The Influence of 'Westernization' on Nutrition and Physical Activity Behaviors of Adolescents in New Delhi, India: Are We Exporting an Epidemic of Obesity?

Purpose: To examine the relationships between "westernization" and nutrition and physical activity behaviors among older adolescents in Delhi, India. These relations have not been explored, despite increasingly strong and pervasive socio-cultural influences from the West. Methods: Students (n=1818) in 8th and 10th grades in 4 Private (higher SES) and 4 Government (lower SES) schools in Delhi, India participated in a cross-sectional study. Height and weight were measured to determine weight status. Information on "westernization" and nutrition, physical activity, sedentary, and dieting behaviors was collected in a survey. The measure of "westernization" assessed 4 domains of culture on a bi-dimensional scale that focused on these young people's identification with Indian (a=0.86) and Western (a=0.81) ways of living. Mixed-effects regression models were used to investigate the association between "westernization," weight status, and health behaviors. Gender, school type (SES), and grade were evaluated as effect modifiers. Results: "Westernization" was not directly associated with weight status or BMI (p>0.500). However, adolescents' identification with Western ways of living was consistently related to both unhealthy (e.g., fast food consumption). Conclusions: The influence of "westernization" on nutrition and physical activity behaviors of older adolescents in Delhi, India is complex and not wholly negative, as might be hypothesized. (This work was presented in part at the Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity, on May 25, 2012.)