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1.  Birth size and physical activity in a cohort of Indian children aged 6–10 years 
There is evidence of a reduction in children’s physical activity in India in the last decade. Our objective was to assess whether size and body composition at birth are associated with physical activity in school-aged children. Children from a prospective observational cohort study born in Mysore, South India between 1997 and 1998 (n = 663) had neonatal anthropometric measurements made within 72 h of delivery [weight, mid-upper arm circumference (MUAC), chest, abdomen and head circumference, crown–heel, crown–buttock and leg length, triceps and subscapular skinfolds]. At 6–10 years, children (n = 449) were asked to wear AM7164 or GT1M Actigraph accelerometers for 7 days. Body composition was measured within 6 months of activity monitoring. Arm muscle area at birth and time of activity monitoring was calculated from MUAC and skinfold measurements.
Activity outcome measures were: mean accelerometer counts per minute (cpm); counts per day and proportion of time spent in moderate and vigorous activity. The mean (S.D.) number of days with ≥500 min of recorded accelerometer data was 7.0 (1.1). Linear regression models showed no significant associations between any of the neonatal anthropometric measures and the activity variables. Body fat percentage at 7.5 years was negatively associated with all activity variables (B = −4.69, CI: −7.31, −2.07 for mean cpm).
In conclusion, this study showed no associations between body size and skinfold thickness at birth and objectively measured physical activity in childhood.
PMCID: PMC3790308  PMID: 24098836
accelerometer; activity; birth size; child; India
2.  Childhood Cognitive Ability: Relationship to Gestational Diabetes Mellitus in India 
Diabetologia  2010;53(10):2134-2138.
To test the hypothesis that maternal gestational diabetes mellitus (GDM) is associated with poorer cognitive ability in children born to mothers with GDM compared to children born to non-GDM mothers in India.
During 1997-98 maternal GDM status was assessed at 30±2 weeks of gestation. Between 2007-2008, at a mean age of 9.7 years, 515 children (32-offspring of GDM mothers (ODM’s); 483-offspring of non-GDM mothers (controls)) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for children-second edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, visuo-spatial and verbal abilities.
Compared to controls, ODM’S scored higher in tests for learning, long-term retrieval/storage (p=0.008), reasoning (p=0.02), verbal ability (p=0.01) and attention and concentration (p=0.003). In multiple regression, adjusted for the child’s age, sex, gestation, neonatal weight and head circumference, maternal age, parity, BMI, parent’s socio-economic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (β=0.4SD (95% CI: 0.01, 0.75); p=0.042) and verbal ability (β=0.5SD (95% CI: 0.09, 0.83); p=0.015) and not with other test scores.
In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM’s. In fact some cognitive scores were higher in ODM’s.
PMCID: PMC3428884  PMID: 20614102
Gestational diabetes mellitus; Children; Cognitive function; India
3.  Adiposity, insulin resistance and cardiovascular risk factors in 9–10-year-old Indian children: relationships with birth size and postnatal growth 
Lower birthweight, and rapid childhood weight gain predict elevated cardiovascular risk factors in children. We examined associations between serial, detailed, anthropometric measurements from birth to 9.5 years of age and cardiovascular risk markers in Indian children. Children (n = 663) born at the Holdsworth Memorial Hospital, Mysore, India were measured at birth and 6–12 monthly thereafter. At 9.5 years, 539 (255 boys) underwent a 2-h oral glucose tolerance test, and blood pressure (BP) and fasting lipid concentrations were measured. Insulin resistance was calculated using the HOMA equation. These outcomes were examined in relation to birth measurements and changes in measurements (growth) during infancy (0–2 years), 2–5 years and 5–9.5 years using conditional s.d. scores. Larger current weight, height and skinfold thickness were associated with higher risk markers at 9.5 years (P<0.05). Lower weight, smaller length and mid-arm circumference at birth were associated with higher fasting glucose concentrations at 9.5 years (P≤0.01). After adjusting for current weight/height, there were inverse associations between birthweight and/or length and insulin concentrations, HOMA, systolic and diastolic BP and plasma triglycerides (P<0.05). Increases in conditional weight and height between 0–2, 2–5 and 5–9.5 years were associated with higher insulin concentrations, HOMA and systolic BP. In conclusion, in 9–10-year-old Indian children, as in other studies, cardiovascular risk factors were highest in children who were light or short at birth but heavy or tall at 9 years. Greater infant and childhood weight and height gain were associated with higher risk markers.
