Fluorosis is a major public health problem in India and aggravates by malnutrition. The present field study has been undertaken to investigate the role of nutrition on outcome of fluorosis in the fluoride affected and normal village in Nalgonda and RR district respectively of Andhra Pradesh, India.

            It was a community based cross sectional study.  The population includes randomly selected 182 individuals between age 15 to >55 years (age and sex matched) from fluorotic Venkapalli (F= 8.00 ppm) and 62 from non fluorotic (F< 1.00 ppm) Rampalli village.  The data was collected on all individuals in respect to clinical examinations, X-ray, DXA, diet survey, blood and urinary examination.

Results revealed that dental and skeletal fluorosis was significantly higher in affected village as compared to control village. Urinary and serum F, total and bone specific ALP were significantly higher in affected village as compared to control village. X-ray report showed narrowed joint space, osteoporosis, formation of osteophytes, where as DXA report indicated that spine area, BMC and BMD were significantly higher in affected group of people as compared to control. The whole body BMC and BMD was significantly higher as compared to control. Serum 25 (OH) Vitamin D, PTH, TRAP was significantly lower in all the age group of affected village as compared to control. Whereas 1, 25 (OH)₂ vitamin D was significantly higher as compared to control.

            Diet survey showed there was significantly higher intake of milk and milk product and nutrient like folic acid, calcium and phosphorus were significantly higher in fluorotic villages as compared to control village.

DXA showed a higher trend (not statistically significant) for total fat and fat percent in control and non affected group of fluorotic village as compared to affected group of fluorotic village. Lean body mass was higher in non affected subjects than affected and control group. Hemoglobin was significantly lower in fluorotic village as compared to control village.  Serum T3 level was significantly higher in affected village as compared to control village whereas T4 and TSH were comparable in both affected and non-affected villages.

In conclusion, there was less effect of high fluoride due to better nutritional status in fluorotic villages.

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