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Accepted manuscript

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

Published online by Cambridge University Press:  03 December 2024

Sabri Bromage Open the ORCID record for Sabri Bromage [Opens in a new window] ,
Shamil Tazhibayev ,
Xin Zhou ,
Chang Liu ,
Enkhtsetseg Tserenkhuu ,
Oksana Dolmatova ,
Munkhbat Khishignemekh ,
Leyla Musurepova ,
Wusigale  and
Soninkhishig Tsolmon
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Sabri Bromage
Affiliation:
Community Nutrition Unit, Institute of Nutrition, Mahidol University, 999 Phutthamonthon 4 Road, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2, Boston, MA 02115, United States of America
Shamil Tazhibayev
Affiliation:
Department of Micronutrients, Kazakh Academy of Nutrition, 66 Klochkov Street, Almaty 050008, Kazakhstan
Xin Zhou
Affiliation:
Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT 06520-0834, United States of America
Chang Liu
Affiliation:
Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT 06520-0834, United States of America
Enkhtsetseg Tserenkhuu
Affiliation:
Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
Oksana Dolmatova
Affiliation:
Department of Micronutrients, Kazakh Academy of Nutrition, 66 Klochkov Street, Almaty 050008, Kazakhstan
Munkhbat Khishignemekh
Affiliation:
Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
Leyla Musurepova
Affiliation:
Department of Micronutrients, Kazakh Academy of Nutrition, 66 Klochkov Street, Almaty 050008, Kazakhstan
Wusigale
Affiliation:
Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
Soninkhishig Tsolmon
Affiliation:
Tana Lab, Graduate School of Business, Mongolian University of Science and Technology, 8th Khoroo, Baga Toiruu 34, Sukhbaatar District, Ulaanbaatar 14191, Mongolia.
Enkhjargal Tsendjav
Affiliation:
Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
Davaasambuu Enkhmaa
Affiliation:
National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar 16060, Mongolia
Rajesh Kumar Rai
Affiliation:
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, MA 02115, United States of America
Bayarmaa Enkhbat
Affiliation:
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
Bilige Menghe
Affiliation:
Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
Davaasambuu Ganmaa*
Affiliation:
Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2, Boston, MA 02115, United States of America Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, United States of America
*
*Corresponding author: Ganmaa Davaasambuu (gdavaasa@hsph.harvard.edu). Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Building 2, Boston, Massachusetts 02115, USA.
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Abstract

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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 harmonized methodology in two cities. Trends were analyzed 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 triglycerides 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). 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 generalized anxiety were observed between cities.

Conclusions:

Findings indicate heterogenous 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.

Keywords

urban migrationurbanizationacculturationfood environmentdrivers of food choicelifestyle risk factorsnutrition transitionnutritional epidemiologyformative researchCentral Asia
Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 41
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Authors 2024