BACKGROUND/OBJECTIVES:Improving the diets of women of reproductive age living in Mumbai slums may benefit their own health and that of their children. Our objective was to identify diet patterns in this population group. SUBJECTS/METHODS:Participants were married women (n = 6513) aged <40 years enroled in a randomised controlled trial of a food-based intervention. We collected dietary data at the time of enrolment using a 212-item food frequency questionnaire. We used principal component analysis and cluster analysis to identify dietary patterns and explored socio-demographic correlates of the patterns using multivariate linear regression models. RESULTS:We identified 2 interpretable patterns. The first, named the 'Snack, Fruit and Sweet' pattern was characterised by vegetable curry, fried snacks, salad, fruit, sweets and sweetened beverages and explained 9.3% of the variance. Scores on this pattern were independently associated with the women not working versus being employed (0.13, CI: 0.06, 0.19, p < 0.001) and with standard of living index score (0.03, CI: 0.02, 0.04, p < 0.001). The second pattern was named 'Non-vegetarian' and was characterised by meat and biriyani and rice and noodle dishes, with low intakes of lentils, legumes, nuts and seeds. This pattern was associated with being Muslim and was negatively associated with age (-0.02, CI: -0.03, -0.02, p < 0.001) and standard of living index (-0.01, CI: -0.01, 0.00, p < 0.001). It explained 6.7% of the variance. CONCLUSIONS:We identified two interpretable patterns that can be used to better understand dietary habits in Mumbai slums. This knowledge can be used to target interventions aimed at improving diet quality in these communities.

This article has been retracted: please see Elsevier policy on article withdrawal (https://www.elsevier.com/about/policies-and-standards/article-withdrawal). This article is retracted at the request of the authors. During post-publication data re-analyses, the authors found four additional hemoglobin datapoints at the endpoint of the trial reported in the above-named article that move the p-value for the primary outcome - the impact of intervention on the change in hemoglobin concentrations across the duration of the trial - from 0.053 to 0.044. Furthermore, the WHO has recently released a revised set of cutoffs for anemia [WHO 2024], and the anemia cutoff for the age group of interest in this article, 12-23 months, was lowered from a hemoglobin concentration of 11 g/dL to 10.5 g/dL. As such, the authors wish to report these revised estimates of anemia based on the revised WHO cutoffs to keep the findings as updated as possible and useful for guidelines. The Editors considered this request and agreed to the retraction of the article. The authors were invited to submit a revised version of the article, which has been peer-reviewed and accepted for publication in the journal. This retraction notice will be updated with a link to the revised paper when it is published.

Iron supplementation studies in children under five suggest potentially adverse gut microbiota shifts. Given iron's importance during early childhood, food-based approaches may offer a more viable supplementation strategy. Using shotgun metagenomics, we examined the effects of 9 months' daily consumption of iron/zinc-biofortified pearl millet (FeZnPM; 8.70 mg/100 g iron) versus control pearl millet (CPM; 3 mg/100 g iron) on the gut microbiome in 12-18-month-old children without severe anemia (hemoglobin ≥9.0 g/dL) from Mumbai urban slums through a randomized controlled trial, the primary outcomes of which were iron status biomarkers and infant growth (ClinicalTrials.gov ID: NCT02233764). In paired (n = 81) and endpoint (n = 108) analyses, FeZnPM consumption was not associated with detectable adverse effects on developing microbiomes and exploratory analyses suggest that it may support beneficial metabolic adaptations via direct modulation of antibiotic, antioxidant, and pollutant degradation pathways. This suggests biofortified crops could provide a sustainable approach to addressing iron deficiency while maintaining healthy microbiome development in early life.

