J Nutr Health.  2016 Apr;49(2):111-124. 10.4163/jnh.2016.49.2.111.

Comparison of dietary behavior, changes of diet, and food intake between 40~59 years old subjects living in urban and rural areas in Lao PDR

• Kim JY
• Yi K
• Kang M
• Kang Y
• Lee G
• Kim HH
• Hansana V
• Kim Y

• KMID: 2209848
• DOI: http://doi.org/10.4163/jnh.2016.49.2.111

Abstract

PURPOSE
The current study was conducted for evaluation and comparison of dietary behavior and food intake in different regions of Lao PDR.
METHODS
The survey was conducted on 979 people aged 40~59 years old living in 25 urban provinces and 25 rural provinces in four districts (VTE Capital-Chanthabuly, Xaysetha, VTE Province-Phonhong, and Thoulakhom) of Laos. General demographic information, health status, and dietary behavior were surveyed using a questionnaire.
RESULTS
The literacy ratio (p = 0.000), education level (p = 0.000), asset ownership level (p = 0.000), and government and private employee ratio (p = 0.000) were higher in urban subjects compared with rural subjects. The mean value of weight (p = 0.000), waist circumference (p = 0.000), and diastolic blood pressure (p = 0.009) and alcohol consumption (p = 0.000), self-rated health status (p = 0.001), and the rate of obesity (p = 0.000) were significantly higher in urban subjects compared with rural subjects. However, the rate of current smoker was significantly higher in the rural group (p = 0.023). Meals are becoming more westernized by higher frequency of eating out, consumption of fatty meat and fried or stir-fried food in urban areas compared to rural areas. Urban subjects had relatively better balanced meals compared to rural subjects whereas they consumed insufficient meals per day and consumed meals irregularly compared to rural subjects. Intake of fruit and milk was significantly higher in urban subjects compared with rural subjects. However, the intake of vegetables was significantly higher in rural areas than urban areas.
CONCLUSION
The result of this study showed that the traditional Lao diet is being replaced by an unhealthy western dietary pattern, which may be a risk factor for increasing development of non-communicable disease (NCD) in Lao PDR. Planning of proper personalized nutritional intervention and education in each area is needed to decrease the health risks of NCD.

Keyword

dietary behavior; westernization; non-communicable diseases; Lao PDR

MeSH Terms

Alcohol Drinking
Blood Pressure
Diet*
Eating*
Education
Fruit
Humans
Laos
Meals
Meat
Milk
Obesity
Ownership
Risk Factors
Vegetables
Waist Circumference

Reference

1. United Nations. Department of Economic and Social Affairs. Population Division. World population prospects: the 2010 revision. New York, NY: United Nations;2011. p. –. .

2. Pingali P. Westernization of Asian diets and the transformation of food systems: implications for research and policy. Food Policy. 2007; 32(3):281–298.

3. Low WY, Lee YK, Samy AL. Non-communicable diseases in the Asia-Pacific region: prevalence, risk factors and community-based prevention. Int J Occup Med Environ Health. 2015; 28(1):20–26.

4. World Health Organization. Noncommunicable diseases [Internet]. Geneva: World Health Organization;2015. cited 2016 Mar 27. Available from: http://www.who.int/mediacentre/factsheets/fs355/en/.

5. World Health Organization. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization;2011.

6. World Health Organization. Noncommunicable diseases country profiles 2014. Geneva: World Health Organization;2014.

7. Chen M, Zhang H, Liu W, Zhang W. The global pattern of urbanization and economic growth: evidence from the last three decades. PLoS One. 2014; 9(8):e103799.

8. Popkin BM, Du S. Dynamics of the nutrition transition toward the animal foods sector in China and its implications: a worried perspective. J Nutr. 2003; 133:11 Suppl 2. 3898S–3906S.

9. Kabagambe EK, Baylin A, Siles X, Campos H. Comparison of dietary intakes of micro- and macronutrients in rural, suburban and urban populations in Costa Rica. Public Health Nutr. 2002; 5(6A):835–842.

10. Yadav K, Krishnan A. Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in north India. Obes Rev. 2008; 9(5):400–408.

11. United Nations Development Programme. Human development reports: Lao People's Democratic Republic- country profile [Internet]. New York, NY: United Nations Development Programme;2015. cited 2016 Feb 27. Available from: http://hdr.undp.org/en/countries/profiles/LAO.

12. The World Bank. World DataBank: world development indicators [Internet]. Washington, D.C.: The World Bank;2014. cited 2016 Feb 27. Available from: http://databank.worldbank.org/data/reports.aspx?source=2&country=&series=NY.GNP.PCAP.CD&period=.

13. Food and Agriculture Organization of the United Nations. The state of food insecurity in the world: 2015. Rome: Food and Agriculture Organization of the United Nations;2015.

