Yena Lee; Ji-Myung Kim; Kyungock Yi; Visanou Hansana; Yuri Kim

doi:10.4163/jnh.2018.51.6.580

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Lee, Kim, Yi, Hansana, and Kim: Comparison of dietary behavior and consumption of processed beverage depend on food insecurity status of adolescents in vientiane, Lao PDR∗

Research Article

J Nutr Health 2018;51(6):580-589.

Published online: 20 January 2018

DOI: https://doi.org/10.4163/jnh.2018.51.6.580

Comparison of dietary behavior and consumption of processed beverage depend on food insecurity status of adolescents in vientiane, Lao PDR^∗

Yena Lee¹, Ji-Myung Kim², Kyungock Yi³, Visanou Hansana⁴, Yuri Kim^5,^†

¹Department of Clinical Health, The Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul 03760, Korea

²Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Gyeonggi 11644, Korea

³Division of Kinesiology & Sports Studies, College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea

⁴Faculty of Post graduate studies, University of Health Sciences, Vientiane Capital City 7444, Lao PDR, Korea

⁵Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea

^† To whom correspondence should be addressed. tel: +82-2-3277-4485, E-mail: yuri.kim@ewha.ac.kr

^∗ This work was supported by the Korea International Cooperation Agency (KOICA) under the NO.2017–002.

Received 8 October 2018 Revised 9 November 2018 Accepted 9 November 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the food insecurity status and dietary behavior and examine the association between the food insecurity status and consumption of processed beverage for secondary school students in Vientiane, capital city of Lao PDR. Methods: The study subjects are 714 students (boys=307 and girls=407) in four secondary schools (Chao_Anouvong, Phiavat, Saysetha, and Chansavang) of Vientiane, Lao PDR. Data on study subject's demographic characteristics, dietary behavior, food insecurity, and Mini Dietary Assessment (MDA) index were collected. A “Self-Administered Food Security Survey Module for Children Aged 12 Years and Older” developed by the United States Department of Agriculture (USDA) was used for the food insecurity assessment. Results: As a result, 72.7% of the subjects were in a state of food insecurity, and food security was associated with higher socioeconomic status (higher life satisfaction, higher parent's education attainment, higher item ownership, fewer number of siblings, and having more lunches at the school restaurant than at home). Compared to the food insecurity group, the frequency of breakfast, self-rated diet, and the total score of MDA index were higher in the food security group. On the other hand, multiple logistic regression analysis showed that ‘food security' was also associated with a higher consumption of processed beverages (OR 1.544; 95% CI 1.078–2.213; p=0.018). Conclusion: Improving the quality of the diet is essential for adolescents in both the food insecurity and food security groups in Lao PDR. Therefore, it is necessary to provide well organized nutrition education and establish adequate nutrition policy for adolescents in Lao PDR.

Keywords: food insecurity, dietary behavior, processed beverage, adolescent, Lao PDR

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Table 1.

Demographic characteristics of total subjects by food insecurity status

Variable	FS¹⁾ (n = 195)	FI¹⁾ (n = 519)	Total (n = 714)	p-value
Age	14.51 ± 1.77²⁾	14.56 ± 1.90	14.55 ± 1.86	0.769³⁾
Sex				0.769³⁾
Boys	73 (37.4)⁴⁾	234 (45.1)	307 (43.0)	0.075⁵⁾
Girls	122 (62.6)	285 (54.9)	407 (57.0)
Grade
Lower	87 (44.6)	248 (47.8)	335 (46.9)	0.501
Upper	108 (55.4)	271 (52.2)	379 (53.1)
Hometown⁶⁾
Vientiane capital	157 (80.5)	418 (80.5)	575 (80.5)	1.000
Others	38 (19.5)	101 (19.5)	139 (19.5)	1.000
Life satisfaction	6.75 ± 1.77²⁾	5.92 ± 1.88	6.15 ± 1.89	< 0.0001³⁾
Number of siblings				< 0.0001³⁾
≤ 2	142 (72.8)	351 (67.6)	493 (69.0)	0.006
3 ∼ 4	45 (23.1)	105 (20.2)	150 (21.0)
≥ 5	8 (4.1)	63 (12.1)	71 (9.9)
Father education level⁷⁾
≤ Primary school	18 (15.4)	77 (25.8)	95 (22.9)	0.019
Secondary school	52 (44.4)	137 (46.0)	189 (45.5)
University/Postgraduate	47 (40.2)	84 (28.2)	131 (31.6)
Mother education level⁷⁾
≤ Primary school	31 (24.0)	141 (41.5)	172 (36.7)	0.002
Secondary school	65 (50.4)	136 (40.0)	201 (42.9)
University/Postgraduate	33 (25.6)	63 (18.5)	96 (20.5)
Item ownership⁸⁾
Low (≤ 6)	16 (8.2)	109 (21.0)	125 (17.5)	< 0.0001
Medium (7 ∼ 8)	49 (25.1)	177 (34.1)	226 (31.7)
High (≥ 9)	130 (66.7)	233 (44.9)	363 (50.8)