BACKGROUND AND AIMS:Biofortification of staple crops with higher concentrations of micronutrients via traditional breeding methods is a sustainable strategy and can possibly complement fortification and other interventions to target micronutrient deficiencies in low resource settings, particularly among populations such as children. We aimed to determine if iron- and zinc-biofortified pearl millet (FeZnPM, Dhanashakti, ICTP-8203Fe)-based complementary feeding improves nutritional status, including iron and zinc biomarkers and growth, in children living in urban slums of Mumbai. METHODS:We conducted a randomized controlled trial of FeZnPM among 223 children aged 12-18 months who were not severely anemic at baseline (hemoglobin ≥9.0 g/dL). Children were randomized to receive either FeZnPM or conventional (non-biofortified) pearl millet (CPM) daily for 9 months. Hemoglobin, serum ferritin, and plasma zinc concentrations as well as growth indicators (length, weight, mid-upper arm circumferences, triceps and subscapular skinfolds) were evaluated at enrollment and throughout the trial. World Health Organization (WHO) anthropometric Z-scores were calculated using WHO growth standards. Primary outcomes were hemoglobin and serum ferritin concentrations, and growth, defined as WHO Z-scores. An intent-to-treat approach was used for analyses. We used the Hodges-Lehmann-Sen test to assess the change in primary outcomes between baseline and the last visit and report corresponding 95 % confidence intervals. RESULTS:At baseline, 49.3 % of children had anemia (hemoglobin <10.5 g/dL) and 59.6 % had iron deficiency (serum ferritin <12 μg/L). Consumption of FeZnPM increased hemoglobin concentration compared to CPM [change over time: 0.10 g/dL (-0.60, 0.90) vs. CPM: -0.15 g/dL (-1.00, 0.40) P = 0.04]. After follow-up, FeZnPM did not increase the concentration of serum ferritin or plasma zincor improve growth, compared to CPM (P > 0.05). Though the trial was not designed to detect this difference, the prevalence of anemia at endpoint was 33.8 % among those consuming FeZnPM, compared to 57.6 % in the CPM group (P = 0.005). CONCLUSIONS:Daily consumption of FeZnPM-based complementary foods improved hemoglobin concentrations and reduced prevalence of anemia in children living in Mumbai's urban slums. However, the intervention did not significantly impact serum ferritin, plasma zincor growth outcomes. TRIAL REGISTRATION:This trial is registered with Clinicaltrials.gov (ID: NCT02233764), and Clinical Trials Registry of India (ID: REF/2014/10/007731).

Human height is strongly influenced by genetics but the contribution of modifiable epigenetic factors is under-explored, particularly in low and middle-income countries (LMIC). We investigated links between blood DNA methylation and child height in four LMIC cohorts (n=1927) and identified a robust association at three CpGs in the suppressor of cytokine signalling 3 (SOCS3) gene which replicated in a high-income country cohort (n=879). SOCS3 methylation (SOCS3m) – height associations were independent of genetic effects. Mendelian randomization analysis confirmed a causal effect of SOCS3m on height. In longitudinal analysis in a LMIC cohort, SOCS3m explained a maximum 9.5% of height variance in mid-childhood while the variance explained by height polygenic risk score increased from birth to 21 years (2% to 18%). Children’s SOCS3m was associated with prenatal maternal folate and socio-economic status. In-vitro characterization confirmed a regulatory effect of SOCS3m on gene expression. Our findings suggest that epigenetic modifications may play an important role in driving child height in LMIC.

S-methyl-N,N-diethylthiolcarbamate-methyl ester (DETC-Me), a proposed disulfiram metabolite, was investigated both in vivo and in vitro for its effectiveness as a liver mitochondrial low Km aldehyde dehydrogenase (L Km ALDH) inhibitor. Male Sprague-Dawley rats were treated intraperitoneally with DETC-Me, killed at various times and L Km ALDH determined. DETC-Me was found to be a more potent in vivo inhibitor of L Km ALDH than either disulfiram, diethyldithiocarbamate (DDTC) or diethyldithiocarbamate-methyl ester (DDTC-Me). The ID50 for DETC-Me, DDTC-Me and disulfiram was 6.5, 15.5 and 56.2 mg/kg, respectively. The ID50 for DDTC was similar to DDTC-Me. Maximal inhibition of L Km ALDH occurred 30 minutes after DETC-Me administration. DETC-Me was ineffective as an in vitro inhibitor. DETC-Me produced a marked disulfiram-ethanol reaction (DER) at one-quarter of the dose of disulfiram or DDTC. Plasma DETC-Me in rats was greater after DETC-Me administration than after DDTC-Me, DDTC or disulfiram. In conclusion, DETC-Me is proposed to be a metabolite of disulfiram, and may be the immediate precursor of the chemical species responsible for L Km ALDH inhibition.

