Examining the association between maternal junk food consumption and obesity among children: evidence from a cross-sectional survey in India.

Background: Childhood obesity is not only a concern for the immediate health of children but also imposes varied health implications throughout the life course and a significant burden on the healthcare system. Parental feeding attitudes and lifestyles, especially mothers', significantly influence the development of children's eating behaviours and nutritional outcomes. This study examines the relationship between 'maternal junk food consumption' and 'childhood obesity' in India.

Methods: Using the 2021 round of the National Family Health Survey, we analysed data from 191,126 children aged 0-5 years across 36 states and Union Territories of India. The study measured childhood overweight/obesity through weight-for-height Z-scores (WHZ). Further, the study constructed a junk food consumption intensity score by creating a composite measure based on the intake frequency of aerated drinks and fried foods. We employed multiple binary logistic regression models and robustness checks to examine the association between 'maternal junk food consumption' and 'children with overweight/obesity' net of parental, household, and geographical characteristics.

Results: Children of mothers with high junk food consumption exhibited a higher prevalence (4.01%) compared to those with moderate (3.29%) and no/low consumption (3.27%). The differences further increased when we adjusted the results for other covariates. Adjusted odds ratio shows that children of mothers with "high" and "moderate" junk food consumption have 1.390 (p < 0.01) times and 1.204 times (p < 0.05), respectively, higher odds of having children with overweight or obesity compared to those with "no/low" consumption. Further, the results are confirmed through multiple robustness checks.

Conclusions: Interpreting these results in the context of existing evidence and policy suggests that tackling childhood obesity necessitates comprehensive, multi-level interventions - spanning individual, family, community and facility levels. These interventions should aim to enhance food and nutrition literacy, foster healthy dietary practices, and promote positive behaviours that minimise risks associated with all obesogenic factors among children and their families.