These factors provide an explanation as to why ‘fat’ children are viewed as healthy, and why food is lavished on children as a sign of affection. Another example comes from Islamic communities, which have a strong religious identity. Faith leaders have a central role in the community and a significant amount of time is spent at

the mosque (place of worship). Children from age 5 are required to attend mosque daily after school, which has implications for food and physical activity behaviours; time to engage in after-school physical activities, time for evening meal preparation and consumption, and time for travel between school, home and mosque is limited. This leads to consumption of energy dense snacks and use of Lenvatinib ic50 cars instead of walking. These examples illustrate www.selleckchem.com/products/abt-199.html the importance of understanding the cultural context. Unhealthy food and physical activity behaviours become a rational course of action when viewed within these contexts. Several cultural stereotypes and assumptions made around South Asian communities were contested, for example, the perception that South Asians always cook with ghee (clarified butter) was contested by a South Asian community leader who believed that healthier oils are increasingly used to prepare traditional meals. The widely perceived

view of disadvantaged communities having poor access to healthy foods was contested by some participants who believed that there was local availability of inexpensive fruit and vegetables. A further example is the challenging of the perception that South Asian children lack interest in sports. These examples else emphasise the danger of relying on assumptions, and the importance of actively seeking a detailed understanding of the communities of interest. The themes emerging within the different contextual levels are presented in Table 3 with illustrating quotes. Crucially, the interrelationships between the different factors are numerous, multidirectional, and operate across the different contextual levels. Thus from the data we have built up

a complex network of contextual factors contributing to the development of childhood obesity in UK South Asian communities (Fig. 1). Overall, participants identified a broad range of contributors to childhood obesity, across multiple contextual levels. There was much focus on the role of parents and family, and many external influences on parents were identified. The South Asian cultural context featured throughout all discussions. In addition to the influence of South Asian family structures, there was focus on traditional cooking practices, social and religious practices, and cultural and religious influences on physical activities. There was also a perception of a lack of awareness of healthy lifestyles in these communities. Acculturation was touched on by some participants, in terms of the changing diets within South Asian communities.