We aimed to determine the prevalence of baseline vitamin A insufficiency (VAI; serum retinol (SR) < 1.05µmol/L) and to identify potential correlates of SR and VAI in a population of 12–18-month-old children participating in a randomized controlled trial in urban slums in Mumbai, India. In this cross-sectional analysis, we determined SR concentrations in archived serum samples (N = 118) that were collected from 12–18-month-old children in urban slum communities of Western Mumbai in March–October 2017. We adjusted SR measurements using the BRINDA adjustment method for C-reactive protein.1 Child, maternal and household characteristics were assessed as potential correlates. Linear [β(SE)] and binomial [RR (95% CI)] regressions were used to identify correlates of SR and VAI, respectively. Age and sex were retained in all models. The children in this population had a median (IQR) age of 14.5 (12.4, 16.7) months, and 46.6% were girls. Almost a third (27.1%) were underweight (weight-for-age Z-score <-2) and 9.3% were wasted (weight-for-length Z-score <-2). One third (30.5%) were anemic (hemoglobin < 11g/dL) and 19.5% of children were zinc-deficient (Zn < 70µg/dL). Median (IQR) unadjusted SR was 1.1 (0.9, 1.4) µmol/L and VAI was present among 50 (42.4%) of the population. After adjusting for inflammation, SR was 1.2 (1.0, 1.5) µmol/L and VAI was present in 38 (32.2%) of children. In multivariate regressions, each nmol/L increase in vitamin D [25(OH)D] was associated with a 0.01 µmol/L increase in SR [β (SE) 0.01 (0.004), p = 0.004], and each additional child under 5 years living in the household was associated with lower SR [−0.13 (0.04), p = 0.003]. In these 12–18-month-old children, VAI was prevalent in nearly two out of every five children. Division of Nutritional Sciences, Cornell University Harvest Plus.

Size at birth is known to be influenced by various fetal and maternal factors including genetic effects. South Asians have a high burden of low birthweight and cardiometabolic diseases, yet studies of common genetic variations underpinning these phenotypes are lacking. We generated independent, weighted fetal genetic score (fGS) and maternal genetic score (mGS) from 196 birthweight-associated variants identified in Europeans and conducted association analysis with various fetal birth parameters and anthropometric and cardiometabolic traits measured at different follow-up stages (5-6 years’ intervals) from seven Indian and Bangladeshi cohorts of South Asian ancestry. The results from above cohorts were compared with South Asians in UK BioBank and The Exeter Family Study of Childhood Health, a European ancestry cohort. Birthweight increased by 50.7g and 33.6g per standard deviation of fGS (p = 9.1x10-11) and mGS (p = 0.003) respectively in South Asians. A relatively weaker maternal genetic score effect compared to Europeans indicates possible different intrauterine exposures between Europeans and South Asians. Birthweight was strongly associated with body size in both childhood and adolescence (p = 3x10-5 - 1.9x10-51), however, fetal genetic score was associated with body size in childhood only (p < 0.01) and with head circumference, fasting glucose and triglycerides in adults (p < 0.01). The substantially smaller newborn size in South Asians with comparable fetal genetic effect to Europeans on birthweight suggests a significant role of factors related to fetal growth that were not captured by the present genetic scores. These factors may include different environmental exposures, maternal body size, health and nutritional status etc. Persistent influence of genetic loci on size at birth and adult metabolic syndrome in our study supports a common genetic mechanism partly explaining associations between early development and later cardiometabolic health in various populations, despite marked differences in phenotypic and environmental factors in South Asians.

