Industrial Food Systems as Environmental Drivers of Women’s Health and Childhood Obesity: A Cross-National Ecological Study

Background: Childhood obesity is a growing global public health concern influenced by early-life conditions and broader environmental factors. Although industrial food systems shape dietary patterns, cross-national ecological evidence on how these environments influence childhood obesity through population-level pathways related to women’s health remains limited. Objective: This study aims to examine whether industrial food systems influence childhood obesity through population-level pathways involving women’s health, and to assess whether female obesity mediates the association between national sugar availability and childhood obesity prevalence. Methods: A cross-national ecological study was conducted using publicly available data from 46 countries (2015–2020). Childhood obesity (ages 5–19 years) and female obesity (≥18 years) were obtained from the WHO Global Health Observatory. Food system indicators were derived from FAOSTAT, and socioeconomic variables from the World Bank. Pearson correlations, multivariable regression models, and mediation analysis with bootstrapping (5000 resamples) were performed. Results: Female obesity was strongly associated with childhood obesity prevalence (r = 0.71, p < 0.001), explaining approximately 50% of its variance. Sugar availability was positively associated with both female obesity and childhood obesity (r = 0.49 for both associations; p < 0.001). In multivariable models, female obesity remained the only significant predictor (β = 0.61, p < 0.001), with the model explaining 59% of the variance (R2 = 0.59; adjusted R2 = 0.49). Mediation analysis showed a significant indirect effect of sugar availability on childhood obesity through female obesity (B = 0.013, p = 0.003), with no significant direct effect. Conclusions: These findings support a population-level framework in which industrial food systems may influence intergenerational obesity through pathways involving women’s health. Female obesity may act as an integrative marker linking food environments to childhood obesity risk.