(P22-045-24) Low Global Diet Quality Score (GDQS) Among Adolescents in Vietnam Is Due to Inadequate Consumption of Fruits and Vegetables Rather Than High Consumption of Unhealthy Foods

Objectives: Rapid urbanization coupled with a nutrition transition has catalyzed significant shifts in lifestyle and diets in mega-cities around the world, but the impacts on adolescent diets are poorly understood. This study aims to fill this gap, comparing diet quality (measured by the Global Diet Quality Score, GDQS) and adequacy of micronutrient intakes among adolescents in urban, peri-urban, and rural areas of Vietnam.

Methods: We collected data on adolescents (11-19 y) from low-income neighborhoods in urban (n=868), peri-urban (n=937), and rural (n=1056) areas and assessed dietary intake using multi-pass 24-hour recalls (15% repeated measures). We classified foods consumed into 25 GDQS food groups (score 0-49; GDQS healthy (+): 0-32; unhealthy (-): 0-17), with a higher score reflecting a lower risk of poor diet quality. Nutrient intakes were derived using food composition tables; and micronutrient probability of adequacy (PA) was calculated using the National Cancer Institute (NCI) method. Differences in diet quality and adequacy by residence were compared using ANOVA with Bonferroni post-hoc tests.

Results: GDQS+ was low (6.6-7.1 over 32 points) while GDQS- was ~11 over 17 points across the three areas. The risk of poor diet quality was slightly higher in rural (23.4%) than peri-urban (18.5%) and urban areas (17.1%), and was driven by low consumption of healthy foods (fruits, vegetables, legumes, and eggs) rather than excessive consumption of unhealthy foods. Refined grains and baked goods were universally consumed, but sweets, ice cream, and sugar-sweetened beverages were consumed by 20% or less of our sample. Consumption of high-fat dairy (32.9%) and red meat (74%) was higher in urban compared to rural areas. The PA of micronutrient intakes was low ( < 0.5) for most micronutrients except iron, zinc and vitamin C and mean PA was very low (0.32-0.35).

Conclusions: Diet quality among Vietnamese adolescents is generally poor across residential areas, mostly due to inadequate consumption of healthy foods. The very low PA for micronutrients across all three areas is concerning. Efforts are needed to stimulate increased consumption of healthy foods, to reduce consumption of red meat and replace high-fat dairy with low-fat options, and to maintain a low consumption of other unhealthy foods.

Funding Sources: IFPRI and CGIAR Research Initiative on SHIFT