Background/Objectives: To study the effectiveness of a multi-component intervention model of nutrition and lifestyle education on behavior modification, anthropometry and metabolic risk profile of urban Asian-Indian adolescents in North India. Subjects/Methods: Two schools matched for student strength and middle socioeconomic strata were randomly allocated to intervention and control group. Changes in nutrition-related knowledge, attitude, lifestyle practices, food frequency and body image of eleventh-grade students (15-17 years) in both schools were tested using a validated questionnaire. Anthropometric and biochemical measurements were made using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. Results: At 6 months follow-up, significant improvement in several domains of knowledge was observed in intervention children (n ¼ 99; males ¼ 60; females ¼ 39) as compared with control school children (n ¼ 102; males ¼ 61; females ¼ 41). In the intervention group, significantly lower proportion of children consumed aerated drinks (15.1%; Po0.001) and energy-dense unhealthy foods (8.9%; P ¼ 0.03), whereas significantly higher proportion brought tiffin (packed lunch) to school (14.9%; P ¼ 0.004) and brought a fruit in their tiffin (30.7%; Po0.001) as compared with the control group. Significant decrease in mean waist circumference (P ¼ 0.02, 95% confidence interval (CI) ¼ À2.43,À0.17), sagittal abdominal diameter (Po0.001, 95% CI ¼ À0.82,À0.09), waist-to-hip ratio (P ¼ 0.02, 95% CI ¼ À0.03,À0.004) and fasting blood glucose (P ¼ 0.05, 95% CI ¼ À0.09, 5.00) was seen in intervention as compared with control school children. Conclusions: Multi-component model of nutrition and lifestyle education was successful in improving the nutrition-related knowledge, eating habits and lifestyle practices, and resulted in beneficial changes in anthropometric and biochemical profiles of the Asian Indian adolescents. This model should be applied on countrywide basis to prevent obesity and diabetes.

India is facing an "epidemic" of diet-related non-communicable diseases (DR-NCDs), along with widely prevalent undernutrition resulting in substantial socioeconomic burden. The aim of this paper is to review secular trends in food groups and nutrient intake, and implications for DR-NCDs in India so as to understand optimal choices for healthy diets for the prevention of DR-NCDs. The literature search was carried out in PubMed (National Library of Medicine, Bethesda, MD, USA) and Google Scholar search engines up to April 2011. A manual search for all other references, national and medical databases was also carried out. Nutrition transition over the past 30 years (1973-2004), has resulted in a 7% decrease in energy derived from carbohydrates and a 6% increase in energy derived from fats. A decreasing intake of coarse cereals, pulses, fruits and vegetables, an increasing intake of meat products and salt, coupled with declining levels of physical activity due to rapid urbanization have resulted in escalating levels of obesity, atherogenic dyslipidemia, subclinical inflammation, metabolic syndrome, type 2 diabetes mellitus, and coronary heart disease in Indians. Studies also suggest that adverse perinatal events due to maternal nutritional deprivation may cause low-birth weight infants, which, coupled with early childhood "catch-up growth", leads to obesity in early childhood, thus predisposing to NCDs later in life. In view of rapidly increasingly imbalanced diets, a multisectoral preventive approach is needed to provide balanced diets to pregnant women, children and adults, and to maintain a normal body weight from childhood onwards, to prevent the escalation of DR-NCDs in India.

Developing countries are undergoing rapid nutrition transition concurrent with increases in obesity, the metabolic syndrome, and type 2 diabetes mellitus (T2DM). From a healthy traditional high-fiber, low-fat, low-calorie diet, a shift is occurring toward increasing consumption of calorie-dense foods containing refined carbohydrates, fats, red meats, and low fiber. Data show an increase in the supply of animal fats and increased intake of saturated fatty acid (SFAs) (obtained from coconut oil, palm oil, and ghee [clarified butter]) in many developing countries, particularly in South Asia and South-East Asia. In some South Asian populations, particularly among vegetarians, intake of n-3 polyunsaturated fatty acids (PUFAs) (obtained from flaxseed, mustard, and canola oils) and long-chain (LC) n-3 PUFAs (obtained from fish and fish oils) is low. Further, the effect of supplementation of n-3 PUFAs on metabolic risk factors and insulin resistance, except for demonstrated benefit in terms of decreased triglycerides, needs further investigation among South Asians. Data also show that intake of monounsaturated fatty acids (MUFAs) ranged from 4.7% to 16.4%en in developing countries, and supplementing it from olive, canola, mustard, groundnut, and rice bran oils may reduce metabolic risk. In addition, in some developing countries, intake of n-6 PUFAs (obtained from sunflower, safflower, corn, soybean, and sesame oils) and trans-fatty acids (TFAs) is increasing. These data show imbalanced consumption of fats and oils in developing countries, which may have potentially deleterious metabolic and glycemic consequences, although more research is needed. In view of the rapid rise of T2DM in developing countries, more aggressive public health awareness programs coupled with governmental action and clear country-specific guidelines are required, so as to promote widespread use of healthy oils, thus curbing intake of SFAs and TFAs, and increasing intake of n-3 PUFAs and MUFAs. Such actions would contribute to decelerating further escalation of "epidemics" of obesity, the metabolic syndrome, and T2DM in developing countries.