title: Cross-regional analysis of multiple factors associated with childhood obesity in India: a national or local challenge?
abstract: OBJECTIVE
  To investigate obesogenic co-causing factors, promoting rise of weight in children, associated to local differences in India.
  
  
  METHODS
  Overall 1,680 children, aged 3-11 and balanced by gender, were recruited in school contexts distributed in seven major Indian cities. All children were weighted and measured in order to calculate their BMI. A validated cultural specific questionnaire was administered to children's parents for assessing socio-demographic data, eating habits, physical activity, etc. Furthermore children's brand awareness scores were computed in order to analyze their affiliation towards food-based advertisement. Descriptive statistics of frequencies, duration and intensity of the various factors were performed. Chi-square tests or Wilcoxon signed rank test were used for evaluating significance of differences in factors distribution across Indian cities.
  
  
  RESULTS
  Four factors, promoting rise of children's weight, were individuated as associated to urban differences, namely meal times consumed in the family, parents' BMI, brand awareness and physical activity. These aspects exercised a significant impact on children's body size in Kolkata and Chennai. Hyderabad and Mumbai, instead, were the cities where religion played some role in influencing children's weight gain.
  
  
  CONCLUSIONS
  Such findings underline the need to frame obesity as a situated phenomenon rather than a national problem. Health policies, implemented in treating and preventing obesity, should be therefore specifically focused on locally situated peculiarities.
authors.affiliation: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Via Loredan, 18, 35121, Padova, Italy, dario.gregori@unipd.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
authors.forename: Achal
authors.initials: A
authors.lastname: Gulati
authors.forename: Elizabeth Cherian
authors.initials: EC
authors.lastname: Paramesh
authors.forename: Powlin
authors.initials: P
authors.lastname: Arockiacath
authors.forename: Rosanna
authors.initials: R
authors.lastname: Comoretto
authors.forename: Haralappa
authors.initials: H
authors.lastname: Paramesh
authors.forename: Alexander
authors.initials: A
authors.lastname: Hochdorn
authors.forename: Ileana
authors.initials: I
authors.lastname: Baldi
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D014504:Urban Health