¹⁾ FS, food security; FI, food insecurity 2) mean ± SD 3) p-value from independent t-test 4) n (%) 5) p-value for chi-square test by each variable 6) Hometown means the residence before entering school. 7) Due to missing data, total number is different. 8) Item ownership were categorized by household asset, including electricity, radio, tape recorder, television, telephone (mobile phone), car, motorcycle, bicycle, refrigerator, gas stove, electric stove, and flush toilet.

Table 2.

Dietary behavior of total subjects by food insecurity status

Variable	FS¹⁾ (n = 195)	FI¹⁾ (n = 519)	Total (n = 714)	p-value
Frequency of meals a day
< 3	27 (13.8)²⁾	97 (18.7)	124 (17.4)	0.292³⁾
≥ 3	153 (78.5)	380 (73.2)	533 (74.6)
Irregular	15 (7.7)	42 (8.1)	57 (8.0)
Frequency of breakfast per week
< 3	51 (26.2)	176 (33.9)	227 (31.8)	0.048
≥ 3	144 (73.8)	343 (66.1)	487 (68.2)
Frequency of eating out
< 3	158 (81.0)	442 (85.2)	600 (84.0)	0.207
≥ 3	37 (19.0)	77 (14.8)	114 (16.0)
Eating lunch
Home	98 (50.3)	310 (59.7)	408 (57.1)	0.027
School restaurant	97 (49.7)	209 (40.3)	306 (42.9)
Processed beverages⁴⁾
Low	88 (45.1)	301 (58.0)	389 (54.5)	0.002
High	107 (54.9)	218 (42.0)	325 (45.5)
Caffeine drinks⁵⁾
Low	168 (86.2)	445 (85.7)	613 (85.9)	1.000
High	27 (13.8)	74 (14.3)	101 (14.1)
Intake of supplements
Yes	37 (19.0)	82 (15.8)	119 (16.7)	0.312
No	158 (81.0)	437 (84.2)	595 (83.3)
Experience nutrition education
Yes	111 (56.9)	277 (53.4)	388 (54.3)	0.401
No	84 (43.1)	242 (46.6)	326 (45.7)
Self-rated diet⁶⁾
Poor/Fair	73 (44.0)	254 (57.1)	327 (53.5)	0.015
Good	63 (38.0)	129 (29.0)	192 (31.4)
Very good/Excellent	30 (18.1)	62 (13.9)	92 (15.1)

¹⁾ FS, food security; FI, food insecurity 2) n (%) 3) p-value for chi-square test by each variable 4) Processed beverages contain carbonated soft drinks and sports drinks. 5) Caffeine drinks contain coffee and energy drinks. 6) Due to missing data, total number is different.

Table 3.

The score of MDA index¹⁾ of total subjects by food insecurity status

Variable	FS²⁾ (n = 195)	FI²⁾ (n = 519)	(n = 714) Total	p-value
1. Drink milk or eat dairy products more than one time every day	3.32 ± 1.09³⁾	2.94 ± 1.03	3.04 ± 1.06	< 0.0001⁴⁾
2. Eat meat, fish, egg, bean, or tofu 3 ∼ 4 times every day	3.27 ± 1.00	3.19 ± 1.00	3.21 ± 1.00	0.312
3. Eat vegetables every meal	3.59 ± 1.03	3.41 ± 0.98	3.46 ± 1.00	0.030
4. Eat fruit or fruit juice every day	3.36 ± 0.94	3.09 ± 0.91	3.16 ± 0.93	< 0.0001
5. Eat fried or stir-fried food more than one time every other day⁵⁾	2.78 ± 0.85	2.77 ± 0.94	2.77 ± 0.91	0.856
6. Eat fatty meat more than one time every three days⁵⁾	3.13 ± 0.95	3.20 ± 0.96	3.18 ± 0.96	0.377
7. Add extra table salt or sauce into food⁵⁾	3.02 ± 1.07	3.06 ± 1.13	3.05 ± 1.11	0.606
8. Eat three meals regularly every day	4.14 ± 1.05	3.72 ± 1.14	3.84 ± 1.13	< 0.0001
9. Eat ice-cream, cake, snack, soda between meals every day⁵⁾	3.04 ± 1.10	3.20 ± 1.07	3.15 ± 1.08	0.086
10. Eat a variety of foods (balanced diet)	3.74 ± 0.99	3.28 ± 1.03	3.40 ± 1.04	< 0.0001
Total	33.40 ± 3.92	31.86 ± 3.65	32.28 ± 3.79	< 0.0001

