Nutrition transition in Vietnam: changing food supply, food prices, household expenditure, diet and nutrition outcomes
Nutrition transition in Vietnam: changing food supply, food prices, household expenditure, diet and nutrition outcomes
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DOI：
10.1007/s12571-020-01096-x
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发表时间：
2020-09-01
期刊：
影响因子：
6.7
通讯作者：
Phuong Nam Huynh
中科院分区：
文献类型：
--
作者：
Harris, Jody;Phuong Hong Nguyen;Phuong Nam Huynh
虽然文献已经注意到在越南存在营养转变，但将上游食物系统因素的变化与下游饮食和营养变化联系起来的证据非常有限。结合来自不同来源的现有数据，并通过概念食品系统框架进行分析，我们的研究考察了越南通过食品供应、食品价格、家庭食品支出、饮食和营养结果进行营养转变的不同途径。我们的发现表明，虽然越南正处于营养转型的开始阶段，但变化正在迅速发生。营养不良正在下降，肥胖症正在上升，与营养相关的慢性病是疾病和死亡的重大负担。在健康食品变化方面，蔬菜和水果供应充足，蔬菜支出保持一致和小额。然而，值得注意的是，蔬菜消费量下降了，而肉类和牛奶消费量的增加对营养来说是一把双刃剑。在与营养转型的负面影响相关的食物方面，近年来甜食和含糖饮料的供应有所增加，油脂和脂肪的增加较少。外出就餐的支出份额随着时间的推移而增加，在许多情况下，这是不太健康饮食的标志。虽然这些变化是营养转型的典型，但越南在某些方面也是异类：菜市场和日常新鲜食品购买继续主导着食品购买行为，而在一个以多样化和健康的街头小吃和路边餐馆文化闻名的国家，外出就餐意味着不同的事情。虽然这项研究汇集了关于越南营养转型的食品体系驱动因素的重要数据，但由于不同水平的数据差距，它无法将这些问题中的每一个都联系到一个标准的统计变化模型中，呼吁在未来的饮食和食品体系研究中改进数据收集。越南卫生政策明确承认营养转型问题，目标是减少肥胖。然而，这项关于营养转型的粮食系统驱动因素的工作表明，需要进一步调整卫生以外其他部门的政策。在让营养丰富的食品更容易获得的同时，如果要增加收入以促进健康饮食，限制越南正在出现的营养转型，就需要降低营养不足或超加工食品的可及性和可取性。
While literature has noted the presence of a nutrition transition in terms of changing nutrition outcomes in Vietnam, very limited evidence linking changes in upstream food system factors to downstream diet and nutrition changes exists. Combining available data from different sources and analyzing it through a conceptual food systems framework, our study examines different pathways of nutrition transition through food supply, food prices, household food expenditures, diets, and nutrition outcomes in Vietnam. Our findings show that while Vietnam is at the start of its nutrition transition, change is happening rapidly. Undernutrition is falling, obesity is rising, and nutrition-related chronic diseases account for a significant burden of diseases and death. In terms of changes in healthful foods, the supply of vegetables and fruits is plentiful, and expenditure on vegetables remains consistent and small. Notably however, vegetable consumption has dropped, and increasing meat and milk consumption have been double-edged swords for nutrition. In terms of foods associated with the negative sides of the nutrition transition, the availability of sweets and sweetened beverages has risen in recent years, with oils and fats rising less. The expenditure share on food eaten away from home, in many contexts a marker for less healthful diets, has increased over time. While these changes are typical of a nutrition transition, Vietnam is also somewhat of an outlier in some respects: wet markets and daily fresh food purchases continue to dominate food purchasing behaviour, and food eaten away from home means a different thing in a country renowned for its diverse and healthy street food and roadside restaurant culture. While this study brings together important data on the food system drivers of a nutrition transition in Vietnam, it cannot link each of these issues into a standard statistical model of change due to data gaps at different levels, calling for data collection improvement in future diet and food systems research. Vietnamese health policy explicitly acknowledges nutrition transition issues, with targets for obesity reduction. This work on the food system drivers of the nutrition transition points to the need to further adapt policy in other sectors beyond health, however. At the same time as making nutrient-rich foods more accessible, nutrient-poor or ultra-processed foods need to be made less accessible and desirable if additional income is to contribute to a healthy diet in limiting Vietnam's emerging nutrition transition.