Cost and affordability of healthy diets in Vietnam

Abstract

Objectives: To estimate the cost and affordability of healthy diets recommended by the 2016-2020 Vietnamese food-based dietary guidelines (FBDG).

Design: Cross-sectional analysis. The Cost of a Healthy Diet (CoHD) indicator was used to estimate the lowest cost of healthy diets and compare the cost differences by food group, region and seasonality. The affordability of healthy diets was measured by further comparing the CoHD to food expenditures and incomes.

Setting: Food prices of 176 food items from January 2016 to December 2020 were derived using data from monthly Consumer Price Index databases nationally and regionally.

Participants: Food expenditures and incomes of participants from three latest Vietnam Household Living Standard Surveys were used.

Results: The average CoHD between 2016 and 2020 in Vietnam was 3·08 international dollars using 2017 Purchasing Power Parity (24 070 Vietnamese Dongs). The nutrient-rich food groups, including protein-rich foods, vegetables, fruits and dairy, comprised approximately 80 % of the total CoHD in all regions, with dairy accounting for the largest proportion. Between 2016 and 2020, the cheapest form of a healthy diet was affordable for all high-income and upper-middle-income households but unaffordable for approximately 70 % of low-income households, where adherence to the Vietnamese FBDG can cost up to 70 % of their income.

Conclusions: Interventions in local food systems must be implemented to reduce the cost of nutrient-rich foods to support the attainment of healthier diets in the Vietnamese population, especially for low-income households.

Keywords: Affordability; Cost of a healthy diet; Food-based dietary guidelines; Seasonality.

Fig. 1

The regional average cost of a healthy diet in 2017 international dollar for an adult per d from 2016 to 2020

Fig. 2

Cost contribution (percentage share of total cost) of each food group in a healthy diet by region (average data from 2016 to 2020)

Fig. 3

Seasonal variation (in 2017 international dollars) in cost of a healthy diet by (a) food group and (b) region. The size of the box shows the IQR. The bottom and top rules illustrate the fifth and fifty-nine percentiles, respectively. The horizontal bar rule inside the box is the median value for the region or food group

Fig. 4

Seasonal variation in cost (in 2017 international dollars) of (a) vegetables and (b) fruits

Fig. 5

The average cost of healthy diets and median daily total food expenditure (per AFE) for each food group by region. CoHD, Cost of a Healthy Diet; AFE, adult female equivalent

Fig. 6

The average cost of healthy diets as a proportion of mean daily per capita income by region and income level. The size of the box shows the IQR. The bottom and top rules illustrate the fifth and fifty-nine percentiles, respectively. The vertical bar rule inside the box is the median value for the region or income level