Dietary intakes and familial correlates of overweight/obesity: a four-cities study in India.

BACKGROUND: The prevalence of overweight and obesity among children is increasing in India. However, knowledge of, attitude towards and practice of health and nutrition in mothers and children have not been researched. OBJECTIVE: To assess knowledge of, attitude towards and practice of nutrition, physical activity and other lifestyle practices in a nationally representative sample of urban children and mothers in India. METHODS: A cross-sectional observational study of 1,800 children aged 9-18 years and their mothers, using qualitative (focus group) and quantitative (semi-structured survey) data. RESULTS: The overall prevalence of overweight/obesity among the children was 19.2% in males and 18.1% in females; 64.8% of mothers were either overweight [body mass index (BMI) 23.0-24.9; 23.3%] or obese (BMI >25.0; 41.5%). Household family income, related socioeconomic factors, and overweight in mothers were most significantly associated with obesity in children (all p ≤ 0.001). Dietary consumption patterns (snacking, fast food etc.) showed a marked association between mothers and children (all p ≤ 0.000). Focus group discussion revealed several interesting attitudes and misconceptions among children ('home-cooked food is old fashioned') and mothers ('a child with chubby cheeks is healthy, not fat'). Importantly, only a few mothers understood that excess weight or diets are contributory factors of morbidities in children or themselves. CONCLUSIONS: This study highlights the poor knowledge, faulty attitudes and practices of urban Asian Indian mothers and their children in a highly correlated manner. These knowledge gaps must be addressed to formulate effective strategies for the prevention of obesity and related metabolic disorders.