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________________ mother continue to be major nutritional concerns in India. Although nationwide intervention programmes are in operation over two decades, the situation has not changed greatly. In addition, the Indian population is passing through a nutritional transition and is expected to witness higher prevalences of adult non-communicable diseases such as diabetes, hypertension and coronary heart disease according to the theory of `fetal origin of adult disease'. Clearly, there is a need for examining several issues of nutritional significance for effective planning of interventions. In particular, maternal nutrition and fetal growth relationship, long term effects of early life undernutrition, interactions of prenatal nutritional experiences and postnatal undernutrition are some of the major issues that have been discussed in the present paper with the help of prospective data from various community nutrition studies carried out in the department. self-sufficient in major food grains. Yet undernutrition continues to be major nutritional problem especially in rural populations. While we are in the midst of combating these long-standing problems of undernutrition in children and women, a new situation has arisen. The World Bank has predicted that coronary heart disease will become the leading cause of premature death in India by 2015 and that the maximum number of diabetic patients in the world will be in India (Bulatao and Stephens 1992). Unlike undernutrition, these diseases are less recognized to be associated with poverty. Clearly, the Indian popula- tion is passing through a transition phase where subsis- tence conditions are being replaced by plentiful food but reduced physical work and therefore, an understanding of the changing nutritional scene is critical. life style factors are not likely to explain risks of these adult diseases but are associated with a suboptimal inutero nutritional environment. As a result, several issues of nutritional significance arise. Firstly, it is essential to be unwise to overlook the effect of postnatal under- nutrition on adult health as it may amplify these risks determined inutero. Thirdly, the interactive effects of inutero undernutrition and postnatal undernutrition may even be more important than considering either factor in isolation. These issues are being discussed worldwide in view of their implications and have high relevance for us, especially for formulating effective interventions for improving the nutritional status of our populations. We have conducted longitudinal community nutrition studies on maternal nutrition and fetal growth, nutritional status of pre-school children and adolescent growth in rural populations around Pune and would like to report factual data and results from these studies in the light of the above issues and discuss strategies for achieving better health of our people. (LBW) (< 2 |
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