Key takeaways

• ·Healthy and unhealthy foods are equally accessible to adolescents in Viet Nam, a study shows. Food options were available close to adolescents’ homes and schools.
• ·School food environments were not less healthy than those around homes. Both offered a similar mix of healthy and unhealthy foods.
• Demand-side policies can help steer healthier eating. Clear labels, restrictions on marketing of unhealthy foods, and taxes on sugary drinks may be more effective than focusing only on availability.

Third in a series. Read the first post here and the second here.

Adolescence is a pivotal period for nutrition and health when young people begin to make more of their own decisions about what, where, and when to eat. Across low- and middle-income countries, adolescent development is now occurring alongside rapid changes in food environments—the places where people purchase and consume food—driven mainly by urbanization. These shifts often make unhealthy options such as ultra-processed snacks and other foods high in added sugar, saturated fats, and salt more convenient, affordable, and desirable.

In this series, researchers from the CGIAR Science Program on Better Diets and Nutrition explore how food environments in Viet Nam, Ethiopia, and Ghana shape adolescent diets and what actions are needed to support healthier choices during this critical stage of life.

The first two posts in this series examined what adolescents eat—how diets and nutritional status differ across rural, peri-urban, and urban settings, and the role of foods prepared outside the home. This post takes a closer look at food environments, exploring what foods are available to adolescents and how easy, or hard, it is to find healthy options.

Diets are not shaped by individual choices alone. Before anyone decides what to eat, the food environment around them determines what is sold, how close it is, and how much it costs. A common assumption is that food environments frequently visited by adolescents such as those around schools pose particular nutrition risks, pushing them towards unhealthy options. But is this the case for adolescents in Viet Nam?

To find out, researchers from IFPRI, Wageningen University & Research in the Netherlands, and Viet Nam’s National Institute of Nutrition mapped food outlets across three districts in northern Viet Nam: Dong Da (urban), Dong Ahn (peri-urban), and Moc Chau (rural). We compared the healthiness of food environments around adolescents’ homes and schools. Published in Current Developments in Nutrition, our study combined data from more than 3,000 adolescents aged 12-18 with a census of over 6,000 outlets selling food and drinks in 2022-2023.

Results

Healthy and unhealthy foods were within similar reach

Around adolescents’ homes and schools, both healthy foods such as whole grains, eggs, fish, and legumes and unhealthy foods such as ultra-processed snacks and sugary drinks were available within similar distances, most within 100 meters. Fruit and vegetables were generally the farthest away and least available, though the differences in distance were small. Across settings, the clearest difference was density: urban areas had far more outlets—selling both healthy and unhealthy foods—than peri-urban or rural areas.

School food environments were no unhealthier than those at home

While some might expect that school food environments—known to attract snack vendors—are less healthy than those around homes, we found no evidence to support this claim in the Vietnamese context. Within each setting, the mix of healthy and unhealthy options was similar.

More food outlets didn’t mean worse diets

Does a higher density of food outlets lead to different diets? Our findings suggest not. A companion analysis of the same adolescents (our first post) found no meaningful difference in the healthiness of diets across rural, peri-urban, and urban settings. Within the range of environments observed, the distance to and the density of food outlets did not appear to be a dominant driver of what adolescents ate. 

Connecting the food environment to diets

Read alongside earlier findings, our results suggest that engagement with the food environment appears to matter more than just exposure to it in shaping adolescent diets and nutrition. Our second post showed that adolescents who ate more food prepared outside the home had less healthy diets—a pattern observed across urban, peri-urban, and rural settings. Even when healthy foods were available and close by, adolescents tended to choose less healthy options. This suggests that diets are driven by other factors such as preferences, affordability, marketing, and social norms, rather than the distance to and/or density of outlets.

Implications for food environment policy

Since healthy and unhealthy foods are similarly available around both homes and schools, policies focused solely on the school food environment are unlikely to substantially improve adolescent diets. Similarly, measures that only modestly restrict access to unhealthy foods may have limited effectiveness, as even relatively low levels of access appear sufficient to drive consumption.

Instead, improving adolescent diets requires making healthy choices easy and appealing and making unhealthy foods and drinks more difficult to obtain. This could include front-of-package labeling so adolescents can quickly differentiate between healthy and unhealthy options, taxes on sugary drinks and unhealthy products, and restrictions on unhealthy food marketing, including on social media. These actions address the factors that draw adolescents toward unhealthy foods—preferences, price, and marketing. Food is always close by in Viet Nam, so policies are needed to help shape the choices adolescents make once it is within reach.

Gabriela Fretes is a Research Fellow with IFPRI’s Nutrition, Diets, and Health (NDH) Unit; Nicholus Zaw is an NDH Research Analyst; Phuong Hong Nguyen is an NDH Senior Research Fellow; Agnes Le Port is a Research Fellow with the French National Research Institute for Sustainable Development; Kim Maasen is an Assistant Professor, Global Nutrition, Wageningen University & Research (WUR), the Netherlands; Elise Talsma is a WUR Associate Professor, Global Nutrition; Mai Tuyet Truong is Vice Director, National Institute of Nutrition (NIN), Viet Nam; Trang TT Tran is with the National Institute of Nutrition, Viet Nam; Inge D. Brouwer is Director of the CGIAR Better Diets and Nutrition Science Program; Marie Ruel and Jef L. Leroy are NDH Senior Research Fellows. Opinions are the authors’.

We would like to thank all funders who supported this research through their contributions to the CGIAR Trust Fund.

Reference:
Fretes, G., Zaw, N. T., Nguyen, P. H., Le Port, A., Maasen, K., Talsma, E. F., Truong, M. T., Tran, T. T., Brouwer, I. D., Ruel, M. T., & Leroy, J. L. (2026). Food is always close by: An assessment of the healthiness of adolescent home and school food environments in Northern Vietnam. Current Developments in Nutrition, 10(7), 109402. https://doi.org/10.1016/j.cdnut.2026.109402