Purpose. To examine the relationships between “westernization” and nutrition and physical activity behaviors among older adolescents in Delhi, India. These relations have not been explored, despite increasingly strong and pervasive socio-cultural influences from the West.

Methods. Students (n=1818) in 8th and 10th grades in 4 Private (higher SES) and 4 Government (lower SES) schools in Delhi, India participated in a cross-sectional study. Height and weight were measured to determine weight status. Information on “westernization” and nutrition, physical activity, sedentary, and dieting behaviors was collected in a survey. The measure of “westernization” assessed 4 domains of culture on a bi-dimensional scale that focused on these young people’s identification with Indian (α=0.86) and Western (α=0.81) ways of living. Mixed-effects regression models were used to investigate the association between “westernization,” weight status, and health behaviors. Gender, school type (SES), and grade were evaluated as effect modifiers. Results. “Westernization” was not directly associated with weight status or BMI (p>0.500). However, adolescents’ identification with Western ways of living was consistently related to both unhealthy (e.g., fast food consumption, pppConclusions. The influence of “westernization” on nutrition and physical activity behaviors of older adolescents in Delhi, India is complex and not wholly negative, as might be hypothesized.

Author Biography

Melissa Harrell is a behavioral epidemiologist at UT Health School of Public Health. Her research studies focus on youth health promotion in domestic and international settings. Her experiences include over 15 years designing health promotion programs for young people in India.

Emily Ussery is a behavioral epidemiologist, currently with the Epidemiologic Intelligence Service at the Centers for Disease Control and Prevention. Her research portfolio includes cross-cultural studies of physical activity, nutrition, and tobacco use behaviors in youth in low and middle income countries, like Uruguay and India.

Blanche Greene-Cramer recently received her PhD in Health Promotion at the UT Health School of Public Health. Her dissertation studies were focused on the emerging epidemic of childhood obesity in India.

Nalini Ranjit is a quantitatively-focused research scientist on faculty at the UT Health School of Public Health. Her research studies focus on childhood obesity, with a special focus on nutrition and physical activity behaviors in youth in low resource settings.

Shreela Sharma is trained in dietetics and physical therapy and currently serves on faculty in epidemiology at the UT Health School of Public Health. Her research program is focused on childhood obesity prevention and includes studies of dietary behavior in Indian children and their families.


This study is supported by grants from (a) the Obesity Prevention Center at the University of Minnesota and (b) the School of Public Health at the University of Texas. The authors are extremely grateful for this support and the participation of schools and students in this study. This work was presented in part at the Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity, on May 25, 2012 (see http://www.isbnpa.org/annual-meeting/).