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Nutrition, Diets, and Health

Gabriela Fretes

Research Fellow

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Bio

Gabriela (Gabi) Fretes is a Research Fellow in the Nutrition, Diets, and Health Unit. Her research focuses on the intersection of child obesity prevention, food policy, and consumer behavior. Her work spans a range of topics and methods including nutrition and dietary assessment, characterizing food environments, and identifying innovations to stimulate the demand for sustainable healthy diets, while also improving livelihoods, gender equity, and social inclusiveness in all sectors of food systems. She has worked or is actively working with a broad range of government, international organizations, academia, public and private sector stakeholders, and decision-makers in Paraguay, Chile, Viet Nam, and Ethiopia. She holds a PhD in Food and Nutrition Policies and Programs from the Friedman School of Nutrition Science and Policy, Tufts University.

Languages: Spanish, English

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Journal Article

Food on the go: How engagement with the food environment affects adolescent diets in northern Vietnam

2026Fretes, Gabriela; Nguyen, Phuong Hong; Gune, Soyra; Maasen, Kim; Talsma, Elise F.; Truong, Mai Tuyet; Hoang, Nga Thu; Brouwer, Inge D.; Ruel, Marie T.; Leroy, Jef L.
Details

Food on the go: How engagement with the food environment affects adolescent diets in northern Vietnam

As adolescents grow older, they increasingly engage with the food environment. Our study aimed to: 1) assess the contribution of prepared out of home (POH) foods to the healthiness of adolescent diets and 2) identify socio-demographic factors associated with POH foods intake in a rural, a peri-urban, and an urban area of Vietnam. We conducted a cross-sectional survey among 11–19-year-old adolescents (n = 2,861) and collected socio-demographic and dietary intake data (24-hour recall). The healthiness and micronutrient adequacy of diets was assessed using the Global Diet Quality Score (GDQS) and the micronutrient adequacy ratio (MAR) respectively. We used regression analyses with robust standard errors (to account for school-level clustering) to assess the consequences and identify the drivers of POH food intake. Over 80% of adolescents consumed foods POH on the previous day, contributing 22–26% of daily energy intake. Healthy food groups were underrepresented in POH foods, which were higher in fat, saturated fat, and sodium, but also had higher micronutrient density than foods prepared at home. POH intake was associated with higher energy intake and micronutrient adequacy, but lower diet healthiness. Socioeconomic status, female sex, pocket money, and smartphone ownership were associated with POH consumption, with site-specific differences. Food environments should be made healthier through front-of-package warning labels, reformulation (e.g., reducing milk fat and sugar), and restrictions on the marketing and availability of unhealthy foods combined with the promotion of healthy foods, snacks and meals.

Year published

2026

Authors

Fretes, Gabriela; Nguyen, Phuong Hong; Gune, Soyra; Maasen, Kim; Talsma, Elise F.; Truong, Mai Tuyet; Hoang, Nga Thu; Brouwer, Inge D.; Ruel, Marie T.; Leroy, Jef L.

Citation

Fretes, Gabriela; Nguyen, Phuong Hong; Gune, Soyra; Maasen, Kim; Talsma, Elise F.; et al. 2026. Food on the go: How engagement with the food environment affects adolescent diets in northern Vietnam. Journal of Nutrition 156(9): 101691. https://doi.org/10.1016/j.tjnut.2026.101691

Country/Region

Vietnam

Keywords

Asia; South-eastern Asia; Foods; Food Environment; Diet; Adolescents; Healthy Diets; Micronutrient Deficiencies; Nutrient Intake; Nutrition

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1016/j.tjnut.2026.101691 Source record

Project

Sustainable Healthy Diets

Record type

Journal Article

Resource thumbnail

Journal Article

Urbanicity and the diets and nutritional status of adolescents and their mothers in Vietnam

2026
Nguyen, Phuong Hong; Maasen, Kim; Talsma, Elise F.; Zagré, Rock Romaric; Gune, Soyra; Tran, Lan Mai; Truong, Mai Tuyet; Hoang, Nga Thu; Vuong, Ngoc Ho Thi; Fretes, Gabriela
…more Brouwer, Inge D.; Ruel, Marie T.; Leroy, Jef L.
Details

Urbanicity and the diets and nutritional status of adolescents and their mothers in Vietnam

