Food on the Go: How Engagement with the Food Environment Affects Adolescent Diets in Northern Vietnam

As adolescents grow older, they increasingly engage with the food environment.

Our study aimed to 1) assess the contribution of prepared out of home (POH) foods to the healthiness of adolescent diets and 2) identify sociodemographic factors associated with POH food intake in a rural, a peri-urban, and an urban area of Vietnam.

We conducted a cross-sectional survey among 11- to 19-y-old adolescents (n = 2861) and collected sociodemographic and dietary intake data (24-h recall). The healthiness and micronutrient adequacy of diets were assessed using the Global Diet Quality Score and the micronutrient adequacy ratio, respectively. We used regression analyses with robust standard errors (to account for school-level clustering) to assess the consequences and identify the drivers of POH food intake.

Of the adolescents, >80% consumed POH foods on the previous day, contributing 22% to 26% of their daily energy intake. Healthy food groups were underrepresented in POH foods, which were higher in fat, saturated fat, and sodium but also had higher micronutrient density than foods prepared at home. POH food intake was associated with higher energy intake and micronutrient adequacy but lower diet healthiness. Socioeconomic status, female sex, pocket money, and smartphone ownership were associated with POH food consumption, with site-specific differences.

Food environments should be made healthier through front-of-package warning labels, reformulation (e.g., reducing milk fat and sugar), and restrictions on the marketing and availability of unhealthy foods combined with the promotion of healthy foods, snacks, and meals.