Sumathi Swaminathan

Sumathi Swaminathan
St. John's Research Institute · Department of Nutrition

PhD

About

77
Publications
46,129
Reads
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5,604
Citations
Citations since 2017
41 Research Items
5053 Citations
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201720182019202020212022202302004006008001,000
201720182019202020212022202302004006008001,000
201720182019202020212022202302004006008001,000
Additional affiliations
January 2015 - November 2016
St. John's Research Institute
Position
  • Professor (Associate)
March 2003 - present
St. John's National Academy of Health Sciences
Position
  • Professor (Assistant)

Publications

Publications (77)
Article
Full-text available
Objective There are scant empirical data on the impacts of the COVID-19 pandemic on food security across the globe. India is no exception, with insights into the impacts of lockdown on food insecurity now emerging. We contribute to the empirical evidence on the prevalence of food insecurity in Bihar state before and after lockdown, and whether the...
Article
Background The alleviation of iron deficiency through iron supplementation has not effectively reduced anemia in India, mainly due to low compliance. Food fortification with iron is considered a viable alternative, and the provision of double fortified salt (DFS, with iron and iodine) has been mandated in public health programs. Limited evidence ex...
Article
Pulses (also known as legumes) are important in achieving nutrient adequacy in India due to their quality protein content. This study compared district-level pulse production and consumption across India, and household and district-level determinants of pulse intake, including availability, accessibility and affordability, using multi-level models...
Article
Background Dietary guidelines recommend limiting red meat intake because it is a major source of medium- and long-chain SFAs and is presumed to increase the risk of cardiovascular disease (CVD). Evidence of an association between unprocessed red meat intake and CVD is inconsistent. Objective The study aimed to assess the association of unprocessed...
Article
Importance Cohort studies report inconsistent associations between fish consumption, a major source of long-chain ω-3 fatty acids, and risk of cardiovascular disease (CVD) and mortality. Whether the associations vary between those with and those without vascular disease is unknown. Objective To examine whether the associations of fish consumption...
Article
Background Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population. Methods This analysis includes 137,851 part...
Article
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Objective To evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study. Design Prospective cohort study. Setting PURE study in 21 countries. Participants 148 858 participants w...
Article
Objective This study examined the association between predominant vegetable oil consumed and body mass index of adult women and men in India, with emphasis on predominant consumption of mustard oil. Design Two nationally representative data, the consumer expenditure survey of National Sample Survey Office (NSSO) -68th round (2011-2012) for food co...
Article
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Dietary patterns and their association with general and central obesity among adult women were studied using a cross-sectional survey with multistage cluster sampling in urban and rural areas nationwide in Botswana. The participants in the study were adult women (N = 1019), 18-75 years old. The dietary patterns were identified using principal compo...
Article
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Objective: Previous prospective studies on the association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study. Research...
Article
Objectives Promoting micronutrient-rich diverse diets through quality foods in the population entails a deep-dive analysis into what people eat, why they eat it and where it came from; a study in Bihar state of India explored agricultural-nutrition linkages to improve local availability and market accessibility of quality foods (egg, chicken, pulse...
Article
Objectives Vitamin A requirements in early infancy are met only by breast milk intake. It is critical to ensure adequate breast milk vitamin A levels which also helps develop liver stores. The objective of the study was to evaluate the effect of a maternal food-based intervention on breast milk vitamin A content Methods Pregnant women (n = 50; 24...
Article
Background: The association of nuts with cardiovascular disease and deaths has been investigated mostly in Europe, the USA, and East Asia, with few data available from other regions of the world or from low- and middle-income countries. Objective: To assess the association of nuts with mortality and cardiovascular disease (CVD). Methods: The P...
Article
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Background: Eggs are a rich source of essential nutrients, but they are also a source of dietary cholesterol. Therefore, some guidelines recommend limiting egg consumption. However, there is contradictory evidence on the impact of eggs on diseases, largely based on studies conducted in high-income countries. Objectives: Our aim was to assess the...
Article
