{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:16:40Z","timestamp":1790792200638,"version":"4.1.0"},"reference-count":49,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007502","name":"Blum Center for Developing Economies, University of California Berkeley","doi-asserted-by":"publisher","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100007502","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003040","name":"Jewish Women's Foundation of New York","doi-asserted-by":"publisher","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100003040","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UC Berkeley Undergraduate Research Program","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and\/or acute malnutrition. In children ages 3\u20136, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02\u20131.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food\/sugary drinks into maternal\u2013child health programs.<\/jats:p>","DOI":"10.3390\/ijerph17228629","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T09:46:18Z","timestamp":1605865578000},"page":"8629","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India"],"prefix":"10.3390","volume":"17","author":[{"given":"Priyanka","family":"Athavale","sequence":"first","affiliation":[{"name":"School of Public Health, University of California, Berkeley, CA 94704, USA"},{"name":"School of Medicine, University of California, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehaa","family":"Khadka","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley, CA 94704, USA"},{"name":"Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shampa","family":"Roy","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley, CA 94704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyasree","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Swasti Health Catalyst, Mumbai 560094, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Chandra Mohan","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley, CA 94704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5464-9305","authenticated-orcid":false,"given":"Bathsheba (Bethy)","family":"Turton","sequence":"additional","affiliation":[{"name":"University of Puthisastra, Phnom Penh 12211, Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-2266","authenticated-orcid":false,"given":"Karen","family":"Sokal-Gutierrez","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley, CA 94704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1017\/S1368980018000423","article-title":"The global nutrition transition: Trends, disease burdens and policy interventions","volume":"21","author":"Ronto","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/ajcn\/84.2.289","article-title":"Global nutrition dynamics: The world is shifting rapidly toward a diet linked with noncommunicable diseases","volume":"84","author":"Popkin","year":"2006","journal-title":"Am. 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