Background: The National Healthcare Safety Network (NHSN) provides detailed surveillance case definitions for healthcare-associated infections (HAI), including central line-associated bloodstream infections (CLABSI). CLABSI data are used for several purposes, including improving patient safety, value-based purchasing, and comparing hospitals’ performance. Our Infection Prevention (IP) team conducts house-wide HAI surveillance. To ensure that our hospital CLABSI reporting is accurate and that staff are implementing case definitions consistently and systematically, we conducted an internal validation of CLABSI. This undertaking allowed us to identify educational opportunities for IPs and improve surveillance data consistency. Methods: At UNC Hospitals, data on all positive blood cultures collected in the inpatient setting from July 2022 – June 2023 were obtained from electronic medical records. A random number generator was used to select 16 records per quarter. Each record was then randomly assigned to two different IPs (out of 8 total inpatient IPs) for review. Concordance of CLABSI classification was summarized across the two reviews and compared to the initial review. Discordant cases were then reviewed by the Associate IP Director (a certified IP with 15 years of experience) for final adjudication. A summary of findings and discordant cases details were discussed at regular IP educational meetings. Results: From July 2022-June 2023, there were 1658 positive blood cultures collected in the inpatient setting. Of the 64 randomly selected blood cultures, total concordance amongst all reviewers occurred 65.6% of the time. Concordance improved in the 2nd half of FY23 compared to the 1st half (72% vs, 59%, p>0.05). Amongst the 33% of blood culture results with reviewer discrepancy, the most common reasons were related to distinction of a bloodstream infection secondary to another infection site (32%) and application of the repeat infection timeframe (18%). Importantly, there was only one instance where a blood culture result was categorized by all 3 reviewers as present on admission, but upon Associate Director review, actually represented a CLABSI (i.e., false negative). Conclusions: Standardized case definitions remain open to interpretation. At our hospital, we experienced discordance in approximately one-third of instances during review of blood culture data amongst trained infection preventionists. Reviewing all blood culture data is key for validation so that both false positives and false negative CLABSIs can be identified. Identifying the most common reasons for discordance and using specific examples when case disagreement occurred for educational purposes may lead to improved reliability and accuracy of application of the NHSN surveillance defintions.

Background: The COVID-19 pandemic required an increased reliance on and utilization of the inpatient nursing workforce. We aim to examine the psychological safety of U.S. inpatient acute care nurses in the two years following the onset of COVID-19. Method: Participants were recruited for participation across two major metropolitan medical centers in the tristate area, six units per site (12 total). Anonymous Qualtrics survey invitations were distributed through work listservs in the first halves of 2022 and 2023. The invitation was open to registered nurses who provided at least 16 hours/week of direct patient care for at least six months at the hospital. The survey was open for 4-6 weeks, with reminders sent every other week. Nurses were offered a $25 gift card the firs year and $35 the second. Nurses were asked to rate how frequently they experience seven conditions indicative of psychological safety in their work environment from 1 = “Never” to 5 = “Always”. Two items were reverse coded in analysis as the prompts were negatively phrased. Blank and ineligible responses were excluded from the analytic sample. As response distributions were skewed, Wilcoxon rank-sum tests were used to analyze differences between years (alpha = 0.5). Blank and ineligible responses were excluded from the final analytic sample. Result: We achieved an overall response rate of 52% for each survey year (n=258 Year 1, n=221 Year 2). Psychological safety was found to be low overall for both years, but lowest for Year 1 (3.5 vs. 3.7, p=0.0132). The highest rated condition in both years was “When a medical error occurs at this hospital, health care workers are encouraged to discuss mistakes in order to learn how to prevent similar future errors” (4.0 Year 1 vs. 4.2 Year 2, p=0.0054). The lowest rated condition changed across years. For Year 1, “At this hospital, people are too busy to invest time in improvement” (reverse coded) received the lowest rating at 3.1 (vs. 3.3 in Year 2, p=0.0685). For Year 2, “If you make a mistake at this hospital, it is often held against you” became the lowest rating at 2.9 (vs. 3.4 year 1, <.0001). A summary of the psychological safety conditions is presented in Figure 1. Conclusion: Nurses in our study reported low psychological safety during the end of the COVID-19 pandemic. This has implications for overall patient safety and for nursing staff retention in acute care units.

