Food Is Always Close By: An Assessment of the Healthiness of the Adolescent Home and School Food Environments in Northern Vietnam.

Background: Adolescents are vulnerable to rapidly evolving food environments. Urbanization is widely thought to contribute to less healthy food environments, and school food environments are often considered less healthy than those at home. These associations, however, have not been quantified. Objectives: Assess differences in adolescent food environments in Northern Vietnam by setting (home compared with school) and area (rural, peri-urban or urban). Methods: We collected cross-sectional data on adolescents ( Results: Both unhealthy food groups (UFG) (e.g., sugar-sweetened beverages, sweets) and healthy food groups (HFG) (e.g., fruits, nuts/seeds) were closer to adolescents' homes in the urban (∼21‒50 m) than the peri-urban (∼75‒200 m) and rural (∼155‒270 m) area. Fruits and vegetables were consistently further away than UFG across all areas in home environments, although still close by (∼ 50‒270 m). Urban adolescents were exposed to the greatest density and diversity of both HFG and UFG close to home and school. There were no differences in healthiness of home and school food environments. Conclusions: Unhealthy foods were more accessible (in distance) and available (in density) than fruits and vegetables across all settings, but differences were small, and food was always close by. Diversity of HFG and UFG was the greatest in urban areas. Healthy foods should be promoted and made the preferred choice through nudging interventions at point-of-purchase, combined with restrictions on the marketing and availability of unhealthy foods.