¹⁾ Mini Dietary Assessment (MDA) index: 1 = never, 2 = rarely, 3 = sometimes, 4 = usually, 5 = always. Higher score means having better dietary quality. 2) FS, food security; FI, food insecurity 3) mean ± SD 4) p-value from independent t-test 5) Reverse coding: 1 = always, 2 = usually, 3 = sometimes, 4 = rarely, 5 = never

Table 4.

Logistic regression analysis correlating variables with food security among total subjects

	OR (95% CI)	p value¹⁾
Life satisfaction	1.270 (1.160–1.390)	< 0.0001
Number of siblings
≥ 5 (reference)	1.00
3 ∼ 4	3.375 (1.495–7.619)	0.003
≤ 2	3.186 (1.488–6.819)	0.003
Father education level²⁾
≤ Primary school (reference)	1.00
Secondary school	1.624 (0.887–2.971)	0.116
University/Postgraduate	2.394 (1.281–4.472)	0.006
Mother education level²⁾
≤ Primary school (reference)	1.00
Secondary school	2.174 (1.334–3.543)	0.002
University/Postgraduate Item ownership	2.382 (1.343–4.226)	0.003
Low (≤ 6) (reference) 1.00
Medium (7∼8)	1.886 (1.022–3.480)	0.042
High (≥ 9)	3.801 (2.156–6.700)	< 0.0001
Frequency of breakfast per week
< 3 (reference)	1.00
≥ 3	1.449 (1.003–2.092)	0.048
Eating lunch
Home (reference)	1.00
School restaurant	1.468 (1.054–2.044)	0.023
Processed beverage
Low (reference)	1.00
High	1.679 (1.205–2.339)	0.002
Self-rated diet²⁾
Poor/Fair (reference)	1.00
Good	1.699 (1.141–2.530)	0.009
Very good/Excellent	1.684 (1.013–2.797)	0.044
MDA score	1.118 (1.068–1.170)	< 0.0001

¹⁾ p-value from logistic regression 2) Due to missing data, total number is different.

Table 5.

Logistic regression analysis correlating variables with high level of processed beverage consumption among total subjects

	OR (95% CI)	p-value¹⁾
Life satisfaction	1.092 (1.009–1.182)	0.028
Item ownership
Low (≤ 6) (reference)	1.00
Medium (7–8)	1.145 (0.734–1.788)	0.550
High (≥ 9)	1.526 (1.009–2.308)	0.045
Frequency of eating out
< 3 (reference)	1.00
≥ 3	2.351 (1.555–3.556)	< 0.0001
Eating lunch
Home (reference)	1.00
School restaurant	1.505 (1.117–2.029)	0.007
Caffeine drink
Low (reference)	1.00
High	5.025 (3.072–8.221)	< 0.0001
Food insecurity status
Food insecurity (reference)	1.00
Food security	1.679 (1.205–2.339)	0.002

¹⁾ p-value from logistic regression

Table 6.

Multiple logistic regression analysis correlating food insecurity status with high level of processed beverage consumption among Total subjects

	FS¹⁾	FI¹⁾	p-value²⁾
	OR (95% CI)
Crude model	1.679 (1.205–2.339)	1.00 (reference)	0.002
Adjusted model³⁾	1.544 (1.078–2.213)	1.00 (reference)	0.018

¹⁾ FS, food security; FI, food insecurity 2) p-value from multiple logistic regression 3) Variables included in the adjusted model were life satisfaction, item ownership, frequency of eating out, eating lunch, caffeine drink.

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