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Soil-transmitted helminth (STH) infections and micronutrient deficiencies are closely related and often coexist among low-income populations. We studied the association between infections with specific STH species and micronutrient status in rural Vietnamese schoolchildren. Children (N = 510) aged 6–9 years were recruited from two primary schools. STH infections were determined in stool samples. Hemoglobin, ferritin, retinol, and zinc were measured in blood samples, as well as C-reactive protein to control for inflammation. Iodine excretion was measured in urine. Associations of single and multiple infections with Ascaris lumbricoides, Trichuris trichiura, and hookworm with micronutrient status (hemoglobin, plasma ferritin, retinol, zinc, and urinary iodine) were estimated by multiple regression analysis. Ascaris infections showed a specific and intensity-dependent negative association with vitamin A. Trichuris and hookworm infections were associated with lower hemoglobin concentration, but not with plasma ferritin. Trichuris-infected children had zinc deficiency less often than uninfected children. In conclusion, our study shows species-specific associations between STH infections and micronutrient status in children. The different life cycles of STH species might have specific effects on the absorption or loss of specific micronutrients. Tailor-made combinations of deworming and nutritional interventions may be needed to improve child health and nutrition.

Background To further reduce stunting in Southeast Asia, a rapidly changing region, its main causes need to be identified. Objective Assess the relationship between different causes of stunting and stunting prevalence over time in Southeast Asia. Methods Review trends in mortality, stunting, economic development, and access to nutritious foods over time and among different subgroups in Southeast Asian countries. Results Between 1990–2011, mortality among under-five children declined from 69/1,000 to 29/1,000 live births. Although disease reduction, one of two direct causes of stunting, has played an important role which should be maintained, improvement in meeting nutrient requirements, the other direct cause, is necessary to reduce stunting further. This requires dietary diversity, which is affected by rapidly changing factors: economic development; urbanization, giving greater access to larger variety of foods, including processed and fortified foods; parental education; and modernizing food systems, with increased distance between food producers and consumers. Wealthier consumers are increasingly able to access a more nutritious diet, while poorer consumers need support to improve access, and may also still need better hygiene and sanitation. Conclusions In order to accelerate stunting reduction in Southeast Asia, availability and access to nutritious foods should be increased by collaboration between private and public sectors, and the Association of Southeast Asian Nations (ASEAN) can play a facilitating role. The private sector can produce and market nutritious foods, while the public sector sets standards, promotes healthy food choices, and ensures access to nutritious foods for the poorest, e.g, through social safety net programs.

Inulin-based prebiotics are non-digestible polysaccharides that influence the composition of the gut microbiota in infants and children, notably eliciting a bifidogenic effect with high short chain fatty acid levels. Inulin, a generic term that comprises β-(2,1)-linked linear fructans, is typically isolated from the chicory plant root, and derivatives such as oligofructose and long chain inulin appear to have different physiological properties. The first 1000 days of a child's life are increasingly recognized as a critical timeframe for health also into adulthood, whereby nutrition plays a key role. There is an ever increasing association between nutrition and gut microbiota composition and development, with life health status of an individual. This review summarizes the latest knowledge in the infant gut microbiota from preterms to healthy newborns, as well as in malnourished children in developing countries. The impact of inulin or mixtures thereof on infants, toddlers and young children with respect to intestinal function and immunity in general, is reviewed. Possible benefits of prebiotics to support the gut microbiome of malnourished infants and children, especially those with infections in the developing world, are considered, as well as for the pregnant mothers health. Importantly, novel insights in metabolic programming are covered, which are being increasing recognized for remarkable impact on long term offspring health, and eventual potential beneficial role of prebiotic inulins. Overall increasing findings prompt the potential for gut microbiota-based therapy to support health or prevent the development of certain diseases from conception to adulthood where inulin prebiotics may play a role.菊粉益生元是一类非消化性多糖，能够影响婴幼儿肠道中微生态的构成，尤其 是增强双岐杆菌转化产生短链脂肪酸的作用。菊粉是一个通用的术语，包括β- (2,1)线性果聚糖（主要从菊苣植物根中分离所得）及其衍生品如低聚果糖和长 链菊粉，尽管各自具有不同的生理功能。婴儿出生后第一个1000 天被认为是影 响健康的一个关键期，甚至关系到成年期的健康，其中营养是关键因素之一。 在此关键期间营养和肠道微生物群组成之间的联系不断增强和发展，从而影响 个体的生命健康。本文总结了对健康新生儿和早产婴儿肠道微生态进行研究的 结果，以及在发展中国家对营养不良患儿进行观察的最新进展。这些研究内容 包括菊粉或其混合物对婴幼儿和较大年龄儿童的肠道功能和免疫力产生的影 响。这些研究结果显示，益生元可以支持营养不良患儿肠道中的有益微生物生 长从而抑制感染，因此特别有益于发展中国家的儿童和孕妇的健康。本文提出 了有关菊粉益生元在肠道微生态代谢编程方面的重要作用，明确了益生元对儿 童长期健康的潜在有益作用。上述研究进展为利用益生元对某些疾病进行肠道 微生态疗法治疗和预防的可能性提供了证据。.