Background: Candida auris (CA) is an urgent threat per Centers for Disease Control and Prevention with rapidly increasing cases across the US. Patient rooms recontaminate with CA within hours after daily cleaning due to skin shedding, persistence on environmental surfaces and resistance to commonly used disinfectants. Continuous dry hydrogen peroxide (cDHP) is a novel environmental technology augmenting daily room disinfection. cDHP reduces CA organism counts based on environmental cultures. Adenosine triphosphatase (ATPase) testing offers rapid results to monitor surface cleanliness. ATPase Testing Protocol: Upon identification of CA, cDHP was activated in the patient’s room. ATPase surface testing was performed in rooms of CA infected inpatients and nearby control rooms of inpatients without CA and thus no cDHP. Group A surfaces near the patient were nurse call handheld devices and/or bed rail. Group B surfaces were horizontal counter and/or computer keyboard, located >3 feet away from the patient. ATPase testing was to occur within one hour of daily room disinfection for CA patient Day0 (day of cDHP activation), Day1, Day7 and Day14 and controls. Daily room disinfection using quaternary disinfectants was replaced with EPA Class P chemicals upon CA identification. Nursing spot disinfects with Class P ready to use disinfectant wipes in all rooms. Results: Testing occurred among 13 CA and 22 control patients in 5 hospitals. In Table 1, pass rates are displayed by cumulative (Day0+1+7+14) test days for surfaces and patient room groups. Analysis applied Pearson’s Chi-squared test with Yates’ continuity correction. Conclusions: Surfaces further from the patient in rooms of CA patients exposed to cDHP had higher ATPase pass rates than controls. Surfaces close to the patient have a high ATPase failure rate, regardless of CA or cDHP. Strategies are needed to ensure disinfection occurs on high touch surfaces near patients. cDHP may have value in supplementing room disinfection. Contributing failure factors include surfaces missed for disinfection, delays in timely testing and known limitations with ATPase methods.

The aviation industry has rapidly developed in recent years. Due to the increased number of flight operations, managing air traffic has become essential. The air traffic management system aims to reduce the air traffic control workload and use existing resources more efficiently. This study proposed a new mixed integer linear programming model to minimise the total fuel consumption during taxi operations for the runway assignment problem, comparing the actual Istanbul Airport runway assignment data. The average taxi times are calculated using the 30,000-flight operations data for each arrival and departure taxi route. Also, 47 different aircraft types are obtained using the data for the fuel consumption calculation. The International Civil. Aviation Organisation (IACO) aircraft engine emissions databank provides the fuel consumption values for each aircraft according to engine type. This approach allows our model to calculate more realistic fuel consumption for taxi operations, as each aircraft engine type has a different fuel consumption value. The proposed model is implemented at Istanbul Airport, the busiest airport in Turkey, where multiple parallel runway operations are applied. The results showed that the proposed model reduced total fuel consumption for taxi operations between 6.6% and 14.4% compared to the actual Istanbul Airport runway assignment data.

The occurrence of dyslipidaemia, which is an established risk factor for cardiovascular diseases, has been attributed to multiple factors including genetic and environmental factors. We used a genetic risk score (GRS) to assess the interactions between genetic variants and dietary factors on lipid-related traits in a cross-sectional study of 190 Brazilians (mean age: 21 ± 2 years). Dietary intake was assessed by a trained nutritionist using three 24-h dietary recalls. The high GRS was significantly associated with increased concentration of TAG (beta = 0·10 mg/dl, 95 % CI 0·05–0·16; P < 0·001), LDL-cholesterol (beta = 0·07 mg/dl, 95 % CI 0·04, 0·11; P < 0·0001), total cholesterol (beta = 0·05 mg/dl, 95 % CI: 0·03, 0·07; P < 0·0001) and the ratio of TAG to HDL-cholesterol (beta = 0·09 mg/dl, 95 % CI: 0·03, 0·15; P = 0·002). Significant interactions were found between the high GRS and total fat intake on TAG:HDL-cholesterol ratio (Pinteraction = 0·03) and between the high GRS and SFA intake on TAG:HDL-cholesterol ratio (Pinteraction = 0·03). A high intake of total fat (>31·5 % of energy) and SFA (>8·6 % of energy) was associated with higher TAG:HDL-cholesterol ratio in individuals with the high GRS (beta = 0·14, 95 % CI: 0·06, 0·23; P < 0·001 for total fat intake; beta = 0·13, 95 % CI: 0·05, 0·22; P = 0·003 for SFA intake). Our study provides evidence that the genetic risk of high TAG:HDL-cholesterol ratio might be modulated by dietary fat intake in Brazilians, and these individuals might benefit from limiting their intake of total fat and SFA.

