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.

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/m; 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 ( < 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 ( < 0·05). Upon multivariable adjustment, nutrition knowledge was positively associated with diet quality in Almaty and adherence to 'acculturated' diet patterns in both cities ( < 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.