To explore influences on the diet and physical activity of adolescents living in Mumbai slums, from the perspectives of adolescents and their caregivers.

Three investigators from Mumbai conducted six focus group discussions.

The study was conducted in suburban Mumbai slums.

Thirty-six adolescents (aged 10–12 and 15–17 years) and twenty-three caregivers were recruited through convenience sampling.

The findings highlighted the complex negotiations between adolescent and caregivers surrounding adolescent junk food consumption and physical activity opportunities. Caregivers learned recipes to prepare popular junk foods to encourage adolescents to eat more home-cooked, and less ‘outside’, food, yet adolescents still preferred to eat outside. To adolescents, the social aspect of eating junk food with friends was an important and enjoyable experience. Caregivers felt that they had no control over adolescents’ food choices, whereas adolescents felt their diets were dictated by their parents. Adolescents wanted to be physically active but were encouraged to focus on their academic studies instead. Gender was also a key driver of physical activity, with girls given less priority to use outside spaces due to cultural and religious factors, and parental fears for their safety.

These findings show that adolescents and caregivers have different agendas regarding adolescent diet. Adolescent girls have less opportunity for healthy exercise, and are more sedentary, than boys. Adolescents and caregivers need to be involved in designing effective interventions such as making space available for girls to be active, and smartphone games to encourage healthy eating or physical activity.

To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers.

Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI<18·5 kg/m2 and normal as BMI≥18·5 kg/m2. Besides calculating mean, sd and 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. The χ2 test was used to assess significance of the difference in CED prevalence across MUAC categories.

An urban slum in Midnapore town, West Bengal State, India.

Male (n 467) and female (n 488) Indian slum dwellers.

MUAC of 22·7 and 21·9 cm, respectively, in males and females were the best cut-off points to differentiate CED from non-CED.

Results supported the validity of the WHO-recommended MUAC cut-offs for adults. There is still a need to establish statistically appropriate MUAC cut-offs to predict undernutrition and morbidity.