Studies on obesity and risk factors from a life-course perspective among residents in the Tibet Plateau with recent economic growth and increasing obesity are important and urgently needed. The birth cohort in this area provides a unique opportunity to examine the association between maternal dietary practice and neonatal obesity. The study aims to detect the prevalence of obesity among neonates, associated with maternal diet and other factors, supporting life-course strategies for obesity control. A cohort of pregnant women was enrolled in Tibet Plateau and followed till childbirth. Dietary practice during pregnancy was assessed using the Chinese FFQ – Tibet Plateau version, food items and other variables were associated with the risk for obesity of neonates followed by logistic regression, classification and regression trees (CART) and random forest. Of the total 1226 mother–neonate pairs, 40·5 % were Tibetan and 5·4 % of neonates with obesity. Consuming fruits as a protective factor for obesity of neonates with OR (95 % CI) = 0·61 (0·43, 0·87) from logistic regression; as well as OR = 0·20 (0·12, 0·35) for consuming fruits (≥ weekly) from CART. Removing fruit consumption to avoid overshadowing effects of other factors, the following were influential from CART: maternal education (more than middle school, OR = 0·22 (0·13, 0·37)) and consumption of Tibetan food (daily, OR = 3·44 (2·08, 5·69). Obesity among neonates is prevalent in the study population. Promoting healthy diets during pregnancy and strengthening maternal education should be part of the life-course strategies for obesity control.

Red meat and processed meat intake has been linked to increased risk of type 2 diabetes; however, evidence from Asia is limited and inconsistent. We prospectively examined the association of intake of total meat and its subtype with type 2 diabetes in a Japanese working population. Participants were 2709 workers aged 18–78 years who reported no history of diabetes when they responded to a health survey for the first time between 2012 and 2019. Dietary intake was assessed using a validated self-administered diet history questionnaire. The incidence of type 2 diabetes was assessed via annual health checkups from baseline through March 2023. Type 2 diabetes was defined as fasting blood glucose ≥ 126 mg/dl, casual blood glucose ≥ 200 mg/dl, HbA1c ≥ 6·5 %, self-report of diabetes or current use of anti-diabetic drugs. Hazard ratios according to tertile of meat intake were estimated using Cox proportional hazards regression. During 16 119 person-years of follow-up, 135 (5·0 %) workers developed type 2 diabetes. Intakes of total meat, red meat, processed meat and poultry were not associated with risk of type 2 diabetes. After adjustment for covariates, hazard ratios for the highest v. lowest tertile of meat intake were 1·01 (95 % CI 0·63, 1·62) for total meat, 1·02 (95 % CI 0·66, 1·58) for red meat, 0·99 (95 % CI 0·65, 1·49) for processed meat and 1·13 (95 % CI 0·71, 1·80) for poultry. Our findings suggest that meat intake is not associated with the risk of type 2 diabetes among Japanese workers.

Diet is a contributing factor to CVD risk, but how diet quality changes over the long term and contributes to CVD risk is less well studied. Diet data were analysed from parents and offspring from the Princeton Lipid Research Study (24-h recall in the 1970s; Block FFQ in 1998). Diet quality was assessed using an 8-point Dietary Approaches to Stop Hypertension nutrient-based scoring index, including a new method for scoring in children, as well as examining twelve key macro/micronutrients. Outcomes included blood glucose, blood pressure, serum lipids and BMI. The analysis included 221 parents (39 % male, mean age 38·9 ± 6·5 at baseline and 66·6 ± 6·6 at follow-up) and 606 offspring (45 % male, 11·9 ± 3·2 at baseline and 38·5 ± 3·6 at follow-up). Parents’ Dietary Approaches to Stop Hypertension score increased slightly from baseline to follow-up (1·4 ± 1·0 and 2·1 ± 1·3, respectively, P < 0·001), while offspring remained consistent (1·6 ± 0·9 and 1·6 ± 1·1, respectively, P = 0·58). Overall, the Dietary Approaches to Stop Hypertension score, adjusted for age, race, sex and BMI, was not significantly associated with any examined outcomes. Of the macro/micronutrients at follow-up, saturated and total fat were associated with increased diabetes and dyslipidaemia in parents, while the inverse was seen with niacin. Among offspring, niacin was associated with lower rates of hypertension and dyslipidaemia. In conclusion, no relationship was detected between Dietary Approaches to Stop Hypertension adherence and disease outcomes. However, both saturated fat and niacin were associated with components of CVD risk, highlighting the need for improved diet quality overall.

