{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:16Z","timestamp":1787028376621,"version":"build-2736575974"},"reference-count":77,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In contrast to several high-income nations, childhood obesity prevalence is rising in low\/middle-income countries. Our objective was to study risk factors and complications of childhood overweight\/obesity in an urban lower middle-income country setting. This was an observational study. Children aged 2\u201318 years at a pediatric clinic in Chennai, India were enrolled over a 12-month period. The definition of overweight was &gt;23rd and obesity &gt;27th adult equivalent percentile Body Mass Index. Parents and children completed a risk-factor questionnaire. Children with obesity\/overweight were evaluated for complications. Of 103 children enrolled, 61% were obese\/overweight and 39% healthy weight. Independent predictors of absence of overweight\/obesity were as follows: never\/rarely consuming sugar-sweetened beverages, never\/rarely eating out, and sleep duration &gt; 11 h. Exercise performed rarely\/never independently predicted overweight\/obesity. No significant difference was observed with screen time or a vegetarian diet. Complications in 54 obese\/overweight children included prediabetes (15%), hypertension (11%), dyslipidemia (22%), nonalcoholic fatty liver disease (22%), acanthosis nigricans (24%), and anxiety\/depression (17%). In conclusion, differences were observed in behaviors associated with childhood obesity in an urban lower middle-income environment compared to those in high-income nations. Behaviors associated with childhood obesity in an urban lower middle-income environment are similar to those reported from high-income nations, with some differences. Complications of overweight\/obesity are common in this setting.<\/jats:p>","DOI":"10.3390\/ijerph22111697","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T10:35:31Z","timestamp":1762770931000},"page":"1697","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk Factors and Complications of Childhood Obesity and Overweight in an Urban Setting of a Lower Middle-Income Country"],"prefix":"10.3390","volume":"22","author":[{"given":"Varun Govind","family":"Krishna","sequence":"first","affiliation":[{"name":"Lyman Briggs College, Michigan State University, East Lansing, MI 48825, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarala","family":"Rajajee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. Mehta\u2019s Hospitals, Chennai 600031, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-8324","authenticated-orcid":false,"given":"Venkatakrishna","family":"Rajajee","sequence":"additional","affiliation":[{"name":"Center for Global Health, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemchand K.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Dr. Mehta\u2019s Hospitals, Chennai 600031, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1056\/NEJMoa0904130","article-title":"Childhood obesity, other cardiovascular risk factors, and premature death","volume":"362","author":"Franks","year":"2010","journal-title":"N. 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