Interactions between Food Environment and (Un)healthy Consumption: Evidence along a Rural-Urban Transect in Viet Nam

Abstract

There is limited evidence on food environment in low and middle-income countries (LMICs) and the application of food environment frameworks and associated metrics in such settings. Our study examines how food environment varies across an urban-peri-urban-rural gradient from three sites in North Viet Nam and its relationship with child undernutrition status and household consumption of processed food. By comparing three food environments, we present a picture of the food environment in a typical emerging economy with specific features such as non-market food sources (own production and food transfers) and dominance of the informal retail sector. We combined quantitative data (static geospatial data at neighborhood level and household survey) and qualitative data (in-depth interviews with shoppers). We found that across the three study sites, traditional open and street markets remain the most important outlets for respondents. Contrary to the common concern that urban households are the major consumers of processed foods, peri-urban and rural areas on average had higher consumption of ultra-processed foods than in urban areas. The low price levels of processed foods and the presence of processed foods even among the traditional convenience stores, those in closest proximity to the rural households, offer potential explanations of this result. Regarding undernutrition, low retail diversity and a household’s dependence on own production have important implications for the high prevalence of child undernutrition in rural areas. Our findings add to the current discussion on the critical role of the food environment on nutrition, such as the potential link between economic marginalization and access to food, and the role of food supply channels in consumption of processed foods.

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

“…To explore the built food environment of the 30 research communes, geospatial mapping of different food outlets was performed to identify and map different food outlets 28 . This mapping process involved a transect walk in the “food ecosystem” from rural to urban areas.…”

“…This mapping process involved a transect walk in the “food ecosystem” from rural to urban areas. In cases where formal maps and data were unavailable, transect walks were considered valuable for documenting community environments 28,31 . During the walk, the researcher, accompanied by a local guide, traversed (walked or drove) the 30 sampled communes within their administrative boundaries, identifying and recording all food retailers in the area.…”

“…To explore the built food environment of the 30 research communes, geospatial mapping of different food outlets was performed to identify and map different food outlets. 28 This mapping process involved a transect walk in the "food ecosystem" from rural to urban areas. In cases where formal maps and data were unavailable, transect walks were considered valuable for documenting community environments.…”

“…In rural areas of Vietnam, the high prevalence of child undernutrition is significantly influenced by factors such as limited retail diversity and households relying on their own production 28 . In a study conducted among urban households in Vietnam, modern market food expenditure was positively associated with consumption of foods rich in heme iron and protein, although there was no significant association with dietary diversity or diet quality 13 …”

Spatial and temporal trends in food security during the COVID-19 pandemic in Asia Pacific countries: India, Indonesia, Myanmar, and Vietnam

“…Livelihoods and household ability to purchase available foods were most affected, especially among the poorest families [ 9 10 ]. Vietnam suffered from lockdown measures that negatively affected the country's economy, particularly the labor market [ 11 ]. In Indonesia, a decline in real wages was reported in the informal sector, but the country’s economy still grew in 2021, suggesting an increasing socio-economic disparity within the country [ 12 ].…”