Objective: To explore influences on the diet and physical activity of adolescents living in Mumbai slums, from the perspectives of adolescents and their caregivers. Design: Three investigators from Mumbai conducted six focus group discussions. Setting: The study was conducted in suburban Mumbai slums. Participants: Thirty-six adolescents (aged 10-12 and 15-17 years) and twenty-three caregivers were recruited through convenience sampling. Results: The findings highlighted the complex negotiations between adolescent and caregivers surrounding adolescent junk food consumption and physical activity opportunities. Caregivers learned recipes to prepare popular junk foods to encourage adolescents to eat more home-cooked, and less 'outside', food, yet adolescents still preferred to eat outside. To adolescents, the social aspect of eating junk food with friends was an important and enjoyable experience. Caregivers felt that they had no control over adolescents' food choices, whereas adolescents felt their diets were dictated by their parents. Adolescents wanted to be physically active but were encouraged to focus on their academic studies instead. Gender was also a key driver of physical activity, with girls given less priority to use outside spaces due to cultural and religious factors, and parental fears for their safety. Conclusions: These findings show that adolescents and caregivers have different agendas regarding adolescent diet. Adolescent girls have less opportunity for healthy exercise, and are more sedentary, than boys. Adolescents and caregivers need to be involved in designing effective interventions such as making space available for girls to be active, and smartphone games to encourage healthy eating or physical activity.

We recently reported genetic variants associated with birth weight and their effect on future cardiometabolic risk in Europeans. Despite a higher burden of low birth weight and cardiometabolic disorders, such studies are lacking in South Asians. We generated fetal and maternal genetic scores (fGS and mGS) from 196 birth weight-associated variants identified in Europeans and conducted association analysis with various birth measures and serially measured anthropometric and cardiometabolic traits from seven Indian and Bangladeshi cohorts. Although fGS and mGS were comparable to Europeans, birth weight was substantially smaller suggesting strong environmental constraints on fetal growth in South Asians. Birth weight increased by 50.7g and 33.6g per standard deviation fGS (P=9.1x10-11) and mGS (P=0.003) in South Asians. The fGS was further associated with childhood body size and head circumference, fasting glucose, and triglycerides in adults (P<0.01). Our study supports a common genetic mechanism partly explaining associations between early development and later cardiometabolic health in different populations, despite phenotypic and environmental differences.

Despite the multitude of evaluations of nutrition intervention trials in low-income settings, documented practice to operate such trials is scarce. We aimed to fill this gap by outlining key steps and resources required to run a small-scale intensive feeding trial such as establishing collaborations, developing an operational infrastructure, and daily orchestration of logistics for food preparation, delivery, and administration. A randomized controlled feeding trial among 223 children in urban slums of Mumbai, India was completed in 2018. We established partnerships to facilitate the acquisition and proper storage of the study intervention, biofortified and conventional pearl millet. Feeding centers (FC) were identified based on a census. Two staff per FC managed daily operations: weighing and dispensing individual portions to participants based on their group allocation, recording of leftovers and adverse events. The study team developed and standardized recipes for all menu items. Development considered staple crop and nutrient density per serving, cost and availability of ingredients, and scalability. Highly accepted recipes were included in a cyclic menu. Hot meals were prepared in partnership with the university canteen, where a kitchen coordinator was responsible for daily quality control, aliquoting, and dispensation to contracted auto-drivers for FC delivery. A certified bakery produced customized shelf stable items in bulk. Items were vacuum packed individually, labeled, and delivered to FC directly. Shelf-life was tested periodically. Over 26 tons of crops were procured at a cost of 25,000 USD. The cost of preparing and delivering about 30,000 fresh meals was about 15,000 USD, while the cost of approximately 60,000 shelf stable meals was about 10,000 USD. Over 15 months, we served 91,815 meals at a cost of 0.59 USD/meal in the context of a randomized controlled feeding trial. We highlight opportunities and challenges of developing a sustainable food supply system for an intervention trial. We also outline a sustainable model for delivery of nutrient-dense meals in partnership with small-scale producers instead of establishing a centralized kitchen to facilitate advocacy and scale up. HarvestPlus.

