Biometry and Nutrition Group, Agharkar Research Institute, Pune, India

Correspondence to: S A Chiplonkar, Biometry and Nutrition Group, Agharkar Research Institute, GG Agharkar Road, Pune 411004, India. E-mail: shashi@aripune.ernet.in

Guarantor: SA Chiplonkar.

Contributers: SAC was the principal investigator of the project, participated in data collection, completed data analysis and statistical treatment of the data, and contributed to writing the manuscript. VVA was co-investigator of the projects, participated in data collection, was in charge of biochemical (food, blood) estimations, and contributed to writing the manuscript. SSM and KVT worked as Project Assistants, assisted in the survey and laboratory analysis of food and blood samples.

Objective: To examine interrelationships between (1) dietary habits, (2) socioeconomic and (3) environmental factors, and their impact on plasma retinol and plasma ascorbic acid.

Design: Cross-sectional study on adults from Western India.

Setting: Rural, semi urban, urban higher/middle/lower socioeconomic regions (HSE/MSE/LSE) having diverse dietary habits and environmental conditions.

Subjects: A total of 214 men and 108 women (20-50 y), apparently healthy and non-anemic.

Main outcome measures: Food intake by food frequency questionnaire, weight, height, age, smoking, environmental score, education, income, plasma retinol and plasma ascorbic acid.

Results: Mean plasma retinol in women (24.84±5.1 µg/dl) and men (24.75±4.53 µg/dl) were not significantly different and 21% had plasma retinol below 20 µg/dl. Mean plasma ascorbic acid in women (0.35±0.12 mg/dl) and men (0.30±0.12 mg/dl) was similar with 75% having plasma ascorbic acid below 0.4 mg/dl. Vitamin A intake (as retinol equivalent) and plasma retinol showed a significant dose response (P<0.05) but not vitamin C intake and plasma ascorbic acid. Plasma retinol showed significant correlation with income (=0.24), education (=0.27), and environment (=0.21; =0.0001). Similar correlations with plasma ascorbic acid were 0.29, 031, -0.23 respectively (P=0.0001). Logistic regression showed education, environment, green leafy vegetables (GLV) and milk intake as predictors of plasma retinol deficiency, while non-sweet fruit intake, education and passive smoking for plasma ascorbic acid deficiency (P<0.05).

Conclusions: Subnormal status of retinol and vitamin C emphasizes the need to increase consumption of fruit, GLV and milk products, and also better education and environment. Avoiding passive smoking demands attention in order to improve levels of these vitamins.

Sponsorship: Department of Science and Technology, India (project no. SP/SO/B39/94).

European Journal of Clinical Nutrition (2002) 56, 96-104. DOI: 10.1038/sj/ejcn/1601291

plasma retinol; plasma ascorbic acid; socioeconomic status; fruit/vegetable intake; passive smoking