Abstract
Childhood obesity has emerged as a formidable public health challenge in metropolitan settings, where rapid urbanization, sedentary routines, and high availability of ultra-processed foods converge. Mothers frequently serve as the primary nutritional gatekeepers, shaping household food security, meal composition, and long-term health trajectories. This cross-sectional survey study investigates the correlation between maternal adherence to sustainable dietary habits and the prevalence of obesity risk factors among children aged 6 to 11 residing in major metropolitan areas of Turkey. A total of 614 mother-child dyads were recruited via stratified convenience sampling in Istanbul and Ankara. Data were collected using an adapted Sustainable Diet Adherence Scale (SDAS), a validated pediatric food frequency questionnaire, and standardized parent-reported anthropometric and lifestyle measures. Multivariable logistic regression revealed that higher maternal sustainable diet scores—characterized by abundant plant-based foods, minimal ultra-processed food consumption, and conscientious waste management—were significantly associated with lower odds of child overweight and obesity (adjusted odds ratio [aOR] = 0.58, 95% confidence interval [CI]: 0.44–0.77, p < 0.001). Furthermore, children of mothers with high sustainability scores demonstrated reduced ultra-processed food intake, lower daily screen times, and higher dietary diversity. These findings underscore that integrating environmental sustainability into maternal nutritional education can yield dual co-benefits: preserving ecological resources while mitigating pediatric metabolic vulnerabilities in urban environments.