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Amid rising packaged food consumption in India and its associated health risks - including obesity and non-communicable diseases - this scoping review synthesised India-specific evidence on consumer awareness, comprehension, and behavioural responses to food labels on pre-packaged products. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and Arksey and O'Malley framework, five databases (PubMed, Scopus, Embase, Web of Science, and CINAHL) and Google Scholar were searched for peer-reviewed primary studies conducted in India between 2014 and 2024. Studies were included if they assessed food label literacy, interpretation, or use in purchase behaviour in Indian settings. Thirty-two studies were included, covering diverse populations and geographic settings. Bibliometric synthesis showed a predominance of cross-sectional knowledge, attitudes, and practices studies, with limited experimental or multidisciplinary research. Findings were organised into three analytical themes: a) determinants of food label literacy, including socio-demographic and cognitive factors; b) consumer perceptions of label components, their placement on packaging, visual appeal, and cognitive utility; and c) behavioural implications of label engagement and its perceived influence on purchase intentions. Evidence from this review highlights persistent gaps between label awareness, engagement, and purchase intentions. To inform policy and practice - and to advance Sustainable Development Goal 3 (Target 3.4 - reducing premature mortality from non-communicable diseases) & Goal 12 (Target 12.8 - promoting awareness and information access) - future research should prioritise experimental and implementation-focused designs tailored to India's demographic, cultural, and market heterogeneity.

Introduction: India is facing a dual burden of malnutrition with high prevalence of underweight and increasing prevalence of overweight/obesity. Methodology: This study reports anthropometric findings (body mass index, waist circumference [WC], and waist-hip ratio [WHR]) from the screening of 3296 students admitted during 2018-2019. Results: Majority of the students were male (70%), with a mean age of 18.57 years. About 31% and 19% of students were underweight and overweight, respectively. Given sex-specific cutoffs for WC and WHR, about 5% and 21% of students were at substantially increased risk of metabolic complications. About 14.5% of normal and underweight students were also found to be at substantially increased risk of metabolic complications. Multivariate analysis found increasing age (odds ratio [OR] = 0.92; 95% confidence interval [CI]: 0.88-0.98) and being male (OR = 0.74; 95% CI: 0.62-0.88) to be protective factors against underweight. We did not find any statistically significant correlation for overweight, for WHR among males, and WC and WHR among females. Conclusion: It has been noted that the college environment increases the risk of weight gain. Hence, it makes a case to periodically study changes in anthropometric measures through a longitudinal study, and accordingly develop life cycle-based interventions for prevention/management of undernutrition, obesity, and related complications.

Background: The prevalence and pattern of skin diseases are influenced by the overall ecosystem of the region. There is a dearth of research about prevalence, health-care seeking, compliance, and treatment outcome in skin diseases among scheduled tribes. Objectives: The aim of this study is to understand the magnitude of skin diseases in tribal area of Dahod, Gujarat using a simple \"Store and Forward\" technique of teledermatology. Materials and Methods: A cross-sectional study was conducted in 10 randomly selected villages of Dahod and Jhalod blocks of Dahod district of Gujarat during June-August 2017. Trained surveyors visited households randomly in different localities (called Faliya) of each village ensuring representativeness. Survey responses were captured on mobile-based MAGPI portal, and images of skin conditions were capture on smart phones, and de-identified images were transferred over WhatsApp. Results: A total of 781 households were approached in 10 villages and 2214 participants consented. Among them, 549 were identified with suspected skin diseases, but 520 consented for photograph. The skin diseases were more prevalent among males, children, and elderly. Of 520, 44 (8.5%) could not be assess due to poor quality photograph and 35 (6.7%) did not have any clinically significant condition. Thus, of 2214 participants, 441 (20%) had skin diseases, and infections and eczema were major conditions constituting two-third of the skin diseases in the study population. The treatment-seeking behavior and compliance to treatment was poor. Conclusion: Considering the high prevalence of skin diseases in tribal villages of Dahod, Gujarat coupled with limited availability of trained dermatologist, new innovative avenues like teledermatology should be explored.

Background: National family health survey-4 data suggests alarmingly high prevalence of anemia among adult population. Hemoglobinopathies such as thalassemias and structural hemoglobin (Hb) variants are the commonly seen autosomal, recessively inherited, monogenic disorders of Hb production, and pose a significant health burden in India. Premarriage screening for thalassemia would help to prevent such marriage, reduce health and financial burdens. Objectives: To assess the burden of anemia and hemoglobinopathies, among newly admitted college students through a University-level screening program. Methodology: A cross-sectional study was conducted among college students of the University. The study was part of regular health check-up of all new admissions. Sample frame included all the 4197 students who appeared for health screening and were screened for anemia and hemoglobinopathies. Results: Out of 4197 students, 73.2% were male and a total of 19.5%were anemic. Gender-wise prevalence among males and females was 13.6% and 35.7%, respectively. Among anemic, the proportion of mild, moderate, and severe anemia was 69%, 29%, and 2%. Prevalence of typical beta thal minor and sickle cell trait was found to be 2.6% and 1.4%. Conclusions: Anemia and hemoglobinopathies are significant public health challenges. University setup offers a unique opportunity for modeling and pilot testing integrated interventions for screening and management.

IntroductionAtrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India, where AF epidemiology is undefined. AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF. This study aims to describe the epidemiology of AF in Anand District, Gujarat, India, characterise the clinical profile of individuals who are diagnosed with AF and determine the performance of two mobile technologies for community-based AF screening.MethodsThis observational study builds on findings from a previous feasibility study and leverages two novel technologies as well as an existing community health programme to perform door-to-door AF screening for 2000 people from 60 villages of Anand District, Gujarat, India using local health workers. A single-lead ECG and a pulse-based application is used to screen each individual for AF three times over a period of 5 days. Participants with suspected arrhythmias are followed up by study cardiologist who makes final diagnoses. Participants diagnosed with AF are initiated on treatment based on current anticoagulation guidelines and clinical reasoning.Analytical planAge-stratified and sex-stratified prevalence of AF in the Anand District will be calculated for sample and estimated for Anand distribution using survey design weights. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated using a 12-lead ECG interpretation as the gold standard.Ethics and disseminationThis protocol was approved separately by the Institutional Review Board of University of Massachusetts Medical School and the Human Research Ethics Committee at Charutar Arogya Mandal. The findings of this study will be disseminated through peer-reviewed journals and scientific conferences.

BackgroundIntegrated Child Development Services (ICDS) is India's flagship programme for infant and young child health, nutrition and development. Supplementary Nutrition Programme (SNP) is one of the core components of ICDS. Balbhog (Energy Dense Micronutrient Fortified Extruded Blended Food) is provided as Take Home Ration (THR) to children 7 months to 3 years (7 packets to normal weight and 10 packets to severe underweight). Pregnant women, nursing mothers and adolescent girls are given Sukhdi (1 packet of 1 kg/month), Sheera (3 packets of 500 g each) and Upma (2 packets of 500 g each).MethodsWe surveyed 360 mothers in three tribal blocks – Limkheda, Dahod, and Jhalod – of Dahod district, Gujarat. Participants' awareness, receipt and consumption of THR were assessed using a structured, pre-tested questionnaire. Trained surveyors were accompanied by tribal community members to facilitate conversation in local dialect with mothers or caregivers of children 0–24 months of age. Descriptive statistics was used to describe the key findings.FindingsNearly 94% (n=338) mothers did not know how many packets of Balbhog they are entitled for children over 6 months as per ICDS norms. Among those eligible (n=264) for receiving Balbhog, 60.3% (n=159) received less than 7 packets during the past month; 47.3% (n=125) reported they disked the taste and 80% (n=101) fed it to livestock. Only 19% (n=50) of children eventually consumed Balbhog, of which more than 90% (n=46) shared it with other family members.Nearly 94% of mothers were not aware of how many packets of Sukhdi, Sheera and Upma pregnant and nursing of mothers were entitled to. About 76% (n=239) and 87% (n=272) of mothers reported Sukhdi and Sheera to be of good taste, while 63.6% (n=194) reported Upma to be not good in taste. Of 254, 266 and 140 mothers who consumed Sukhdi, Sheera and Upma respectively, only 15% (n=38), 12% (n=32) and 12% (n=17) consumed it exclusively, while the others shared the packets with other family members. Among those who didn't like the taste of Upma, 82% (n=159) used it for cattle feed.No mothers were aware of the self-record section provided in Mamta Card (mother and child health tracking document) for recording monthly THR received under the SNP.Discussion and recommendationsThe first volume of the Evaluation Study on Integrated Child Development Schemes by the Programmed Evaluation Organization reports on complaints about quality and quantity of food provided under SNP. The report mentions wide divergences between official statistics on nutritional status, registered beneficiaries, number (norms) of days food/supplementary nutrition served on the one hand and grassroots reality with regard to these indicators on the other hand.While improving ICDS services requires effective monitoring and supervision, demand generation could also play an important role to push for improved service delivery. Information about various entitlements under ICDS programme shall be made part of routine ANC and PNC counselling by community health workers such as ASHA and Female Health Workers working under the Department of Health. The THR could improve nutrition status of economically disadvantaged tribal populations.The Village Health Sanitation Nutrition committee is independent and can be vested with the authority to conduct periodic investigations to assess distribution of THR to intended beneficiaries. The E-Mamta programme, designed for online tracking of maternal and child health records, should also have provision for tracking receipt of THR by registered beneficiaries. E-Mamta tracking could also help to find out migrant beneficiaries and devise strategies for distribution of THR to such populations from Anganwadi centres near their workplace.In addition, shared consumption of THR by family members also requires behaviour change communication to promote optimum consumption by target beneficiaries, i.e. pregnant/nursing mothers and children over 6 months of age. Medical and non-medical academic institutions could be involved in monitoring and evaluation of THR and SNP on a periodic basis, and in piloting context-specific interventions for improving demand, distribution and utilisation of ICDS services. Grant funding (Indian Council of Medical Research, grant 5/7/1058/2013-RCH) for research but no other competing interests.