Adopting policies that promote health for the entire biosphere (One Health) requires human societies to transition towards a more sustainable food supply as well as to deepen the understanding of the metabolic and health effects of evolving food habits. At the same time, life sciences are experiencing rapid and groundbreaking technological developments, in particular in laboratory analytics and biocomputing, placing nutrition research in an unprecedented position to produce knowledge that can be translated into practice in line with One Health policies. In this dynamic context, nutrition research needs to be strategically organised to respond to these societal expectations. One key element of this strategy is to integrate precision nutrition into epidemiological research. This position article therefore reviews the recent developments in nutrition research and proposes how they could be integrated into cohort studies, with a focus on the Swiss research landscape specifically.

Iron (Fe) deficiency anaemia is a public health concern among adolescent girls worldwide. Food-to-food fortification may be a sustainable and effective solution to Fe deficiency anaemia. However, the effect of food-to-food fortification on Fe deficiency anaemia reduction is understudied particularly in Ghana. This study seeks to investigate the efficacy of baobab pulp-fortified pearl millet beverage powder in improving the Fe and anaemia status of adolescent girls in Ghana. A three-arm cluster randomised controlled trial design, which will involve 258 anaemic adolescent girls (86/arm) selected through multi-stage cluster sampling in Kumbungu District of Ghana, will be used. Participants in arm 1 will receive 350 ml of baobab pulp-fortified pearl millet beverage, containing 13 mgFe (96 % of average RDA), 18·8 mg vitamin C (30·4 % of average RDA) and 222·1 mg citric acid, while participants in arm 2 will receive similar volume of unfortified pearl millet beverage, once a day, five times a week, for six months. Participants in arm 3 will receive the routine weekly Fe (60 mg)-folate (400 μg) supplementation for six months. Serum ferritin, C-reactive protein and haemoglobin (Hb) of participants will be assessed at baseline and end-line. The primary outcomes will be serum ferritin and Hb concentrations. Secondary outcomes will be prevalence of Fe deficiency, Fe deficiency anaemia and BMI-for-age. One-way ANOVA and paired t test will be used to compare means of serum ferritin and Hb levels among and within groups, respectively. This study will provide novel concrete evidence on the efficacy of pearl millet-baobab pulp beverage powder in improving Fe and anaemia status of adolescent girls.

Amino acids (AA) are essential nutrients in human milk (HM) and critical for infant growth and development. Several maternal lifestyle factors have been suggested to influence HM AA composition, with possible consequences for the breastfed infant. Whether maternal dietary protein and AA intake is associated with AA concentrations in HM is still largely unknown. Therefore, the aim of this study was to investigate the association between maternal dietary AA intake and AA concentrations in HM over the first month postpartum. Data from the observational longitudinal Amsterdam Mother’s Milk study were used, consisting of 123 lactating women in their first postpartum month. HM samples were collected three times, on day 10, 17 and 24 postpartum. Maternal dietary protein and AA intake on these collection days was assessed using three 24-h recalls. HM protein-bound and free AA (BAA and FAA, respectively) were analysed by liquid chromatography. Associations between maternal AA intake and AA concentrations in HM were assessed using linear mixed models. Maternal intake was negatively associated with milk concentrations of free arginine (–0·0003; P = 0·01) and free lysine (–0·0004; P = 0·03) and was positively associated with free glutamine (0·002; P = 0·03) and free threonine (0·0008; P = 0·03). However, these associations were attenuated after correction for multiple testing. Both the quality and quantity of dietary protein intake in lactating women do not seem to influence the amino composition of their breast milk when living in an affluent environment.