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Background and objectives: The efficacy of nutrient interventions to prevent/reverse stunting is considered to be restricted to early life. Whether such interventions are equally effective in later childhood is not clear. The present study evaluated the effect of a food-based high-quality protein and micronutrient intervention on the linear growth...
Article
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Background and Objectives: The efficacy of nutrient interventions to prevent/reverse stunting is considered to be restricted to early life. Whether such interventions are equally effective in later childhood is not clear. The present study evaluated the effect of a food-based high-quality protein and micronutrient intervention on the linear growth...
Article
OBJECTIVE To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults. DESIGN International prospective cohort study. SETTING 18...
Article
Introduction: Diet and South Asian ethnicity are both associated with early onset of cardiovascular risk factors. Among youth of South Asian origin, little is known about the role of culture in determining healthy dietary patterns. We aimed to assess dietary patterns and their relationships with acculturation to Western and traditional lifestyles...
Article
Millets can play a role in providing nutrition security as they are rich in various macro and micronutrients, and can help to fight various non-communicable diseases. Hence, a suggestion was made to include them in the basket of goods provided through the public distribution system. The findings of this article suggest that, with the present level...
Article
Objectives: Economic analyses add value beyond evidence to the implementation of any policy. The study explored the association between iron deficiency anemia (IDA) and the wages of adult men and women between 15- 49 years in India so that the possible monetary benefits of iron fortification policies could be evaluated. Methods: National sample...
Article
Indian diets and national subsidy programmes are biased towards cereals, offering only limited quality protein. Promoting appropriate levels of production and consumption of high quality foods rich in protein is critical in India's attempts to enhance diet quality and resolve stubbornly high levels of undernutrition. Using nationally representative...
Article
Background: Anemia prevalence in India remains high despite preventive iron supplementation programs. Consequently, concurrent national policies of iron fortification of staple foods have been initiated. Objectives: This study evaluated the relation between dietary iron intake and anemia (hemoglobin <12 g/dL) in women of reproductive age (WRA; 1...
Article
Full-text available
Objective To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults. Design International prospective cohort study. Setting 1...
Article
Full-text available
Anaemia prevalence in pregnant women of India declined from 57.9% to 50.3% from National Family Health Survey (NFHS)-3 to NFHS-4. However, over the course of that decade, the uptake of iron and folic acid (IFA) supplementation for 100 days of pregnancy improved by only 15%. To understand demand side risk factors of anaemia specifically related to I...
Article
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The daily energy requirements are now based on replacing the measured daily energy expenditure (WHO/FAO/UNU 1985). When energy expenditure is equal to energy intake, energy balance is achieved, and is best indicated by weight stability. The specific energy requirement (expenditure) of a population is calculated using a factorial method that is base...
Article
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Recent National Family Health Survey-4 data shows that anaemia continues to be a major public health problem in India. In India much of the anaemia is due to iron deficiency, and women and children are at the greatest risk of anaemia. TheMinistry of Health and Family Welfare took a policy decision, in 2013, to develop the National Iron+ Initiative...
Article
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Although functional impairment begins with iron deficiency in the absence of anaemia, the development of anaemia heralds a homeostatic dysfunction that impairs daily activity. Iron deficiency anaemia is often the reason for poor physical performance, maternal and child morbidity and referral to a healthcare professional. (1) Women in their reproduc...
Article
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The prevalence of anemia in India is still unacceptably high at 53.1 % in non-pregnant women, 50.3% in pregnant women, 58.4% in children 6 months and 22.7% in adult men(1) and remains a major public health problem. For screening, tracking as well as monitoring the progress of anemia in both in primary and community health care for public health pro...
Article
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Introduction Social capital, characterised by trust, reciprocity and cooperation, is positively associated with a number of health outcomes. We test the hypothesis that among hypertensive individuals, those with greater social capital are more likely to have their hypertension detected, treated and controlled. Methods Cross-sectional data from 21...
Article
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Background: The association between intake of fruits, vegetables, and legumes with cardiovascular disease and deaths has been investigated extensively in Europe, the USA, Japan, and China, but little or no data are available from the Middle East, South America, Africa, or south Asia. Methods: We did a prospective cohort study (Prospective Urban Rur...
