Table 2.

Somali (S), Latino (L) and Hmong (H) parents’ perceptions of healthy weight and causes of childhood obesity, the Twin Cities, Minnesota, USA, September 2011 through August 2012

Themes	Summary/sub-themes	Parent quotes
Parents’ perceptions of healthy-weight children	Health is not necessarily weight-based for younger children, as children can be healthy at either weight extremes	S: ‘I think children can be fat until they are age 10 without being unhealthy, after that they become tall and all the fat melts away.’ L: ‘I think there are a lot of ways to say that there is a healthy kid. Physically, that they’re not too fat. That they’re not too skinny or too fat.’ H: ‘If their muscles are tight, even if they’re fat, they’re healthy. They will not be sick. If he is fat and his muscles are loose, then he will be very tired and not have much strength. You have to take him to go exercise so his muscles are tight and he has strength.’
Parents’ perceptions of causes of childhood obesity	Food: overeating, or eating ‘tasty’ foods that are salty, fatty and sweet, or American foods	S1: ‘Junk food is the worst! If a child just eats food from outside he will become fat, and he isn’t cooked natural food that was made in a pot, the child will become fat.’ S2: ‘The mixed powdered juice that we add sugar.’ S3: ‘Juice is a drink, people don’t become fat from it.’ L1: ‘Maybe the fast food because, being in this country … the fast food is one of the main causes.’ L2: ‘The amount of juice. Because juice is recommended, but it’s the amount of juice that they drink.’ H1: ‘Parents like to feed their children to make them plump. They love their kids. They overfeed them. They don’t feed only three meals a day. Our Hmong men and women at home, as long as our kids are hungry we generously feed them. They eat meats and rice only. They drink milk, eat whatever they want and eat as much as they want.’ H2: ‘The thing that makes kids big is ice cream and McDonalds … [and] overeating. I have an older daughter that eats a lot like … she is a lot bigger than the rest of the kids.’
	Physical activity: children are not moving, are not exercising enough	S: ‘That he doesn’t exercise a lot … A child that doesn’t exercise – eating a lot of food – all that brings about the child getting fat.’ L: ‘Watch television for long periods of time and only eating without doing any type of exercise [causes obesity].’ H: ‘[I]n this country, you don’t have a garden. You don’t sweat. You eat and sit around. You don’t have a chance to sweat. It can make you sick. Your body is not healthy.’
	Environment: cost of food, easy access and availability of food, processed foods, chemicals in foods, weather	S: ‘Children become fat if they have permission to go into the fridge so they can eat anything they want all night. That child will become fat and his food will be without control, so that he can eat whatever he wants.’ L: ‘I don’t know what they inject in them [food]. I imagine it is hormones and I think that, the same way the little chickens are growing, we are also consuming those hormones that they’re injecting in the little chickens. And I think that is also affecting the girls that gain weight.” H: ‘Another reason why they overeat is because in this country, when it gets cold, there are not enough places to be active. The kids are always home. The kids don’t get a chance to jump around and be active or go anywhere.’