Background Urbanization catalyzes significant shifts in diets worldwide, yet its impact on adolescent diets and nutrition is poorly understood. Objectives We examined the association between urbanicity and diets and nutritional status among Vietnamese adolescents and their mothers. Methods We assessed diets using a multipass 24-h recall (15% repeated) and collected anthropometric data from 2861 adolescents and their mothers (n = 2664) in rural, peri-urban and urban areas. We calculated the Global Diet Quality Score (GDQS: total 0–49; healthy: 0–32; unhealthy: 0–17) and risk categories. We estimated usual intakes (National Cancer Institute’s method) and the mean probability of adequacy (MPA) for 11 micronutrients. We compared outcomes across areas using regression models adjusted for school-level clustering. Results GDQS healthy was higher in the urban area (adolescents 7.5, mothers 9.5) than in the rural area (6.6 and 7.7). GDQS unhealthy was comparable across areas (∼11 in adolescents and mothers). Adolescent and maternal diets in the rural area were most likely to fall in the GDQS high-risk category for nutrient inadequacy and non-communicable diseases(23% and 11%). MPA was low across all areas for both adolescents and mothers (≤40%). The prevalence of overweight/obesity was highest in urban areas among adolescents (29%) and similar across areas among mothers (15%–19%). Conclusions Urbanicity was positively associated with healthier diets due to greater healthy food consumption, but also with higher risks of adolescent overweight/obesity. Differences by study area, however, were small and diet healthiness was low across all settings. Innovative school and food environment interventions and policies are needed to promote greater consumption of healthy foods and limit unhealthy food intake among Vietnamese adolescents and their mothers, and to prevent and control rising overweight/obesity.

Year published

2026

Authors

Nguyen, Phuong Hong; Maasen, Kim; Talsma, Elise F.; Zagré, Rock Romaric; Gune, Soyra; Tran, Lan Mai; Truong, Mai Tuyet; Hoang, Nga Thu; Vuong, Ngoc Ho Thi; Fretes, Gabriela; Brouwer, Inge D.; Ruel, Marie T.; Leroy, Jef L.

Citation

Nguyen, Phuong Hong; Maasen, Kim; Talsma, Elise F.; Zagré, Rock Romaric; Gune, Soyra; et al. 2026. Urbanicity and the diets and nutritional status of adolescents and their mothers in Vietnam. Journal of Nutrition 156(7): 101624. https://doi.org/10.1016/j.tjnut.2026.101624

Country/Region

Vietnam

Keywords

Asia; South-eastern Asia; Urbanism; Diet; Healthy Diets; Nutritional Status; Adolescents; Nutrient Intake; Trace Elements; Rural Areas

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1016/j.tjnut.2026.101624 Source record

Project

Sustainable Healthy Diets

Record type

Journal Article

Resource thumbnail

Journal Article

Food is always close by: An assessment of the healthiness of the adolescent home and school food environments in northern Vietnam

2026
Fretes, Gabriela; Zaw, Nicholus Tint; Nguyen, Phuong Hong; Le Port, Agnes; Maasen, Kim; Talsma, Elise F.; Truong, Mai T.; Tran, Trang T.T.; Brouwer, Inge D.; Ruel, Marie T.
…more Leroy, Jef L.
Details

Food is always close by: An assessment of the healthiness of the adolescent home and school food environments in northern Vietnam

Background Adolescents are vulnerable to rapidly evolving food environments. Urbanization is widely thought to contribute to less healthy food environments, and school food environments are often considered less healthy than those at home. These associations, however, have not been quantified. Objective Assess differences in adolescent food environments in Northern Vietnam by setting (home vs school) and area (rural town, peri-urban or urban). Methods We collected cross-sectional data on adolescents (n=3,005) and surveyed all outlets (n=6,194) that sold food or beverages around adolescents’ homes and schools (n=13) in three sites that differed in urbanicity. We calculated distances from home and school to the nearest outlet selling select food groups and measured outlet density and diversity of foods offered (within 100-meter radius). We analyzed differences by urbanicity and by home/school environment using regression models, accounting for clustering at commune level. Results Both unhealthy food groups (UFG) (e.g., sugar-sweetened beverages, sweets), and healthy food groups (HFG) (e.g., fruits, nuts/seeds) were closer to adolescents’ home in the urban (∼21-50 m) than the peri-urban area (∼75-200 m) and rural town (∼155-270 m). Fruits and vegetables were consistently further away than UFG across all areas in home environments, although still close by (∼ 50-270 m). Urban adolescents were exposed to the greatest density and diversity of both HFG and UFG close to home and school. There were no differences in healthiness of home and school food environments. Conclusions Unhealthy foods were more accessible (in distance) and available (in density) than fruits and vegetables across all settings, but differences were small and food was always close by. Diversity of HFG and UFG was the greatest in urban areas. Healthy foods should be promoted and made the preferred choice through nudging interventions at point-of-purchase, combined with restrictions on the marketing and availability of unhealthy foods.

