Medical Bulletin 21/November/2025

This shift toward processed foods high in sugars and unhealthy fats, combined with reduced physical activity and limited access to nutrient-rich foods, fosters the rise of non-communicable diseases (NCDs) like obesity, type 2 diabetes, heart disease, and hypertension.

To address this, ICMR has released 17 evidence-based dietary guidelines focused on promoting balanced, nutrient-dense diets. Key recommendations include limiting salt intake, consuming healthy fats from nuts, seeds, and seafood moderatively, minimizing sugars and ultra-processed foods, and paying close attention to food labels. The guidelines discourage regular use of protein supplements due to risks such as kidney damage. Encouraging physical activity alongside good nutrition is emphasized for optimal health. Dietary advice includes ensuring calorie intake is balanced across food groups, with cereals constituting no more than 45% of calories, pulses and meats about 15%, and the remainder from fruits, vegetables, nuts, and dairy.

ICMR’s guidelines represent a logical, sustainable approach to combating malnutrition and chronic diseases by enhancing the availability and affordability of diverse, nutrient-rich foods. With processed food consumption rising, many Indians overly rely on staples like rice and cereals, which limits protein and essential fat intake.

The report is a call to action for individuals to diversify meals with vegetables, fruits, pulses, and nuts while reducing ultra-processed food intake. Families can support healthy habits by prioritizing home-cooked meals rich in nutrients. Policymakers are urged to improve access to nutritious foods to support healthier communities.

Following these guidelines can significantly reduce India's chronic disease burden, improving health outcomes and preventing premature deaths. Healthy eating choices today set a healthier foundation for families and future generations.

REFERENCE: Rupal Manoj Shah, Geetanjali Sachdeva, Uddhav K. Chaudhari; Dietary guidelines across different countries & comparisons to dietary guidelines for Indians, 2024; Indian Journal of Medical Research; 162(1);53-65; doi:10.25259/IJMR_1674_2024

Study shows ketogenic diet effectively improves hormonal balance in PCOS women

A transformative new study offers hope for women with Polycystic Ovary Syndrome (PCOS) struggling with weight, hormonal imbalances, and metabolic challenges. Published in the British Journal of Nutrition, researchers conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) examining the very low-carbohydrate ketogenic diet (VLCKD) and its effects on anthropometric, hormonal, and metabolic outcomes in over 800 women with PCOS across multiple countries.

PCOS affects roughly one in ten women of reproductive age and is closely linked to insulin resistance, weight gain, and chronic low-grade inflammation, resulting in irregular cycles, fertility issues, and enhanced cardiometabolic risks. Since modest weight loss can normalize menstrual function and improve fertility, dietary interventions remain vital but often hard to sustain. VLCKD, which triggers nutritional ketosis and reduces insulin and visceral fat, may offer a practical solution.

Following PRISMA guidelines and a PROSPERO-registered protocol, the team searched global databases for RCTs up to July 2025, selecting studies involving adult women with PCOS on a VLCKD. Outcomes assessed included weight, BMI, waist circumference, fat mass, waist-to-hip ratio, key reproductive hormones (free and total testosterone, SHBG, LH, FSH, LH/FSH ratio), and metabolic markers like fasting glucose, insulin, insulin resistance (HOMA-IR), and lipid profiles.

Meta-analyses using random-effects models revealed significant reductions in body weight (~9.6 kg), waist circumference (~7.7 cm), fat body mass (~7.4 kg), and BMI (~3.5 kg/m²). Hormonal shifts indicated decreased free and total testosterone, lowered LH and LH/FSH ratio, and increased SHBG, which collectively suggest reduced hyperandrogenism and enhanced ovulatory potential. Metabolic control improved with lower fasting glucose and insulin levels and reduced insulin resistance. Triglycerides decreased; however, changes in LDL, HDL, and total cholesterol were inconsistent.

Despite moderate evidence certainty and heterogeneous trial designs — including varied caloric intakes and durations (4 to 24 weeks) — results consistently support VLCKD as an effective dietary approach to alleviate PCOS symptoms and improve cardiometabolic health. However, larger, longer-term studies are necessary to ascertain safety, adherence, and benefits across PCOS phenotypes, as well as direct comparisons with other diets.

This pioneering research charts a promising path for managing PCOS through targeted nutritional ketosis, with potential to improve fertility, metabolic function, and quality of life for millions affected worldwide.

REFERENCE: Tosatti, J. A. G., Magalhães, F. M. V., and Gomes, K. B. (2025). Effects of the very low-carbohydrate ketogenic diet in women with Polycystic Ovary Syndrome: a systematic review with meta-analysis of clinical trials. British Journal of Nutrition. DOI: 10.1017/S0007114525105692 https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effects-of-the-very-lowcarbohydrate-ketogenic-diet-in-women-with-polycystic-ovary-syndrome-a-systematic-review-with-metaanalysis-of-clinical-trials/A99D5670AC6F774E4531D143A4DB6395

Research uncovers new molecular and immune insights into recurrent miscarriage causes

A new study sheds light on a hidden cause of recurrent miscarriage, offering hope for affected couples worldwide. Researchers at the Victor Chang Cardiac Research Institute, University of Sydney, and Royal Hospital for Women investigated whether disturbances in vitamin B3 (niacin) metabolism might explain why some pregnancies end in repeated loss.

Their work, published in Human Reproduction, reveals complex alterations in NAD metabolism in women with recurrent miscarriage, opening new pathways for diagnosis and treatment.

The study analyzed blood, plasma, and urine samples from 88 women, including those with two or more consecutive miscarriages and healthy controls. Using ultra-high performance liquid chromatography paired with tandem mass spectrometry, the team quantified 25 NAD-related metabolites. Sophisticated statistical analyses, including partial least-squares discriminant analysis and machine learning, identified three key metabolites—1-methylnicotinamide (1MNA) and its derivatives—differing significantly between groups. These changes were independent of vitamin B3 supplementation, suggesting fundamental metabolic disruptions. Elevated plasma 1MNA levels correlated with a 2% higher miscarriage risk per unit increase.

Building on earlier discoveries that low NAD levels cause developmental defects in mice, this research reveals a more nuanced picture in humans involving altered vitamin B3 metabolism rather than simple deficiency. The study’s methodological strength lies in its multi-sample design, advanced metabolomic profiling, and robust statistical approach, enhancing confidence in findings despite modest sample size.

With funding secured for a three-year longitudinal follow-up starting in 2026, researchers will explore NAD biomarkers, dietary impacts, and other clinical factors in larger cohorts, including women currently experiencing miscarriages. Ultimately, this work aims to develop predictive tests and targeted interventions to reduce recurrent pregnancy loss, offering tangible hope for families.

This discovery dramatically advances our molecular understanding of miscarriage risk, heralding new precision medicine approaches to protect maternal and fetal health.

REFERENCE: Cuny, H., et al. (2025). Identification of potential NAD-related biomarkers of recurrent miscarriage risk. Human Reproduction. doi: 10.1093/humrep/deaf195. https://academic.oup.com/humrep/advance-article/doi/10.1093/humrep/deaf195/8307317