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Food choices that shape human diets and health are influenced by various socio-economic factors. Vietnam struggles to meet many nutrition targets where links between food choice and diet have not been widely explored. This study assesses the food choice motives, based on a 28-item food choice questionnaire (FCQ), and the diet quality of 603 adults in three sites (urban, peri-urban, and rural) in northern Vietnam. We assess diet quality using the Diet Quality Index–Vietnam (DQI-V) which consists of variety, adequacy, moderation, and balance components. Using factor analysis, we grouped FCQ items into five factors: health focus, sensory appeal, mood ethics, convenience, and familiarity. The structural equation modeling indicates that food choice motives significantly impact the DQI-V and its components but in different directions. The results show that sensory appeal has a positive association with the overall DQI-V score, while having a negative impact on the variety component. Findings present a potential trade-off issue for interventions and policies related to food products. Nutrition knowledge is positively associated with all elements of diet quality across all three study sites. Vietnamese agrobiodiversity could be better utilized to increase dietary diversity. Differentiated policies are necessary to address the poor dietary diversity and adequacy in northern Vietnam.

Human diets and their associated environmental impacts differ across segments of the population. There is evidence that consumer choices of food intake can also affect the overall environmental impacts of a food system. This paper analyzes the environmental impact of diets and food choices across a rural–urban transect in Northern Vietnam by using mixed survey data from 619 adult respondents. The average greenhouse gas emissions (GHGE) resulting from producing the daily food intake of adults in the urban and peri-urban districts were similar, while the average in the rural district was lower. Although starchy staples contributed the most to energy intake, pork and beef were the largest contributors to GHGE. Metrics of blue water use were higher for diets of males than those of females in all three districts. Interestingly, the difference in mean diet diversity score between urban and rural households was significant, and females’ diets were more diverse than those of males. As expected, urban households were more likely to buy food, while rural households often produced their own foods. Urban households reported prioritizing personal health and the natural content of food and would increase seafood and fruits if their income were to increase. In rural regions, interventions aimed at reducing undernutrition should address improving diet quality without significant increases to diet-related environmental impacts.