PMCID: PMC3272429  PMID: 22318657
birthweight; infancy; insulin resistance; postnatal growth
4.  Association of genetic variation in FTO with risk of obesity and type 2 diabetes with data from 96,551 East and South Asians 
Diabetologia  2011;55(4):981-995.
FTO harbours the strongest known obesity-susceptibility locus in Europeans. While there is growing evidence for a role for FTO in obesity risk in Asians, its association with type 2 diabetes, independently of BMI, remains inconsistent. To test whether there is an association of the FTO locus with obesity and type 2 diabetes, we conducted a meta-analysis of 32 populations including 96,551 East and South Asians.
All studies published on the association between FTO-rs9939609 (or proxy [r2 > 0.98]) and BMI, obesity or type 2 diabetes in East or South Asians were invited. Each study group analysed their data according to a standardised analysis plan. Association with type 2 diabetes was also adjusted for BMI. Random-effects meta-analyses were performed to pool all effect sizes.
The FTO-rs9939609 minor allele increased risk of obesity by 1.25-fold/allele (p = 9.0 × 10−19), overweight by 1.13-fold/allele (p = 1.0 × 10−11) and type 2 diabetes by 1.15-fold/allele (p = 5.5 × 10−8). The association with type 2 diabetes was attenuated after adjustment for BMI (OR 1.10-fold/allele, p = 6.6 × 10−5). The FTO-rs9939609 minor allele increased BMI by 0.26 kg/m2 per allele (p = 2.8 × 10−17), WHR by 0.003/allele (p = 1.2 × 10−6), and body fat percentage by 0.31%/allele (p = 0.0005). Associations were similar using dominant models. While the minor allele is less common in East Asians (12–20%) than South Asians (30–33%), the effect of FTO variation on obesity-related traits and type 2 diabetes was similar in the two populations.
FTO is associated with increased risk of obesity and type 2 diabetes, with effect sizes similar in East and South Asians and similar to those observed in Europeans. Furthermore, FTO is also associated with type 2 diabetes independently of BMI.
Electronic supplementary material
The online version of this article (doi:10.1007/s00125-011-2370-7) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
PMCID: PMC3296006  PMID: 22109280
Asians; FTO; Meta-analysis; Obesity; Type 2 diabetes
5.  FTO Gene Variants are Strongly Associated with Type 2 Diabetes but only weakly with Obesity in South Asian Indians 
Diabetologia  2008;52(2):247-252.
Variants in FTO (fat mass and obesity associated) gene are associated with obesity and type 2 diabetes (T2D) in white Europeans. These associations are not consistent in Asians and there are few reports in South Asian Indians who develop T2D at a much lower body mass index (BMI) than that in the white Europeans.
Aims and hypothesis
We studied the association of FTO variants with T2D and measures of obesity in South Asian Indians in Pune, India.
We genotyped by sequencing, two SNPs rs9939609 and rs7191344, in the FTO gene in 1453 type 2 diabetes patients and 1361 controls and a further 961 population based individuals from India .
We observed a strong association of the minor allele A at rs9939609 with T2D (OR per allele =1.26 [95% CI, 1.13-1.40], P=3×10-5). The variant was also associated with BMI but this association appeared to be weaker (0.06SDs; 95%CIs:0.01-0.10, p=0.017) than the previously reported effect in Europeans (0.10SDs 95%CIs:0.09-0.12). Unlike in the Europeans, the association with T2D remained when adjusting for BMI (OR per allele for T2D=1.21 (95% CI, 1.06-1.37); P=4.0 × 10-3). Similar results were obtained when using waist circumference and other anthropometric parameters.
Our study replicates the strong association of FTO variants with type 2 diabetes in South Asian Indians but suggests that the association of FTO with T2D in them might operate through mechanisms other than obesity. This could imply a fundamental difference between Indians and Europeans in the mechanisms linking body size with T2D.
PMCID: PMC2658005  PMID: 19005641
FTO; type 2 diabetes mellitus; polymorphisms; ethnicity; body mass index

Results 1-5 (5)