South East Asia Obesogenic Food Environment (SEAOFE) Study to address the Double Burden of Malnutrition through Healthier Food Retail: Preliminary Findings

Background and objectives: The double burden of malnutrition in Southeast Asian countries is of concern. Although undernutrition rates are decreasing, overweight and obesity is rising, and micronutrient deficiencies are also prevalent. Tackling dietary intakes through multi-pronged approach focussing on retail food environment is expected to improve access to healthier foods in the community. As such, the SEAOFE Study was designed to examine the retail food environment, perspectives of consumers and retailers regarding factors influencing food retail-related decisions, and existing policies influencing food retail in four Southeast Asian countries. Methods: The SEAOFE study is conducted in four phases in Indonesia, Malaysia, Thailand and Philippines. Phase I involved document and database review to provide in-depth analysis of retail food landscape and health status in each country. Phase II will be conducted in two parts, namely consumer intercept survey on perception of their retail food environment, and audit of selected food retailer outlets. Phase III is a qualitative study involving in-depth interviews with food retailers to understand decision-making related to stocking of food and beverages. Phase IV involves document review and in-depth interviews with stakeholders related to retail food policy to identify opportunities for change towards healthier food retail. Throughout the study, researchers will engage closely with relevant stakeholders through regular meetings. Results: Phase I has been completed and findings indicate that adult malnutrition and non-communicable diseases are prevalent in all four countries, with Malaysia having the highest prevalence of overweight/obesity and diabetes, and Indonesia having the highest prevalence of hypertension. The major player in food retail industry in Indonesia, Malaysia and Philippines are local companies, whereas in Thailand it is a multi-national company. In Indonesia, traditional food retail format is more commonplace, while in the other three countries modern and traditional formats are equally frequented. With the COVID-19 pandemic, however, there is increasing evidence that online food retail and e-commerce are becoming more common. Conclusions: The SEAOFE study will generate evidence on consumer and retailer perspectives of the food environment. We hope to also identify opportunities and barriers towards food policy changes in order to develop evidence-informed policy recommendations in this regio