Article
Background The relation between dietary nutrients and cardiovascular disease risk markers in many regions worldwide is unknown. In this study, we investigated the effect of dietary nutrients on blood lipids and blood pressure, two of the most important risk factors for cardiovascular disease, in low-income, middle-income, and high-income countries.
Article
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Background: The relation between dietary nutrients and cardiovascular disease risk markers in many regions worldwide is unknown. In this study, we investigated the effect of dietary nutrients on blood lipids and blood pressure, two of the most important risk factors for cardiovascular disease, in low-income, middle-income, and high-income countries...
Article
Background: Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational. We examined whether different amounts and types of physical...
Article
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Background: The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear. Methods: The Prospective Urban Rural Epidemiology (PURE) study is a larg...
Article
Background: The association between intake of fruits, vegetables, and legumes with cardiovascular disease and deaths has been investigated extensively in Europe, the USA, Japan, and China, but little or no data are available from the Middle East, South America, Africa, or south Asia. Methods: We did a prospective cohort study (Prospective Urban...
Article
Full-text available
Background: The relation between dietary nutrients and cardiovascular disease risk markers in many regions worldwide is unknown. In this study, we investigated the effect of dietary nutrients on blood lipids and blood pressure, two of the most important risk factors for cardiovascular disease, in low-income, middle-income, and high-income countrie...
Article
Introduction: Dietary patterns have contributed to the rising prevalence of overweight and obesity among Indian adolescents. Yet there are limited studies on their perspectives on healthy eating. The purpose of this study was to understand perceptions and attitudes of Indian-origin adolescents in India and Canada that may contribute to healthy eat...
Article
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Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region. Methods: This substudy of the international, community-b...
Article
Anthropometry involves the external measurement of morphologic traits of human beings. High quality anthropometric measurements are fundamental to clinical and epidemiological research. The measurements for each method have inherent variations, either due to biologic variation or due to error in measurement. Errors in measurement cannot be avoided...
Article
Background: Reduced muscular strength, as measured by grip strength, has been associated with an increased risk of all-cause and cardiovascular mortality. Grip strength is appealing as a simple, quick, and inexpensive means of stratifying an individual's risk of cardiovascular death. However, the prognostic value of grip strength with respect to t...
Article
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Food packages were objectively assessed to explore differences in nutrition labelling, selected promotional marketing techniques and health and nutrition claims between countries, in comparison to national regulations. Cross-sectional. Chip and sweet biscuit packages were collected from sixteen countries at different levels of economic development...
Article
This review examines the effect of B vitamins on women and child health from recent evidence available. Findings were related to functional outcomes. In terms of foetal growth, although supplementation with B12 increased B12 status of nonpregnant and pregnant women and infants, maternal plasma homocysteine, which is related to multiple deficiencies...
Article
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Background Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparabilit...
Article
Purpose – The purpose of this paper is to investigate the behaviors of India’s information technology (IT) and business process outsourcing (BPO) employees in relation to diet, exercise, sleep, stress, and social habits. Design/methodology/approach – This was a qualitative research study, using in-depth, semi-structured interviews. Descriptive dat...
Article
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Background More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. Methods We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk...
Article
Full-text available
Background: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. Methods: We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular ri...
Article
Objectives: To understand perceived benefits, facilitators, disadvantages and barriers for physical activity amongst South Asian adolescents in India and Canada. Methods: 13 focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canad...
Article
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To examine the patterns of weight loss behaviour and the association between weight loss attempts with actual weight status and children's and parental perceptions of weight status. A cross-sectional study. Karnataka, South India. 1874 girls and boys aged 8-14 years from seven schools in Karnataka, South India. The association between weight loss a...