Patients with type 2 diabetes have increased risks for dyslipidaemia and subsequently for developing vascular complications. A recent meta-analysis found that cetoleic acid (C22:1n-11) rich fish oils resulted in lower cholesterol concentration in rodents. The aim was to investigate the effect of consuming fish oils with or without cetoleic acid on serum cholesterol concentration in diabetic rats and to elucidate any effects on cholesterol metabolism. Eighteen male Zucker Diabetic Sprague Dawley rats were fed diets containing herring oil (HERO) or anchovy oil (ANCO) or a control diet with soyabean oil for 5 weeks. The HERO diet contained 0·70 % cetoleic acid, with no cetoleic acid in the ANCO diet. The HERO and ANCO diets contained 0·35 and 0·37 wt% EPA + DHA, respectively. Data were analysed using one-way ANOVA. The serum total cholesterol concentration was 14 % lower in the HERO group compared with ANCO and Control groups (P = 0·023). The HERO group had a higher faecal excretion of bile acids (P = 0·0036), but the cholesterol production in the liver, the hepatic secretion of VLDL and the liver’s capacity to take up cholesterol were similar to controls. The ANCO diet did not affect the serum cholesterol concentration, but the hepatic cholesterol biosynthesis, the clearance of lipoprotein cholesterol and the excretion of bile acids in faeces were higher than in the Control group. To conclude, consumption of herring oil, but not of anchovy oil, led to a lower cholesterol concentration in a type 2 diabetes rat model.

Disordered eating (DE) is associated with elevated cardiometabolic risk (CMR) factors, yet little is known about this association in non-Western countries. We examined the association between DE characteristics and CMR and tested the potential mediating role of BMI. This cross-sectional study included 2005 Chinese women (aged 18–50 years) from the 2015 China Health and Nutrition Survey. Loss of control, restraint, shape concern and weight concern were assessed using selected questions from the SCOFF questionnaire and the Eating Disorder Examination-Questionnaire. Eight CMR were measured by trained staff. Generalised linear models examined associations between DE characteristics with CMR accounting for dependencies between individuals in the same household. We tested whether BMI potentially mediated significant associations using structural equation modelling. Shape concern was associated with systolic blood pressure (β (95 % CI) 0·06 (0·01, 0·10)), diastolic blood pressure (DBP) (0·07 (95 % CI 0·03, 0·11)) and high-density lipoprotein (HDL)-cholesterol (–0·08 (95 % CI –0·12, −0·04)). Weight concern was associated with DBP (0·06 (95 % CI 0·02, 0·10)), triglyceride (0·06 (95 % CI 0·02, 0·10)) and HDL-cholesterol (–0·10 (95 % CI –0·14, −0·07)). Higher scores on DE characteristics were associated with higher BMI, and higher BMI was further associated with lower HDL-cholesterol and higher other CMR. In summary, we observed significant associations between shape and weight concerns with some CMR in Chinese women, and these associations were potentially partially mediated by BMI. Our findings suggest that prevention and intervention strategies focusing on addressing DE could potentially help reduce the burden of CMR in China, possibly through controlling BMI.

The study aimed to describe trajectories of free sugar (FS) intake, its main sources and the associations with socio-economic status (SES) in Portuguese children/adolescents evaluated at 4, 7, 10 and 13 years of age from Generation XXI birth-cohort. Dietary intake was assessed through 3-day food diaries (n 5268). Added sugar intake was estimated following a systematic methodology, and FS was based on the WHO definition. A mixed-effects model with linear and quadratic terms for time was used to estimate FS trajectories and its association with SES, adjusting for children’s sex, age, BMI and SES. The FS mean intake (g/day) was 37, 47, 51 and 48 at 4, 7, 10 and 13 years, respectively. FS intake increased 4·6 g/year (CI 95 %: 4·20, 5·04), but velocity decreased by 0·3 g/year2 until 13 years. At all ages, the main food source was sweets. Some item’s consumption declined (sweets 25–21 % and yoghurts 22–7 %) as children grew older. Inversely, soft drink intake increased (9–18 %). Boys and children from younger mothers had higher FS intake, whereas higher maternal–SES was associated with lower children’s FS intake: occupational status (β = –3·5; 95 % CI: –4·97, –1·94), years of education (β = –3·7; 95 % CI: –4·93, –2·40) and household income (β = –4·9; 95 % CI: –6·50, –3·27). The FS trajectories were similar by SES categories but different by obesity status (interaction term β = –1·04; CI 95 % (–1·50, –0·59)). An increasing FS trajectory during childhood is mainly driven by an increasing intake of soft drinks and nectars. The FS trajectory pattern did not change according to SES categories, but children’s FS intake was always higher when their mothers had a lower SES.