To examine and compare the concentration of acute phase proteins, including nutritional and inflammation biomarkers, by morbidity status among children 12–24 months old living in urban slums of Mumbai. 12–24-month-old children were screened for participation in a randomized controlled trial involving feeding of iron- and zinc-biofortified pearl millet complementary foods. Information on acute illness including fever, respiratory symptoms, and diarrhea on the day of screening, in the past 7 days, and the last 4 weeks was collected along with blood samples for analysis of concentrations of nutritional (ferritin, retinol) and inflammation biomarkers (C-reactive protein, alpha-1-glycoprotein) involved in the acute phase response. Difference in medians were compared by the Kruskal-Wallis Test. The mean age of children was 14.9 months; 51% were males. More than half the children (54%) had at least one or more symptoms such as fever, cough, or diarrhea at any timepoint in the 4 weeks prior to the interview. Among those with symptoms, fever and respiratory symptoms, either alone or in combination, were most common (44.8%), while diarrhea (alone or in combination with fever or respiratory symptoms) was present in only 11% of the population. More than a quarter had some illness in the 7 days before the interview (25.8%) with 2.5% having illness (fever and/or respiratory symptoms) on the day of the interview. Among those reporting no morbidity, 7% had elevated CRP. Among those reporting acute illness on the day of interview or in the past 7 days, 13% had elevated CRP. When compared across different kinds of acute illness and having no symptoms, there was no significant difference in the median concentrations of CRP, ferritin, and retinol. Similar results were observed on comparing the concentration of these acute phase reactants across children with no, one, two, or more symptoms. Among this pediatric population, we did not observe any significant difference in the concentration of acute phase reactants by illness type or number of concurrent illnesses compared with apparently healthy children. HarvestPlus.

To examine the burden of anemia and micronutrient deficiencies among young children living in urban slums of Mumbai, India. Participants were children 10–18 months of age (n = 278) residing in urban slums in Mumbai who were screened as part of a randomized feeding trial of biofortified pearl millet. Venous blood was collected by a pediatric phlebotomist and hemoglobin (Hb) concentrations were assessed via Coulter counter. Samples were processed and stored <−80°C until laboratory analyses. Serum ferritin (SF), vitamin B12, and erythrocyte (RBC) folate concentrations were analyzed via chemiluminescence. C-reactive protein (CRP) was analyzed by nephelometry, α-1 acid glycoprotein (AGP) was analyzed by spectrophotometry, and serum retinol was evaluated via HP-LC. Serum ferritin and serum retinol levels were adjusted for inflammation using methods proposed by Thurman. Anemia and severe anemia were defined as Hb < 11.0 g/dL and Hb < 7.0 g/dL. Iron deficiency (ID) was defined as SF < 12.0 µg/L, iron insufficiency was defined as SF < 20.0 µg/L, and inflammation was defined as CRP > 5.0 mg/L. Iron deficiency anemia was defined as Hb < 11.0 g/dL and SF < 12.0 µg/L. Vitamin A deficiency was defined as serum retinol <20.0 µg/L. Vitamin B12 deficiency and vitamin B12 insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L; folate deficiency was defined as RBC folate <340 nmol/L. Linear and binomial regression models were used to examine associations of micronutrient biomarkers with Hb levels and risk of anemia. A total of 75.5% of children were anemic and 2.9% had severe anemia. The prevalence of iron deficiency was 61.4% (69.5% after Thurman adjustment), 57.4% of children had IDA, and 9.7% had CRP > 5.0 mg/L. The prevalence of vitamin B12 deficiency was 17.0%, 41.8% of children had vitamin B12 insufficiency, and 19.9% had folate deficiency. Among anemic children, 84.5% had ≥1 micronutrient deficiency and 22.7% had ≥ 2 micronutrient deficiencies. Iron deficiency (RR: 2.15; 95% CI: 1.55, 2.99; P < 0.001), and vitamin B12 deficiency (RR: 1.32; 95% CI: 1.09, 1.60; P < 0.01) were associated with significantly increased risk of anemia. Findings indicate that the burden of anemia, iron deficiency, and vitamin B12 insufficiency were high in young children in Mumbai, India. Harvest Plus; AF was supported by the National Institutes of Health.

