Title: Analysing the drivers of dietary diversity, diet quality and household food security in developing Asia: Evidence from urban Vietnam and rural Bangladesh by Jesmin Ara Rupa Thesis submitted to the University of Adelaide in fulfilment of the requirements for the degree of Doctor of Philosophy The Centre for Global Food and Resources Faculty of the Professions The University of Adelaide February 2019 [Page left bank intentionally] ii Contents Title: Analysing the drivers of dietary diversity, diet quality and household food security in developing Asia: Evidence from urban Vietnam and rural Bangladesh ............................................ i Contents ................................................................................................................................................. iii List of Tables ....................................................................................................................................... viii List of Figures ......................................................................................................................................... x Abstract .................................................................................................................................................. xi Declaration ........................................................................................................................................... xiii Acknowledgements .............................................................................................................................. xiv Conference papers from this thesis (peer-reviewed) ............................................................................ xvi Chapter 1: Introduction ........................................................................................................................... 2 1.1 Background ....................................................................................................................................... 2 1.2 Research gaps and motivation........................................................................................................... 7 1.3 Research questions ............................................................................................................................ 8 1.4 The context of food security and nutrition in urban Vietnam and rural Bangladesh ...................... 10 Urban Vietnam ...................................................................................................................................... 10 Rural Bangladesh.................................................................................................................................. 11 1.5 Description of data and methods ..................................................................................................... 12 The Urban Vietnam Consumption and Expenditure Study 2016-2017 ................................................. 12 The Bangladesh Integrated Household Survey 2011-2012 ................................................................... 16 1.6 The Structure of the thesis .............................................................................................................. 17 1.7 References ....................................................................................................................................... 19 iii Chapter 2: Statement of Authorship ...................................................................................................... 31 Chapter 2: Does food market modernization lead to improved dietary diversity and diet quality for urban Vietnamese households? ............................................................................................................. 33 Abstract ................................................................................................................................................. 33 2.1 Introduction ............................................................................................................................... 34 2.2 Materials and methods .............................................................................................................. 37 2.2.1 Data............................................................................................................................................ 37 2.2.2 Measurement of outcome variables ........................................................................................... 41 2.2.3 Variables explaining household dietary diversity and diet quality ............................................ 43 2.2.4 Empirical estimation .................................................................................................................. 46 2.3 Results and discussion .............................................................................................................. 50 2.3.1 Direct estimates of household diet quality ................................................................................. 50 2.3.2 Indirect estimates of household diet quality through household dietary diversity..................... 54 2.3.3 Discussion .................................................................................................................................. 55 2.4 Conclusions ............................................................................................................................... 57 2.5 References ................................................................................................................................. 58 Chapter 3: Statement of Authorship ...................................................................................................... 67 Chapter 3: Understanding food westernization and other contemporary drivers of adult, adolescent and child diet quality in urban Vietnam ................................................................................................ 69 Abstract ................................................................................................................................................. 69 3.1. Introduction .................................................................................................................................... 70 3.1.1. Transformation of food markets and diet-related health issues in Vietnam ............................... 73 3.2. Materials and Methods ................................................................................................................... 75 iv 3.2.1 Data collection: household surveys and 24-hour food diaries .................................................... 75 3.2.2 Measures of dietary outcomes and diet quality ............................................................................ 80 3.2.2.1 Individual total energy (kcal) intake ......................................................................................... 80 3.2.2.2 Macronutrient calorie shares .................................................................................................... 83 3.2.3 Explaining dietary outcomes ........................................................................................................ 85 3.2.3.1 Share of total calories from western share of food-away-from home ....................................... 85 3.2.3.2 Other covariates used to explain dietary outcomes .................................................................. 85 3.2.4 Empirical estimation .................................................................................................................... 87 3.3. Results ............................................................................................................................................ 90 3.3.1 Estimation of energy intake.......................................................................................................... 90 3.3.2 Estimation of macronutrients as a share of total calories ........................................................... 93 3.4 Summary and conclusions .............................................................................................................. 98 3.5 References ..................................................................................................................................... 101 Chapter 4: Statement of Authorship .................................................................................................... 113 Chapter 4: The impact of health and economic shocks on food security in rural farm households in Bangladesh .......................................................................................................................................... 115 Abstract ............................................................................................................................................... 115 4.1 Introduction ............................................................................................................................. 116 4.2 Materials and Methods ............................................................................................................ 118 4.2.1 Data ........................................................................................................................................... 118 4.2.2 Descriptive statistics .................................................................................................................. 119 4.2.3 The estimation strategy of health and economic shocks on household food security ...............