The association between food environment, diet quality and malnutrition in low- and middle-income adult populations across the rural-Urban gradient in Vietnam.

Autor: Vuong VT; Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA., Fiorella KJ; Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA., Jones AD; School of Public Health, Ann Arbor, MI, USA., Thi Trinh H; Department of Mathematics and Statistics, Thuongmai University, Hanoi, Vietnam., Khoury CK; San Diego Botanic Garden, Encinitas, CA, USA., Huynh TTT; The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam., Hoang KT; WorldFish, Penang, Malaysia and The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam., Nguyen KT; The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam.
Jazyk: angličtina
Zdroj: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association [J Hum Nutr Diet] 2023 Dec; Vol. 36 (6), pp. 2201-2218. Date of Electronic Publication: 2023 Oct 04.
DOI: 10.1111/jhn.13242
Abstrakt: Background: Economic reforms and trade liberalisation in Vietnam have transformed the food environment, influencing dietary patterns and malnutrition status. The present study focuses on the relationship between food environments (proximity and density of food outlets) and malnutrition (underweight, overweight, obesity) through diet quality in adult populations across urban, periurban and rural areas of Vietnam.
Methods: We evaluated food environment by geospatial mapping of food outlets through a transect walk across the "food ecosystem" from rural to urban areas. Diet quality was assessed using the Diet Quality Index - Vietnamese (DQI-V) comprising Variety, Adequacy, Moderation and Balance components. Malnutrition status was determined using body mass index. We performed a mediation analysis utilising mixed effect models to control for neighbourhood clustering effects. Confounders included age, education, income and nutrition knowledge score.
Results: Analysis of data from 595 adult participants (mean ± SD age: 31.2 ± 6.4 years; 50% female) found that longer distance to the nearest food outlet was associated with higher overall DQI-V (β = 2.0; 95% confidence interval = 0.2-3.8; p = 0.036) and the Moderation component (β = 2.6; 95% confidence interval = 1.2-4.0; p = 0.001). Outlet density shows a negative association with the odds of underweight among women (odds ratio = 0.62; 95% confidence interval = 0.37-0.96). However, we did not observe statistically significant relationships between diet quality and malnutrition. Education and nutrition knowledge scores were positively associated with diet diversity, while income was negatively associated with diet moderation.
Conclusions: The findings of the present study have important implications for nutrition and dietetics practice in Vietnam and globally. It emphasises the need to consider various dimensions of sustainable diets, including economic, health and socio-cultural/political factors. Longer distances to food outlets are associated with higher diet quality, whereas lower food outlet density increases the odds of underweight among women. This poses challenges in balancing modernisation and its adverse effects on sustainable food systems. Socio-economic status consistently correlated with diet quality and malnutrition, necessitating further research to promote healthy diets across socio-economic strata.
(© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)
Databáze: MEDLINE
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