Gabriela Fretes

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.

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.

Front-of-pack labels and young consumers: An experimental investigation of nutrition and sustainability claims in Chile