{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:29:08Z","timestamp":1786472948995,"version":"build-2736575974"},"reference-count":78,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004595","name":"Universiti Sains Malaysia","doi-asserted-by":"publisher","award":["304\/PPSP\/6316152"],"award-info":[{"award-number":["304\/PPSP\/6316152"]}],"id":[{"id":"10.13039\/501100004595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004595","name":"Universiti Sains Malaysia","doi-asserted-by":"publisher","award":["1001\/PPSP\/8012255"],"award-info":[{"award-number":["1001\/PPSP\/8012255"]}],"id":[{"id":"10.13039\/501100004595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Maternal and child overweight and\/or obesity (OW\/OB) are growing public health concerns, especially in low-income households, where they contribute to intergenerational transmission and increased financial burden. Using a convergent mixed methods design, this study aimed to investigate the determinants of intergenerational obesity among low-income families in Malaysia. Quantitative data were derived from the Malaysian National Health and Morbidity Survey for the years 2006, 2011, and 2015, while qualitative insights were obtained through in-depth interviews. The quantitative study included 2,057, 994, and 952 mother-child pairs from low-income households in 2006, 2011, and 2015, respectively classified based on body mass index categories. Factors associated with overweight mother\/overweight child pairs (OWM\/OWC) were analyzed using multiple logistic regressions. To explore the factors contributing to OW\/OB, the qualitative study involved 27 in-depth interviews with mothers, and the data were analyzed using thematic analysis and findings from both studies were integrated through a narrative approach. Maternal ages between 41\u201350 years (2006: AOR\u2009=\u20092.35, 95% CI\u2009=\u20091.21\u20134.60, p\u2009=\u20090.012) and above 50 years (2006: AOR\u2009=\u20092.29, 95% CI\u2009=\u20091.06\u20134.98, p\u2009=\u20090.036; 2015: AOR\u2009=\u20093.23, 95% CI\u2009=\u20091.14\u20139.13, p\u2009=\u20090.025) were associated with higher odds of OWM\/OWC. Children aged between 10\u201314 years had higher risk (2006: AOR\u2009=\u20092.38, 95% CI\u2009=\u20091.63\u20133.47, p\u2009&lt;\u20090.001; 2011: AOR\u2009=\u20091.76, 95% CI\u2009=\u20091.05\u20132.96, p\u2009=\u20090.032). Chinese (2006: AOR\u2009=\u20090.46, 95% CI\u2009=\u20090.23\u20130.92, p\u2009=\u20090.027; 2015: AOR\u2009=\u20090.40, 95% CI\u2009=\u20090.19\u20130.83, p\u2009=\u20090.014), other ethnicities (2006: AOR\u2009=\u20090.49, 95% CI\u2009=\u20090.32\u20130.73, p\u2009=\u20090.001; 2011: AOR\u2009=\u20090.46, 95% CI\u2009=\u20090.25\u20130.83, p\u2009=\u20090.010; 2015: AOR\u2009=\u20090.53, 95% CI\u2009=\u20090.31\u20130.91, p\u2009=\u20090.020), and large household size (2015: AOR\u2009=\u20090.19, 95% CI\u2009=\u20090.04\u20130.94, p\u2009=\u20090.041) were protective against OWM\/OWC. Four major themes emerged from the in-depth interviews: (1) personal factors (demographics, cognitions, and skills), (2) social environment (parent-child relationships), (3) physical environment (home and built environments), and (4) macro-level environment (food price and media influence). The findings suggest that intergenerational OW\/OB in low-income households is influenced by interconnected personal factors, as well as social, physical, and macro-level environments. This study not only provides a comprehensive understanding of how such factors interact within real-life contexts but also highlights the importance of multi-level interventions that address individual behaviors and broader environmental and socio-economic constraints.<\/jats:p>","DOI":"10.1371\/journal.pone.0355312","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:31:22Z","timestamp":1786469482000},"page":"e0355312","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obese mother, obese child: A convergent mixed methods study of intergenerational obesity in low-income households in Malaysia"],"prefix":"10.1371","volume":"21","author":[{"given":"Nur Nadia","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0385-5966","authenticated-orcid":true,"given":"Abdul Jalil","family":"Rohana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Aman","family":"A Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank B","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasanti S","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Fadhli","family":"Mohd Yusoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"11","key":"pone.0355312.ref001","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1038\/s41574-020-00411-y","article-title":"Nearly a decade on - trends, risk factors and policy implications in global obesity","volume":"16","author":"VS Malik","year":"2020","journal-title":"Nat Rev Endocrinol"},{"issue":"1","key":"pone.0355312.ref002","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12884-024-06268-7","article-title":"The risk prediction of intergenerational transmission of overweight and obesity between mothers and infants during pregnancy","volume":"24","author":"X Wei","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0355312.ref003","doi-asserted-by":"crossref","first-page":"104754","DOI":"10.1016\/j.compbiomed.2021.104754","article-title":"A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity","volume":"136","author":"M Safaei","year":"2021","journal-title":"Comput Biol Med"},{"key":"pone.0355312.ref004","unstructured":"World Obesity Federation. 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