Article
Several micronutrient deficiencies affect functional, particularly cognition and physical performance of children. Identifying and preventing sub-clinical deficiencies may be important so that adverse effects on functional performance by these deficiencies, particularly of iron and the B vitamins, are prevented. There is also the potential for chil...
Article
Background/objectives: Although there are some studies on familial clustering of metabolic risk factors, there are few on clustering of diet and physical activity. The aim of this study was to identify the extent of familial clustering of weight status, diet and physical activity in urban and rural families in South India. Subjects/methods: Anth...
Article
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Background Public health research has turned towards examining upstream, community-level determinants of cardiovascular disease risk factors. Objective measures of the environment, such as those derived from direct observation, and perception-based measures by residents have both been associated with health behaviours. However, current methods are...
Data
Full-text available
Community-level item-factor loadings from the multilevel factor analysis models for thirteen scales measuring characteristics of the community environment potentially related to cardiovascular disease (CVD) derived from individual responses to questionnaire items in the EPOCH 2 survey done in 84 urban and rural communities in 5 countries. (PDF)
Article
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Background Food Frequency Questionnaires (FFQs) are commonly used in epidemiologic studies to assess long-term nutritional exposure. Because of wide variations in dietary habits in different countries, a FFQ must be developed to suit the specific population. Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emergi...
Data
Full-text available
Figure S1. Example of a food photograph (200gms of rice).
Article
The food frequency questionnaire (FFQ) was validated against multiple 24-hour dietary recalls (24-HDRs) and for a few blood biomarkers in 154 pregnant women at the obstetrics and gynecology department of St John's Medical College Hospital, Bangalore, India. Absolute nutrient intakes from the FFQ correlated positively with the average 24-HDR during...
Article
Full-text available
Indian diets derive almost 60 % of their protein from cereals with relatively low digestibility and quality. There have been several surveys of diets and protein intakes in India by the National Nutrition Monitoring Board (NNMB) over the last 25 years, in urban and rural, as well as in slum dwellers and tribal populations. Data of disadvantaged pop...
Article
Establishing the relationship between childhood physical inactivity and noncommunicable disease (NCD) is difficult, since chronic disease and mortality are not direct health outcomes of physical inactivity in children. Published literature explores the relationship of physical inactivity with appearance of early childhood disease risk markers, the...
Article
Full-text available
Objective: To evaluate the current and ideal body weight perceptions of schoolchildren in relation to their actual body weight and socio-economic status (SES). Design: Baseline evaluation of schoolchildren from January 2008 to April 2008 as part of a 3-year longitudinal study. Setting: City and non-city locations, Karnataka State, South India....
Article
There are very few studies describing the pattern of physical activity of children in India. This study was carried out to document patterns of physical activity in south Indian school children aged 8 to 15 yr and examine changes over a one year period. Physical activity was assessed using interviewer-administered questionnaires at baseline (n=256)...
Data
Reliability testing by country (0.25 MB DOC)
Data
Full-text available
EPOCH 1 instrument: Version August 21, 2008 (0.04 MB PDF)
Data
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EPOCH 2 instrument: version September 4, 2008 (0.02 MB PDF)
Data
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EPOCH manual: version September 8, 2008 (0.28 MB PDF)
Article
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Background The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions...
Article
Objective To document children's views on healthy eating, perceptions of healthy and unhealthy foods and health consequences of consuming unhealthy foods. Design Baseline data from a three-year longitudinal study. Setting A purposive sample of 307 school children aged 7 to 15 years were recruited from three schools representing various socio-econom...
Article
Full-text available
The dietary patterns and extent of overweight in 307 urban school going children aged 7 to 15 years representing various socio-economic strata was evaluated at baseline of a 3 year longitudinal study. Dietary habits were recorded through interviewer-administered questionnaires. Height and weight were measured and 8.2% of the children were over-weig...
Article
Although several prediction equations to evaluate peak expiratory flow rate (PEFR) of Indian children are available in literature, clinicians and researchers need to make a logical choice of which equation to use as reference. The aim was to demonstrate a practical approach to making such a logical choice by using prediction equations on our study...

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