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Khadilkar A.V.,Hirabai Cowasji Jehangir Research Institute | Kadam N.S.,Hirabai Cowasji Jehangir Medical Research Institute | Chiplonkar S.A.,Hirabai Cowasji Jehangir Medical Research Institute | Khadilkar V.V.,Hirabai Cowasji Jehangir Medical Research Institute
Journal of Pediatric Endocrinology and Metabolism | Year: 2014

The aim of this study was to investigate the effect of 1-year micronutrient supplementation on the height velocity of underprivileged premenarchal girls in comparison with the natural growth of apparently healthy girls from an affluent class. A 1-year cluster-randomisation intervention trial was conducted in 119 premenarchal girls (8-12 years) from two schools catering to the lower socioeconomic strata (LSES) in Pune, India. Three classes of age-matched girls were randomly allocated to any one of the three intervention groups: (i) Ca+MZn+D group (C1: zinc, 15 mg/day+multivitamins; calcium, 500 mg/day; vitamin D, 30,000 IU/3 months); (ii) Ca+D group (C2: calcium, 500 mg/day; vitamin D, 30,000 IU/3 months); and (iii) M+D group (C3: multivitamins; vitamin D, 30,000 IU/3 months). Height, weight, and Tanner stage were assessed at baseline and endline. A total of 119 age-matched, apparently healthy school girls from a higher socioeconomic group (HSES) were assessed for their growth after 1 year without any supplementation. At baseline, mean heightfor- age Z-scores and weight-for-age Z-scores by Indian references were > -2 in 99% of HSES girls and 28% of LSES girls had height-for-age Z-scores < -2. Post-intervention, increase in height-for-age Z-scores adjusted for Tanner stage was significantly higher in the Ca+MZn+D group (0.32 ± 0.06) than in the respective age-matched controls (C1 group) (-0.02 ± 0.05) (p < 0.05) as well as in both the Ca+D group (0.18 ± 0.06) and the M+D group (0.14 ± 0.04) (p < 0.05). After adjusting for Tanner stage, height velocity was significantly higher for the Ca+MZn+D group (6.7 ± 0.4 cm/year) than for the M+D group (6.1 ± 0.2), Ca+D group (5.6 ± 0.5) as well as age-matched controls (C1 group) (5.0 ± 0.3) (p < 0.05). Supplementation with calcium+vitamin D, zinc and multivitamins may be effective in improving stature in underprivileged Indian premenarchal girls. © 2014 by Walter de Gruyter Berlin Boston 2014. Source


Chiplonkar S.,Hirabai Cowasji Jehangir Medical Research Institute | Khadilkar A.,Hirabai Cowasji Jehangir Research Institute | Pandit-Agrawal D.,Hirabai Cowasji Jehangir Medical Research Institute | Kawade R.,Health Genesis | And 4 more authors.
Journal of Pediatric Endocrinology and Metabolism | Year: 2013

Micronutrient deficiencies are common consequences of the plant-based diet in children from developing countries which may affect their linear and ponderal growth. The aim of the study was to investigate the association between micronutrient status and growth indices in Indian girls. In cross-sectional studies (2006-2010), data on weight, height and diet were collected on 1302 girls (2-18 years) from Pune city, India. Fasting hemoglobin was measured on 1118 girls and serum zinc was measured on 695 girls. Height-for-age Z-scores (HAZ) and body mass index for age Z-score (BMIZ) were computed using contemporary Indian references. HAZ >-1 was observed in 54% girls, and 18.1% were short (HAZ <-2). BMIZ was within the reference range (-2-1 than in short girls even after adjusting for socioeconomic status (SES). The mean serum zinc level of thin girls (BMIZ <-2) was significantly lower than those of both normal and overweight girls after adjusting for SES. Micronutrient sufficiency is of paramount importance for adequate growth in Indian girls. Source


Kadam N.S.,Agharkar Research Institute | Chiplonkar S.A.,Hirabai Cowasji Jehangir Research Institute | Khadilkar A.V.,Hirabai Cowasji Jehangir Research Institute | Fischer P.R.,Mayo Medical School | And 2 more authors.
Journal of Pediatric Endocrinology and Metabolism | Year: 2011

Low adolescent peak bone mass is associated with bone problems in adulthood. Our aim was to assess underprivileged premenarchal Indian girls for low bone mineral content and to study the influence of anthropometric, lifestyle factors on bone health. Data on anthropometry, diet, lifestyle, total body bone mineral content (TBBMC), bone area, bone mineral density, and biochemical parameters [parathyroid hormone, vitamin D (25OH-D), calcium, and zinc] were assessed in 214 premenarchal girls (8-12 years). Compared with the Indian reference database, 15.6% girls had TBBMC for age Z-scores below-2 and 37.5% had Z-scores between-2 and-1. The TBBMC for total body bone area Z-scores were below-2 for one fifth of girls, indicating undermineralized bones. Mean rate of increase in TBBMC with age and Tanner stage was lower in our study population (11.6% and 20.7%, respectively) than reference database (14.2% and 33.4%, respectively). Low weight, 25OH-D, and intake of protein, calcium, and zinc adversely affected TBBMC (p<0.05). Many underprivileged premenarchal Indian girls are at risk of achieving low bone mass. Steps to improve underweight, 25OH-D, intakes of protein, calcium, and zinc might improve bone health. © 2011 by Walter de Gruyter Berlin Boston. Source


Sanwalka N.,University of Pune | Sanwalka N.,Hirabai Cowasji Jehangir Research Institute | Khadilkar A.,Hirabai Cowasji Jehangir Research Institute | Chiplonkar S.,Hirabai Cowasji Jehangir Research Institute | And 3 more authors.
Journal of Bone and Mineral Metabolism | Year: 2013

To study the association between vitamin D receptor (VDR) gene polymorphisms and bone mass indices in adolescent girls, a cross-sectional study was conducted in 120 post-menarchal girls aged 15-18 years in Pune city, India. Serum levels of ionised calcium, inorganic phosphorous, parathyroid hormone and 25-hydroxy vitamin-D were measured. Bone mineral content (BMC), bone area (BA) and bone mineral density (BMD) were measured at total body (TB), lumbar spine (LS) and left femoral neck (FN) using dual energy X-ray absorptiometry. Polymorphisms of the VDR gene at the Fok1 and Bsm1 loci were detected using SYBR Green quantitative polymerase chain reaction. The overall distribution of genotypes at the Bsm1 locus in this study was 33.3 % Bb, 29.2 % bb and 37.5 % BB while that for the Fok1 locus was 44.2 % Ff, 7.5 % ff and 48.3 % FF. There were no significant differences in the blood parameters when classified according to Bsm1 or Fok1 genotypes. Subjects with BB genotype have significantly higher mean TBBMC, TBBA, TBBMD and LSBMD than Bb and bb (p < 0.05) and showed a tendency for association with LSBMC and LSBA (p < 0.1). Subjects with Ff genotype showed a tendency for association with left FNBMC and FNBA (p < 0.1). Bsm1 genotype did not show an association with FN bone indices whereas Fok1 genotype did not show association with TB or LS bone indices. In conclusion, the present study demonstrates VDR gene polymorphism, defined by Bsm1 genotype, has an influence on total body and lumbar spine bone mass indices in post-menarchal Indian girls. © 2012 The Japanese Society for Bone and Mineral Research and Springer Japan. Source

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