifera leaves powder (8gm) and Azadirachta indica seeds powder (6gm) per day
respectively in three divided doses for 40 days. The third group of 9 subjects did not receive
any treatment and were designated as the control group. There was a significant reduction in
fasting blood glucose (p<0.01), the post prandial blood glucose levels (p<0.05) of the subjects in
the two groups showed significant reduction, while there was no reduction in the control
group. A significant reduction in the mean blood lipid levels of the subjects who were
administered the two herbal powders was observed. Among the two herbs selected Moringa
oleifera leaves powder was found to be more effective followed by Azadirachta indica seeds
powder.
11
The antidiabetic activity of two low doses of Moringa seed powder (50 and 100 mg/kg body
weight, in the diet) on streptozotocin (STZ) induced diabetes male rats was investigated. Forty
rats were divided into four groups. The diabetic positive control (STZ treated) group showed
increased lipid peroxide, increased IL-6, and decreased antioxidant enzyme in the serum and
kidney tissue homogenate compared with that of the negative control group. Immunoglobulins
(IgA, IgG), fasting blood sugar, and glycosylated hemoglobin  were also increased as a result of
diabetes in G2 rats. Moreover albumin was decreased, and liver enzymes and α-amylase were
not affected. In addition, the renal functions and potassium and sodium levels in G2 were
increased as a sign of diabetic nephropathy. Urine analysis showed also glucosuria and
increased potassium, sodium, creatinine, uric acid, and albumin levels. Kidney and pancreas
tissues showed also pathological alteration compared to the negative control group. Treating
the diabetic rats with 50 or 100 mg Moringa seeds powder/kg body weight in G3 and G4,
respectively, ameliorated the levels of all these parameters approaching the negative control
values and restored the normal histology of both kidney and pancreas compared with that of
the diabetic positive control group.

12
INTRODUCTION: Although obesity is well recognized as a current public health problem, its
prevalence and impact among pregnant women have been less investigated in Brazil. The
objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant
women, describing its prevalence and risk factors, and their association with adverse
pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more,
enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six
state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age,
educational level and parity were obtained from a standard questionnaire. Height was
measured in duplicate and the interviewer assigned the skin color. Nutritional status was
defined using body mass index (BMI), according to World Health Organization (WHO) criteria.
Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS:
Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7%
(5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was
more frequently observed in older black women, with a lower educational level and
multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia,
hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional
status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was
associated with increased risk for several adverse pregnancy outcomes, such as gestational
diabetes and pre-eclampsia.