Atrial fibrillation (AF), the world's most common arrhythmia, often goes undetected and untreated in low-resource communities, including India, where AF epidemiology is undefined. AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF. This study aims to describe the epidemiology of AF in Anand District, Gujarat, India, characterise the clinical profile of individuals who are diagnosed with AF and determine the performance of two mobile technologies for community-based AF screening. This observational study builds on findings from a previous feasibility study and leverages two novel technologies as well as an existing community health programme to perform door-to-door AF screening for 2000 people from 60 villages of Anand District, Gujarat, India using local health workers. A single-lead ECG and a pulse-based application is used to screen each individual for AF three times over a period of 5 days. Participants with suspected arrhythmias are followed up by study cardiologist who makes final diagnoses. Participants diagnosed with AF are initiated on treatment based on current anticoagulation guidelines and clinical reasoning. Age-stratified and sex-stratified prevalence of AF in the Anand District will be calculated for sample and estimated for Anand distribution using survey design weights. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated using a 12-lead ECG interpretation as the gold standard. This protocol was approved separately by the Institutional Review Board of University of Massachusetts Medical School and the Human Research Ethics Committee at Charutar Arogya Mandal. The findings of this study will be disseminated through peer-reviewed journals and scientific conferences.

Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly. The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor. Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team of trained research coordinators and community health workers enrolled a total of 354 participants aged 50 years and older and screened them at their residences using Alivecor for 2 minutes on 5 consecutive days over a period of 6 weeks beginning June, 2015. Almost two-thirds of study participants were 55 years or older, nearly half were female, one-third did not receive any formal education, and more than one-half were from households earning less than US $2 per day. Twelve participants screened positive for atrial fibrillation yielding a sample prevalence of 5.1% (95% CI 2.7-8.7). Only one participant had persistent atrial fibrillation throughout all of the screenings, and 9 screened positive only once. Our study suggests a prevalence of atrial fibrillation in this Indian region (5.1%) that is markedly higher than has been previously reported in India and similar to the prevalence estimates reported in studies of persons from North America and Europe. Historically low reported burden of atrial fibrillation among individuals from low and middle-income countries may be due to a lack of routine screening. Mobile technologies may help overcome resource limitations for atrial fibrillation screening in underserved and low-resource settings.

Introduction The rising prevalence of overweight and obesity has a direct correlation with increasing prevalence of hypertension, dyslipidaemia, type 2 diabetes, metabolic syndrome (MetS) and cardiovascular diseases. Most of the previous studies have been cross-sectional in nature and have looked at the prevalence of metabolic syndrome. Despite the clinical and public health importance of this phenomenon, not enough work has been carried out so far to study and remedy this situation. The objectives of the proposed study is to develop an innovative user-centred informatics platform that will facilitate delivery of a multifactorial intervention after taking into account user sociodemographics, health behaviour, prior disease state and knowledge attitudes and practices. Objective The objective of the proposed study is to develop an innovative user-centred informatics platform that will facilitate delivery of a multifactorial intervention after taking into account users’ sociodemographics, health behaviour, prior disease state and knowledge, attitudes and behaviour. Methods and analysis A randomised two-group repeated-measures clinical trial design will be used, on 750 subjects from urban, rural and slum areas, in an Indian setting. The study participants will be randomly assigned to either the intervention (computer-based MetS Program, CBMP) or control (printed educational material, PEM) group. Both the groups will undergo screening, learning and evaluation assessments at the time of the visit and at follow-up visits 30, 60 and 90 days after the first visit. Outcomes The outcomes expected in the intervention group include improvement in Mets-related knowledge, adherence to self-care practices, better quality of life and increased satisfaction with medical care. Ethics and dissemination The study has been approved by the Institutional Review Board of Asian Institute of Public Health (IRB#621). The proposed study will also help us assess the usefulness and challenges of technology to disseminate health education among diverse users. Findings will be disseminated through peer-reviewed publications and national and international conference presentations to various stakeholders and local community health leaders. The ClinicalTrials.gov Identifier is NCT01713465.