Obese mother, obese child: A convergent mixed methods study of intergenerational obesity in low-income households in Malaysia

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 41–50 years (2006: AOR = 2.35, 95% CI = 1.21–4.60, p = 0.012) and above 50 years (2006: AOR = 2.29, 95% CI = 1.06–4.98, p = 0.036; 2015: AOR = 3.23, 95% CI = 1.14–9.13, p = 0.025) were associated with higher odds of OWM/OWC. Children aged between 10–14 years had higher risk (2006: AOR = 2.38, 95% CI = 1.63–3.47, p