The impact of computed tomography-defined sarcopenia on outcomes in head and neck cancer has been well described. Sarcopenic obesity (SO) (depleted muscle mass combined with obesity) may pose a more serious risk than either condition alone. We investigated SO and its impact on survival and critical weight loss (≥ 5 %) in patients with head and neck cancer who received curative radiotherapy (± other modalities). Retrospective analysis of computed tomography cross-sectional muscle at cervical (C3), thoracic (T2) and lumbar (L3) regions was conducted. Patients were grouped by BMI and sarcopenia status based on established thresholds. A total of 413 patients were included for analysis, the majority having oropharyngeal carcinoma (52 %), and 56 % received primary concurrent chemoradiotherapy. The majority of the cohort (65 %) was overweight or obese (BMI ≥ 25 kg/m2). Sarcopenia was found in 43 %, with 65 % having SO (n 116), equating to 28 % of the whole cohort. Critical weight loss was experienced by 58 % (n 238). A significantly higher proportion of patients with SO experienced critical weight loss (n 70 v. 19, P < 0·001) and were four times more likely to do so during treatment (OR 4·1; 95 % CI 1·5, 7·1; P = 0·002). SO was not found to impact on overall or cancer-specific survival; however, in patients with sarcopenia, those with SO had better overall survival (median 9·1 v. 7·0 years; 95 % CI 5·2, 16·8; P = 0·021). SO at the time of presentation in patients with head and neck cancer is predictive of critical weight loss during treatment, and muscle evaluation can be useful in identifying patients at nutritional risk regardless of BMI and obvious signs of wasting.

Recent studies suggest an association between greater dietary inflammatory index (DII) and higher biological ageing. As α-Klotho has been considered as a longevity protein, we examined whether α-Klotho plays a role in the association between DII and ageing. We included 3054 participants from the National Health and Nutrition Examination Survey. The associations of DII with biological and phenotypic age were assessed by multivariable linear regression, and the mediating role of α-Klotho was evaluated by mediation analyses. Participants’ mean age was 58·0 years (sd 11·0), with a median DII score of 1·85 and interquartile range from 0·44 to 2·79. After adjusting for age, sex, race/ethnicity, BMI, education, marital status, poverty income ratio, serum cotinine, alcohol, physical activity, a higher DII was associated with both older biological age and phenotypic age, with per DII score increment being associated with a 1·01-year increase in biological age (1·01 (95 % CI: 1·005, 1·02)) and 1·01-year increase in phenotypic age (1·01 (1·001, 1·02)). Negative associations of DII with α-Klotho (β = –1·01 pg/ml, 95 % CI: –1·02, –1·006) and α-Klotho with biological age (β= –1·07 years, 95 % CI: –1·13, –1·02) and phenotypic age (β= –1·03 years, 95 % CI: –1·05, –1·01) were found. Furthermore, α-Klotho mediated 10·13 % (P < 0·001) and 9·61 % (P < 0·001) of the association of DII with biological and phenotypic age, respectively. Higher DII was associated with older biological and phenotypic age, and the potential detrimental effects could be partly mediated through α-Klotho.

Childhood overweight is not only an immediate health concern due to its implications but also significantly increases the risk of persistent obesity and consequently CVD in the future, posing a serious threat to public health. The objective of this study was to examine the trends and associated factors of childhood overweight in India, using nationally representative data from three rounds of the National Family Health Survey (NFHS). For the primary analysis, we used data from 199 375 children aged 0–59 months from fifth round of the NFHS (NFHS-5). Overweight was defined as BMI-for-age Z (BMI Z) score > +2 sd above the WHO growth standards median. We compared the prevalence estimates of childhood overweight with third round of the third round of NFHS and fourth round of the NFHS. Potential risk factors were identified through multiple logistic regression analyses. The prevalence of overweight increased from 1·9 % in third round of NFHS to 4·0 % in NFHS-5, a trend seen across most states and union territories, with the Northeast region showing the highest prevalence. The BMI Z-score distributions from the latest two surveys indicated that the increase in overweight was substantially larger than the decrease in underweight. The consistent upward trend in the prevalence across different demographic groups raises important public health concerns. While undernutrition rates have remained relatively stable, there has been a noticeable rise in the incidence of overweight during the same time frame. The increasing trend of overweight among children in India calls for immediate action.