Soc Sci Med 2019 07 5;233:103-112. Epub 2019 Jun 5.
Department of Global Health and Social Medicine, King's College London, Bush House, North East Wing, 40 Aldwych, London, WC2B 4BG, United Kingdom; Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, United States.
The nutrition transition hypothesis poses that as low-and-middle-income countries (LMICs) become wealthier and more urbanised, they experience a shift in dietary consumption towards 'Western' diets high in sugars, fats, animal-source foods, processed and packaged products. This paper uses panel data covering a period of 23 years to examine how changes in the urban environment relate to food expenditures, dietary diversity and traditional practices (food self-production and sharing) in Indonesia, a country that has experienced rapid economic growth and urbanisation over the last few decades. We first examine trends separately for urban and rural areas, and then use fixed effect models to examine whether change in urban residence is associated with changes in food expenditures, traditional practices, and overall dietary diversity. Results show that, despite some increases in acquisitions of animal-source foods and of packaged and ready-made foods, budget allocations for other food groups has remained constant, and that changes have largely occurred in parallel across urban and rural areas. In turn, traditional diets high in cereal and plant products, as well as traditional food practices continue to be dominant in both rural and urban areas, despite the context of rapid socio-economic change and urbanisation. Fixed effect regression suggests that transition from rural to urban residence is not significantly associated with changes in food expenditures for any of the outcomes examined. On the other hand, there is some evidence that moving specifically to Jakarta is associated with some change towards 'Western' food preferences.