Perceptions of nutrition transition problems: a qualitative study of Vietnamese health and education professionals

Abstract

The nutrition transition (The transition towards higher levels of economic development in developing countries brings with it several other transitions: demographic [rural to urban, younger to older population distribution], technological [low to high mechanisation and motorisation] and nutritional and epidemiological [infectious diseases to NCDs]. The nutrition transition relates to a large shift in a population’s dietary and activity patterns, which are characterised by less physically active lifestyles and increased consumption of processed and energy-dense foods [and fewer traditional foods and cuisines]. These changes are reflected in nutritional and health outcomes, especially the rapid increases in levels of obesity and non-communicable diseases in many low- and middle-income countries’ populations.) presents critical challenges for population health in low- and middle-income countries. The implementation of health policies and programmes to mitigate the negative effects of the nutrition transition requires the engagement of schools and health service institutions in addition to government nutrition organisations to enhance awareness about health risks in the broad community. University education is the foundation for later professional practice. However, insufficient preparation of lecturers and outdated and static curricula have been claimed to contribute to the poor preparation of health and education graduates to respond nutrition transition. Thirty interviews were conducted to examine health and education professionals’ and nutrition lecturers’ perceptions of the nutrition transition in Vietnam and its drivers. The informants correctly understood the impact of the nutrition transition on their clients and the population, and their perceptions of the underlying drivers of these health conditions were identified. The education professionals claimed that it is easier to control undernutrition than to manage obesity and stressed the urgent need for programmes to control obesity. Economic improvement was viewed as a core driver contributing to the rise in the prevalence of obesity and chronic diseases. Family influences were perceived to be responsible for children’s poor eating patterns and obesity. Environmental influences were claimed to hasten the changes, including poor food safety, aggressive food marketing and the attractiveness of ‘new’ (Western) food in an emerging market economy. These findings suggest the need for more education for health and education professionals to respond to the nutrition transition.

Keywords:

• nutrition transition
• double burden of disease
• nutrition education
• qualitative study
• Vietnam

Notes

1. Health report: schools organise annual general health checks (weight, height, sight, oral health, respiration) for children, fees are paid by parents. Results of children’s individual health checks are sent confidentially to parents.

2. Schools provide lunches and snacks (which are paid by parents) to children. Some schools have kitchens to prepare and serve meals for children while others use caterers. More information about school meal programs is to be found in (Le 2011).

3. The 2013 Bellagio ‘Conference on Program and Policy Options for Preventing Obesity in LMICs’ emerges from need to significantly step up action to reduce obesity by learning from some current examples of best practice and strengthening the role of the academic and civil society players in translating global evidence and experience into action at the national level. The set of papers developed from the conference provides examples of existing best practice and a road map ahead for LMICs in the various areas of action needed to reduce obesity across LMICs, and can be found at http://onlinelibrary.wiley.com/doi/10.1111/obr.12104/abstract.