The impact of comprehensive nutritional status, defined as growth, nutritional blood biomarkers, dietary intakes, and feeding practices, on the gut microbiome in children living in low-resource settings has remained underreported in microbiome research. Among undernourished children living in urban slums of Mumbai, India, we observed a high relative abundance of Proteobacteria , a phylum including many potentially pathogenic species similar to the composition in preterm infants, suggesting immaturity of the gut, or potentially a high inflammatory burden. We found head circumference, fat and iron intake, and current breastfeeding were positively associated with microbial diversity, while hemoglobin and weight for length were associated with lower diversity. Findings suggest that examining comprehensive nutrition is critical to gain more understanding of how nutrition and the gut microbiota are linked, particularly in vulnerable populations such as children in urban slum settings.

To (1) describe micronutrient intakes among women of reproductive age living in Mumbai slums; (2) assess the adequacy of these intakes compared with reference values; (3) identify important dietary sources of micronutrients. Participants were 6426 non-pregnant women aged 16–39 years, registered in a randomised controlled trial of a food-based intervention set in the Bandra, Khar and Andheri areas of Mumbai, India. Cross-sectional quantified food frequency questionnaire (FFQ) data were collected. Vitamin (n = 9) and mineral (n = 6) intakes were calculated and analysed in relation to dietary reference values (DRVs). Important dietary sources were identified for each micronutrient. Median intakes of all micronutrients, except vitamin E, were below the FAO/WHO reference nutrient intake (RNI). Intakes of calcium, iron, vitamin A and folate were furthest from the RNI. For seven of the micronutrients, over half of the women had intakes below the lower reference nutrient intake (LRNI); this figure was over 75% for calcium and riboflavin. The majority of women (93%) had intakes below the EAR for 5 or more micronutrients, and 64% for 10 or more. Adolescents had lower intakes than women aged >19 years. Less than 1% of adult women and no adolescents met the EAR for all micronutrients. Animal source foods and micronutrient-rich fruit and vegetables were consumed infrequently. These women had low intakes of multiple micronutrients, increasing their risk of insufficiency. There is a need to determine the factors causing poor intakes, to direct interventions that improve diet quality and nutritional sufficiency.

Background:Micronutrient deficiencies have been a serious public health problem among women of reproductive age in low- and middle-income countries including India, adversely affecting maternal and child health and human capital outcomes. Fruit and vegetables are important sources of micronutrients, and consumption of these foods is less than recommendations. Objective:The objective of this study was to identify perceived barriers and facilitators to fruit and vegetable consumption among women of reproductive age living in rural communities in the State of Maharashtra, India. Methods:Women aged 18 to 40 years were recruited from 8 villages surrounding the city of Wardha, Maharashtra, India. We used qualitative methods and held 9 focus group discussions and 12 one-to-one interviews. The data collection was stopped when no new information emerged. We used inductive thematic coding to analyze the data. Results:Women knew that fruit and vegetables were beneficial to health and expressed that they wanted to increase the intake of these foods for themselves and their children. Seven main themes were identified as being barriers or facilitators to fruit and vegetable consumption: (1) personal factors, (2) household dynamics, (3) social and cultural norms, (4) workload, (5) time pressures, (6) environmental factors, and (7) cost. Conclusions:Rural Indian women consumed fruit and vegetables infrequently and said they would like to consume more. Several potentially modifiable factors affecting the intake of fruit and vegetables were identified. Value chain analyses of fruit and vegetables in these communities will be important to identify opportunities to intervene and increase consumption.

Objectives a) To examine the mean nutrient intake among young children 12–18 months of age in urban slums of Mumbai, b) to determine the adequacy of micronutrient intake in their diet as per the National Institute of Nutrition (NIN) recommendations for optimum growth and development, and c) to determine if there is a difference in the nutrient intake of those randomized vs not randomized to the trial involving feeding of iron- and zinc-biofortified pearl millet complementary foods. Methods A total of 407 children were screened of which dietary data was available for 359 children. Of the total randomized (n = 223), dietary data was available for 216 children who were randomized to one of the two study arms (Arm 1: n = 107, Arm 2: n = 109). A 24-hour dietary recall was performed, and nutrient intake was calculated using CS dietary software using the NIN food composition tables. Results The average age of children was 14.81 months; 51% were males and 49% females. Majority of the children (81.64%) breastfed the previous day. The mean intake per day of calories, protein, iron, and zinc from complementary foods was found to be 598 kcal, 19.9 g, 3.25 mg, and 1.85 mg, respectively. On average, complementary feeding contributed to 89.6% of RDA for energy, 82.4% of calcium, 57.9% of iron, 58.8% of zinc, 51.9% vitamin A, 7.2% of vitamin B12, and 83.3% of dietary folate. All children had adequate caloric and protein intake. However, > 90% of children consumed inadequate iron, zinc, and folate according to the nutrient density of the complementary food, and > 50% of children consumed inadequate vitamin A and calcium. Overall, children randomized to the intervention were found to have a significantly higher intake of calories, protein, folate, and zinc. Conclusions Majority of children living in the urban slums of Mumbai consumed diet inadequate for most micronutrients. Our findings confirm the suitability of this population for interventions aiming to improve micronutrient intake Funding Sources HarvestPlus.

1. To characterize the gut microbiome and 2. explore associations between dietary intake and gut microbiome composition and predicted function among children at screening for participation in a randomized controlled feeding trial in urban slums of Mumbai, India. Young children (10–18 months old) living in urban slums of Mumbai were screened from March to November 2017 after obtaining informed consent from caregivers. Nutrient intakes from 24-hour dietary recall were analyzed as absolute intakes, % of RDA, and using the nutrient residual to adjust for energy intake. DNA extracted from rectal swabs was sequenced (16S rRNA V3-V4 region; Illumina MiSeq) and further processed using QIIME2 and PICRUSt algorithm. Linear regression was used to estimate associations between nutrient intakes (adjusted for age and sex) and measures of gut microbiome α-diversity, including Shannon Index, Chao1 estimator, observed OTUs, Proteobacteria relative abundance, Firmicutes: Bacteroidetes ratio, and predicted KEGG pathways. Statistical analysis was performed using RStudio, and SAS 9.4. A subset of 53 children with rectal swabs collected were included. Sequencing yielded 8984,126 reads including 2173 unique operational taxonomic units (OTUs). Mean relative abundance of Proteobacteria was 78.2%. Shannon Diversity Index was positively associated with absolute intakes of total carotenoids and beta-carotene. Children with adequate intakes of zinc and beta-carotene had a higher mean Shannon Diversity Index. The Chao1 estimator was positively associated with absolute intakes of calcium. The number of observed OTUs was positively associated with calcium and zinc intakes. The predicted gene counts for germination, sporulation, amoebiasis, and protein digestion and absorption pathways were also associated with both macro- and micro-nutrient intakes. The gut microbiome in this sample of young children in Mumbai was dominated by Proteobacteria, which includes many potentially pathogenic species. Dietary intakes of macro- and micronutrients were associated with measures of diversity and predicted functional pathways after adjustment for age and sex, warranting further longitudinal study of the diet’s impact on the microbiome particularly in young children. HarvestPlus.