Year published

2026

Authors

Fretes, Gabriela; Zaw, Nicholus Tint; Nguyen, Phuong Hong; Le Port, Agnes; Maasen, Kim; Talsma, Elise F.; Truong, Mai T.; Tran, Trang T.T.; Brouwer, Inge D.; Ruel, Marie T.; Leroy, Jef L.

Citation

Fretes, Gabriela; Zaw, Nicholus Tint; Nguyen, Phuong Hong; Le Port, Agnes; Maasen, Kim; et al. 2026. Food is always close by: An assessment of the healthiness of the 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

Country/Region

Vietnam

Keywords

Asia; South-eastern Asia; Foods; Healthy Diets; Adolescents; Food Environment; School Feeding; Spatial Analysis; Urbanism

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1016/j.cdnut.2026.109402 Source record

Project

Sustainable Healthy Diets

Record type

Journal Article

Blogs

Food is always close by: Why availability alone doesn’t explain adolescent diets in Viet Nam
Research Post
 | 
October 06, 2026

Food is always close by: Why availability alone doesn’t explain adolescent diets in Viet Nam

By Gabriela Fretes, Nicholus Zaw, Phuong Nguyen, Agnes Le Port, Kim Maasen, Elise Talsma, Mai Tuyet Truong, Trang TT Tran, Inge D. Brouwer, Marie Ruel, and Jef L. Leroy

Third in a series on food environments and youth nutrition.

Food on the go: How food environments shape adolescent diets in Viet Nam
Research Post
 | 
August 28, 2026

Food on the go: How food environments shape adolescent diets in Viet Nam

By Gabriela Fretes, Phuong Nguyen, Soyra Gune, Kim Maasen, Elise Talsma, Mai Tuyet Truong, Nga Thu Hoang, Inge D. Brouwer, Marie Ruel, and Jef L. Leroy

How nutritious are snacks and meals outside the home?

Urban living linked to slightly healthier diets but also higher overweight and obesity among adolescents in Viet Nam
Research Post
 | 
July 17, 2026

Urban living linked to slightly healthier diets but also higher overweight and obesity among adolescents in Viet Nam

By Phuong Nguyen, Kim Maasen, Elise Talsma, Rock Zagré, Soyra Gune, Lan Mai Tran, Mai Tuyet Truong, Nga Thu Hoang, Ngoc Ho Thi Vuong, Gabriela Fretes, Inge D. Brouwer, Marie Ruel, and Jef L. Leroy

A study shows a complex reality.

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IFPRI @ XXI Latin American Congress of Nutrition (SLAN 2026)

The XXI Latin American Congress of Nutrition (SLAN 2026) will take place from 25–29 October 2026 in Santiago, Chile, bringing together researchers, academics, health professionals, policymakers, and students from across the region to discuss the future of food systems and nutrition. The congress will be held at the Centro Cultural CEINA, a prominent cultural and […]

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Dissemination Seminar on Consumer & Food Environment Research in Ethiopia

Globalization, urbanization, and economic growth are rapidly reshaping food environments, driving shifts in dietary patterns and increasing the risk of nutritional challenges. The CGIAR Science Program on Better Diets and Nutrition (BDN) aims to address these issues by stimulating both the demand for and supply of sustainable nutritious foods. This seminar will feature BDN’s work […]

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Shaping Food Policy in a Changing World: Research Priorities for Greater Impact

In today’s fast-changing world and evolving food systems, the need for evidence-based food policy has never been more urgent – demanding research that is timely, inclusive, and tailored to context. Reliable data and rigorous analysis are essential, but research must also evolve – and become more timely, more relevant, and more inclusive of diverse voices […]

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