14. von Grebmer K, Bernstein J, de Waal A, Prasai N, Yin S, Yohannes Y. 2015 Global hunger index: armed conflict and the challenge of hunger. Washington, D.C.: International Food Policy Research Institute;2015.

15. Dans A, Ng N, Varghese C, Tai ES, Firestone R, Bonita R. The rise of chronic non-communicable diseases in Southeast Asia: time for action. Lancet. 2011; 377(9766):680–689.

16. World Health Organization. Vientiane Capital city, LAO PDR. 2008.

17. Clark G, Huberman M, Lindert PH. A British food puzzle, 1770-1850. Econ Hist Rev. 1995; 48(2):215–237.

18. Ferraro KF, Farmer MM. Utility of health data from social surveys: Is there a gold Standard for measuring morbidity? Am Sociol Rev. 1999; 64(2):303–315.

19. Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography. 2001; 38(1):115–132.

20. Montgomery MR, Gragnolati M, Burke KA, Paredes E. Measuring living standards with proxy variables. Demography. 2000; 37(2):155–174.

21. World Health Organization. Prevention of cardiovascular disease: pocket guidelines for assessment and management of cardiovascular risk. Geneva: World Health Organization;2007.

22. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35(8):1381–1395.

23. World Health Organization Western Pacific Region. The Asia Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia;2000.

24. Kim WY, Cho MS, Lee HS. Development and validation of mini dietary assessment index for Koreans. Korean J Nutr. 2003; 36(1):83–92.

25. United Nations Development Programme. Human development reports: Lao People's Democratic Republic-adult literacy rate, both sexes (% aged 15 and above) [Internet]. New York, NY: United Nations Development Programme;2015. cited 2016 Feb 28. Available from: http://hdr.undp.org/en/countries/profiles/LAO.

26. Zimmer Z, Kwong J. Socioeconomic status and health among older adults in rural and urban China. J Aging Health. 2004; 16(1):44–70.

27. Fezeu L, Minkoulou E, Balkau B, Kengne AP, Awah P, Unwin N, Alberti GK, Mbanya JC. Association between socioeconomic status and adiposity in urban Cameroon. Int J Epidemiol. 2006; 35(1):105–111.

28. Kawachi I, Kennedy BP, Glass R. Social capital and self-rated health: a contextual analysis. Am J Public Health. 1999; 89(8):1187–1193.

29. Midha T, Idris MZ, Saran RK, Srivastav AK, Singh SK. Prevalence and determinants of hypertension in the urban and rural population of a North Indian district. East Afr J Public Health. 2009; 6(3):268–273.

30. Banwell C, Lim L, Seubsman SA, Bain C, Dixon J, Sleigh A. Body mass index and health-related behaviours in a national cohort of 87,134 Thai Open University students. J Epidemiol Community Health. 2009; 63(5):366–372.

31. Son PT, Quang NN, Viet NL, Khai PG, Wall S, Weinehall L, Bonita R, Byass P. Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey. J Hum Hypertens. 2012; 26(4):268–280.

32. Mendez MA, Cooper R, Wilks R, Luke A, Forrester T. Income, education, and blood pressure in adults in Jamaica, a middle-income developing country. Int J Epidemiol. 2003; 32(3):400–408.

33. Mendez MA, Monteiro CA, Popkin BM. Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr. 2005; 81(3):714–721.

34. Popkin BM, Horton S, Kim S, Mahal A, Shuigao J. Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev. 2001; 59(12):379–390.

35. Bowen L, Ebrahim S, De Stavola B, Ness A, Kinra S, Bharathi AV, Prabhakaran D, Reddy KS. Dietary intake and rural-urban migration in India: a cross-sectional study. PLoS One. 2011; 6(6):e14822.

36. Popkin BM. Nutritional patterns and transitions. Popul Dev Rev. 1993; 19(1):138–157.

37. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004; 28:Suppl 3. S2–S9.

38. Soon JM, Tee ES. Changing trends in dietary pattern and implications to food and nutrition security in Association of Southeast Asian Nations (ASEAN). Int J Nutr Food Sci. 2014; 3(4):259–269.

39. Kim Y, Seo S, Kwon O, Cho MS. Comparisons of dietary behavior, food intake, and satisfaction with food-related life between the elderly living in urban and rural areas. Korean J Nutr. 2012; 45(3):252–263.

40. Liu Y, Rao K, Fei J. Economic transition and health transition: comparing China and Russia. Health Policy. 1998; 44(2):103–122.

41. Park K. Dietary habits, body weight satisfaction and eating disorders according to the body mass index of female university students in Kyungnam province. J East Asian Soc Diet Life. 2009; 19(6):891–908.

42. Kaufmann S. The nutrition situation in Northern Laos: determinants of malnutrition and changes after four years of intensive interventions [dissertation]. Giessen: Justus Liebig University Giessen;2008.