Longitudinal analysis of lifestyle risk factors, nutrition status and drivers of food choice among urban migrants in Ulaanbaatar, Mongolia, and Almaty, Kazakhstan: a formative study
Bromage S. Tazhibayev S. Zhou X. Liu C. Tserenkhuu E. Dolmatova O. Khishignemekh M. Musurepova L. Wusigale Tsolmon S. Tsendjav E. Enkhmaa D. Rai R.K. Enkhbat B. Menghe B. Ganmaa D.
3 December 2024Cambridge University Press
Public Health Nutrition
2024#28Issue 1
Objective: To quantify and compare concurrent within-person trends in lifestyle risks, nutrition status and drivers of food choice among urban migrants in Central Asia. Design: We collected panel data on household structure, drivers of food choice, nutrition knowledge and diverse measures of nutrition status and lifestyle risk from urban migrants at 0, 3, 6 and 9 months using harmonised methodology in two cities. Trends were analysed using mixed-effects models and qualitatively compared within and between cities. Setting: Ulaanbaatar, Mongolia, and Almaty, Kazakhstan. Participants: 200 adults (22-55 years) who migrated to these cities within the past 2 years. Results: Adjusting for age and sex, each month since migration was positively associated with fasting TAG in Almaty (0·55 mg/dl; 95 % CI: 0·13, 0·94) and BMI (0·04 kg/m2; 95 % CI: 0·01, 0·07), body fat (0·14 %; 95 % CI: 0·01, 0·26) and fasting glucose (0·04 mmol/l; 95 % CI: 0·02, 0·05) and lipids in Ulaanbaatar (P < 0·05). In Almaty, nutrition knowledge (measured using an objective 20-point scale) declined despite improvements in diet quality (measured by Prime Diet Quality Score). The influence of food availability, price and taste on food choice increased in Almaty (P < 0·05). Upon multivariable adjustment, nutrition knowledge was positively associated with diet quality in Almaty and adherence to acculturated diet patterns in both cities (P < 0·05). Different trends in smoking, sleep quality and generalised anxiety were observed between cities. Conclusions: Findings indicate heterogeneous shifts in nutrition, lifestyles and drivers of food choice among urban migrants in Central Asia and provide an evidence base for focused research and advocacy to promote healthy diets and enable nutrition-sensitive food environments.
Acculturation , Central Asia , Drivers of food choice , Food environment , Nutrition transition , Nutritional epidemiology , Urban migration
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Community Nutrition Unit, Institute of Nutrition, Mahidol University, 999 Phutthamonthon 4 Road, Phutthamonthon, Salaya, Nakhon Pathom, 73170, Thailand
Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2, Boston, 02115, MA, United States
Department of Micronutrients, Kazakh Academy of Nutrition, 66 Klochkov Street, Almaty, 050008, Kazakhstan
Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, 06520-0834, CT, United States
Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, 13312, Mongolia
Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, 010018, China
Tana Lab, Graduate School of Business, Mongolian University of Science and Technology, 8th Khoroo, Baga Toiruu 34, Sukhbaatar District, Ulaanbaatar, 14191, Mongolia
National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, 16060, Mongolia
Human Nutrition Unit, Institute of Nutrition, Mahidol University, 999 Phutthamonthon 4 Road, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, 02115, MA, United States
Department of Pathology & Forensic Medicine, School of Biomedicine, Mongolian National University of Medical Sciences, S. Zorig Street, Ulaanbaatar, 14210, Mongolia
Department of Pathology, Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, Baruun Janjin 25 573, Ulaanbaatar, 13270, Mongolia
Channing Division of Network Medicine, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, 02115, MA, United States
Community Nutrition Unit
Department of Nutrition
Department of Micronutrients
Department of Biostatistics
Mongolian Health Initiative
Key Laboratory of Dairy Biotechnology and Engineering
Tana Lab
National Center for Maternal and Child Health
Human Nutrition Unit
Department of Global Health and Population
Department of Pathology & Forensic Medicine
Department of Pathology
Channing Division of Network Medicine
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