A journey through adolescents’ food environments in Vietnam: Innovative research using participatory video making

What can we learn about food environments from an adolescent's perspective?

In Vietnam, the rapidly changing food environment-shaped by globalization, urbanization, economic growth, and other factors-has led to changes in dietary patterns and heightened the risk of malnutrition among adolescents. These transformations have notably led to the increased availability and consumption of ultra-processed foods, which is likely to have adverse dietary and health implications.

The CGIAR Research Initiative on Sustainable Healthy Diets through Food Systems Transformation (SHiFT) seeks to address these issues by stimulating both the demand for and supply of sustainable nutritious foods. In 2023, researchers from the Alliance of Bioversity International and CIAT launched activities aimed at co-creating interventions to enhance food environments and foster the adoption of sustainable healthy diets among adolescents. Their primary objectives are to document adolescents' perceptions of their food environments, identify the main challenges and opportunities for accessing and consuming sustainable healthy diets, and co-design community action plans to enhance these food environments for better diets.

The first stage of this research focused on understanding adolescents' perceptions of their food environments through participatory video-making. This initial stage provided insights into how adolescents perceive and interact with their food environments. The study was conducted in three districts: Moc Chau (rural), Dong Anh (peri-urban), and Dong Da (urban). It involved 54 adolescents (ages 15-17 years) from selected public schools, with a balanced representation of boys and girls.

Our preliminary results from the first stage indicate that adolescents' food environments are characterized by a range of channels including wet markets, street stalls, food stores, restaurants, school canteens, convenience stores, supermarkets and more. This mix provides adolescents with access to a wide range of both fresh, locally sourced foods and processed and packaged foods.

Brice Even, researcher at the Alliance, explains:

"Overall, there seems to be a relative balance between healthy and unhealthy food options available to adolescents, but the latter are often more accessible when at school, and are likely more appealing due to their cost and convenience. For example, school canteens provide both fresh, processed and ultra-processed food options, but ultra-processed food items tend to be cheaper. Another concern is that local restaurants, convenience stores, and street stalls depicted in adolescent's videos predominantly serve processed and ultra-processed foods high in sugar, salt, and fat. While fresh and minimally processed foods are available, the prevalence of processed and ultra-processed options within and around schools is significant and may contribute to less healthy eating habits among adolescents."

Food prices and affordability seem to be crucial factors influencing food choices, with lots of options for affordable unhealthy snacks and beverages. School canteens offer cheaper food compared to other food outlets, with ultra-processed foods being the most inexpensive options offered. Convenience also seems to be a significant driver of food choices, where for instance, the need for quick and easy meals often results in a preference for ultra-processed, ready-to-eat options over healthier alternatives. to these foods is further compounded by the close proximity of various outlets (both within and just outside school premises), many of which remain open from early morning until late evening.

Deborah Nabuuma, scientist at the Alliance and leader of this research work, notes that:

"Peer influence, social media, and advertisements seem to play a significant role in shaping adolescents' food choices, often toward less nutritious options. Marketing predominantly promotes ultra-processed foods, most likely influencing adolescents' preferences and choices. While adolescents recognize the nutritional benefits of fresh foods, their nutritional knowledge is limited and somehow reflects wrong messages conveyed through processed food advertisements."

"While adolescents recognize the nutritional benefits of fresh foods, their nutritional knowledge is limited and somehow reflects wrong messages conveyed through processed food advertisements." - Deborah Nabuuma

The preliminary analysis of the participatory video-making outputs reveals the complexities of adolescents' food environments in Vietnam, characterized by the coexistence of traditional and modern food outlets and the significant influence of ultra-processed foods. As we advance, we will engage in participatory co-design (stage 2) at the community level, involving local stakeholders-including adolescents, school staff, food retailers, and local authorities- in a co-analysis process involving the identification of key challenges and areas for improvement. The results of this co-analysis will provide the basis for the co-design of community-level interventions targeting the food environment to promote healthier and more sustainable food choices. Concurrently, similar participatory research is being conducted in Ethiopia, providing a comparative perspective that will deepen our understanding of adolescents' food environments across diverse contexts.

This blog was coauthored by…

Brice Even, Research Team Leader from the Alliance of Bioversity International and CIAT, Vietnam.

Deborah Nabuuma, Scientist I from the Alliance of Bioversity International and CIAT, Vietnam.

Header image: Adolescents in Moc Chau working on a storyboard. ©2024 International Center for Tropical Agriculture (CIAT) /Nguyen Hong Duong N.

All images featured in this blog are either screenshots from the videos produced by adolescents or photographs captured by members of the WP1 research team during the participatory research process. Consent for the use of these images was obtained from all participants at the outset of the participatory process.

The International Food Policy Research Institute and the Alliance of Bioversity and CIAT lead SHiFT in close collaboration with Wageningen University and Research and with contributions from the International Potato Center. SHiFT combines high-quality nutritional and social science research capacity with development partnerships to generate innovative, robust solutions that contribute to healthier, more sustainable dietary choices and consumption of sustainable healthy diets. It builds on CGIAR's unparalleled track record of agricultural research for development, including ten years of work on food systems and nutrition under the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH).