The mean AMQI score was 41.599.4, and 86.8% girls had the AMQI score lower than 50, indicating inadequate dietary nutrient intakes by the girls. The majority of the girls showed adherence to three of the healthy choice components, i.e. at least 50% grains as whole grains, low frequency of consuming fried foods and greater food variety. Adherence by the girls to the consumption of micronutrient dense pulses, sprouts, salad and fermented foods and not consuming tea with meals was poor. Association of socio-demographic variables with AMQI was evaluated using the data on family size, mother’s and father’s education and occupation. In our data, mother’s education and occupation were signifi- cantly associated with AMQI. A logistic regression analysis of the AMQI with socio-demographic factors revealed that age, mother’s education and occupation were significantly and positively associated with the AMQI (R2 0.07, p B0.01). Partial correlations of the micronutrient intakes with the AMQI scores after adjusting for energy intake and socio-demographic factors were at the range of 0.4 0.5 and were statistically significant (p B0.01), which demon- strated the concurrent validity of the new index. Higher AMQI scores were associated with higher concentrations of plasma vitamin C (r 0.26), b-carotene (r 0.34) and zinc (r 0.12) after controlling for socio-demographic factors (p B0.05). Thus, the AMQI provides an updated measure to evaluate micronutrient quality of diets of lacto-vegetarian Indian adolescent girls. Our index is the first of its kind to consider bio- availability aspects of diet in the evaluation of diet quality. We anticipate that such concept of emphasising adequate contents and bio-availability of micronutrients while constructing the diet quality index can be widely applicable to different lacto-vegetarian population groups, although some of the components of the index may require modification with respect to nutrient re- quirements of different age sex groups and food habits. Efficacy of dietary supplementation in improving blood micronutrient status and functional indices of zinc in adolescent girls Dietary intervention strategies have been identified as the principal approach to tackle nutritional problems in the population. We have developed diet supplements in the form of zinc-rich recipes to improve intake of zinc and other micronutrients. An intervention trial was conducted to determine the efficacy of proposed recipes in improv- ing zinc and other micronutrient status (Paper IV) (63) and functional indices of zinc (Paper V) (64). Effect of the diet supplementation was viewed in light of supplement- ing ayurvedic zinc (Jasad Bhasma) tablet. Diet and Jasad supplementation both showed a significant increase in plasma zinc (9.9 and 61.3%, respectively) (p B0.01) (63). Further, the diet supplement Citation: Glob Health Action 2012, 5: 7353 - DOI: 10.3402/gha.v5i0.7353 Zinc status and its association with health of Indian adolescent showed significant increase in blood status of b-carotene and vitamin C as compared to control group (p B0.01). Thus, devising such recipes would prove a better sustain- able strategy for promoting micronutrient status of adolescents. Our results demonstrated the beneficial effects of zinc supplementation on cognitive scores of the girls by reducing reaction time (6 13%) and improving in Mem- ory (25%) and RPM scores (15%) than the control group (64). Median recognition threshold for salt taste reduced significantly from 5 to 2.5 mmol/l after both diet and zinc supplementation (p B0.01); however, it remained same in the control group. This suggests a positive effect of supplementation on cognitive performance and taste acuity of the girls. As observed in our study, decrease in reaction time has been reported by Pennland et al. (72) in school children. Furthermore, our study demonstrated that zinc supple- mentation improved memory and non-verbal intelligence in adolescent girls as well as established positive effect of zinc supplementation on taste perception. Thus, zinc supplementation through diet or ayurvedic Jasad tablet not only improves zinc status of the girls but also was a useful strategy for improving cognitive performance and taste acuity function in adolescent girls. Conclusions The present research provided first-hand estimates of micronutrient deficiencies in a cohort of urban Indian adolescent girls. Our data demonstrated that the diets of the girls were deficient in zinc and other micronutrients. Blood biomarkers of zinc and vitamin A were below the normal range in majority of the girls. Dietary zinc deficiency and low blood zinc status lead to poor cognition and taste perception amongst adolescent girls. Therefore, there is a concurrent requirement of a simple tool to identify dietary micronutrient deficiencies and a diet intervention strategy to improve zinc and other micro- nutrient status of the girls. The new diet quality index i.e. AMQI has successfully assessed micronutrient deficiency risk among study population and thus provided an updated measure to assess micronutrient quality of diets of lacto-vegetarian adolescent girls. The AMQI may be modified suitably for different age sex groups considering their specific needs for assessing their micronutrient status. An intervention trial on a group of 180 girls has demonstrated effectiveness of the proposed recipes in improving zinc status. Large-scale studies are needed to confirm its potential as a diet diversification strategy for vegetarian population. This study is the only one so far to demonstrate a positive effect of zinc supplementation in improving cognitive performance and taste acuity of adolescent girls. Effect of zinc supplementation on other aspects of health such as bone development, infections and obesity may be studied in adolescents. 7 (page number not for citation purpose)