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.