RESUMO
Food choices that shape human diets and health are influenced by various socio-economic factors. Vietnam struggles to meet many nutrition targets where links between food choice and diet have not been widely explored. This study assesses the food choice motives, based on a 28-item food choice questionnaire (FCQ), and the diet quality of 603 adults in three sites (urban, peri-urban, and rural) in northern Vietnam. We assess diet quality using the Diet Quality Index-Vietnam (DQI-V) which consists of variety, adequacy, moderation, and balance components. Using factor analysis, we grouped FCQ items into five factors: health focus, sensory appeal, mood ethics, convenience, and familiarity. The structural equation modeling indicates that food choice motives significantly impact the DQI-V and its components but in different directions. The results show that sensory appeal has a positive association with the overall DQI-V score, while having a negative impact on the variety component. Findings present a potential trade-off issue for interventions and policies related to food products. Nutrition knowledge is positively associated with all elements of diet quality across all three study sites. Vietnamese agrobiodiversity could be better utilized to increase dietary diversity. Differentiated policies are necessary to address the poor dietary diversity and adequacy in northern Vietnam.
RESUMO
Child overweight or obesity is increasing in most countries, including Vietnam. We sought to elucidate the drivers of child overweight or obesity in Vietnam and understand how they vary geographically. We compiled nationally representative cross-sectional data from the Vietnam Nutrition Surveillance Survey collected annually between 2012-2015 and household income data from the General Statistics Office. We used a quasi-Poisson log link function to calculate relative risks (RRs) of under-five child overweight or obesity for 13 variables and stratified analyses by child age (<2 y and 2-5 y) and region. Additional analysis included log-log linear regression to assess the relationship between average provincial monthly per capita income and child overweight or obesity. The strongest associations with child overweight or obesity included birthweight >4000 g (RR: 1.66; 95% confidence interval (CI): 1.48, 1.86), maternal body mass index (BMI) ≥27.5 compared with BMI <23 (RR: 1.62; 95% CI: 1.47, 1.78), and living in the Southeast (RR: 2.06; 95% CI: 1.84, 2.30), Mekong River Delta (RR: 1.58; 95% CI: 1.41, 1.77), or Central South (RR: 1.54; 95% CI: 1.37, 1.74) compared with the Central Highland. A 20% higher provincial average monthly per capita income was associated with a 17.4% higher prevalence in child overweight or obesity (P < 0.0001, Adjusted R2 = 0.36). High birthweight and maternal BMI were strongly associated with child overweight or obesity but are not likely primary drivers in Vietnam, given their low prevalence. C-section delivery, sedentary lifestyle, high maternal education, urbanicity, and high household income affect a large proportion of the population and are, therefore, important risk factors. Policies and programs should target these factors and regions at greatest risk of overweight or obesity, particularly the Southeast and Mekong River Delta.