Traditional complementary foods (CF) with a low nutrient density have been implicated in growth faltering, stunting, and other adverse outcomes in children. The efficacy of 2 types of locally produced, micronutrient-fortified CF to prevent stunting of infants living in rural Vietnam was evaluated. In a village-randomized controlled study, 426 infants, 5 mo of age, received for 6 mo a fortified CF, either as an instant flour (FF) or a food complement (FC) in village canteens, or traditional CF at home (C). After 6 mo of intervention, weight, length, length-for-age Z-score (LAZ) and weight-for-age Z-score were greater in the 2 intervention groups compared with the C group, with an estimated effect of +0.22 LAZ for the FF group and +0.21 LAZ for the FC group. At the last follow-up, 18 mo after the intervention, there was no significant difference in height-for-age Z-score (HAZ) between the groups, even though the HAZ in the FF group was 0.17 greater than that in the C group (P = 0.18). In contrast, the weight-for-height Z-score and BMI Z-score, indices of ponderal growth, were greater in the FF group (20.49 and 20.26, respectively) than in the FC group (20.73 and 20.49, respectively), with Z-scores in the C group intermediate and not significantly different from the others. This study shows that regular provision of locally produced CF fortified with micronutrients partly stopped growth faltering in Vietnamese infants, with differential effects on long-term length and ponderal growth. Providing only micronutrients instead of a complete array of nutrients might result in only short-term length growth benefits. J. Nutr. 142: 1735‐1740, 2012.

ObjectiveTo determine the prevalence of and associated factors for overweight, especially to determine the relationship between the intake of monosodium glutamate (MSG) as a seasoning and overweight in Vietnam.DesignA cross-sectional survey was conducted of Vietnamese adults aged ≥20 years in 2008. Dietary intake was assessed by the 24 h recall method for 3 d. MSG intake was evaluated by the weighing method on three consecutive days. Physical activity was assessed based on the Global Physical Activity Questionnaire recommended by the WHO. Overweight was defined as BMI ≥ 23·0 kg/m2. Other characteristics such as age and lifelong occupation were determined by a structured questionnaire.SettingSome rural and urban areas of Hanoi, Thua Thien Hue Province and Ho Chi Minh City, Vietnam.SubjectsA total of 1528 adults living in surveyed areas were randomly selected by the multistage cluster sampling method.ResultsThe prevalence of overweight was 27·9 %, and 81·0 % of participants were MSG users. Average MSG intake was 2·2 (sd 1·8) g/d. Multiple logistic regression analysis revealed that factors associated with overweight were age, region of residence, lifelong occupation, physical activity and intakes of energy, carbohydrates, saturated fat and animal protein. There was no significant association between MSG intake and overweight.ConclusionsThe study demonstrated that overweight was not associated with MSG intake in Vietnamese adults. Further longitudinal studies should be done in different populations to determine the relationship between MSG and overweight.

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95 % CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95 % CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95 % CI 15·2, 51·2) μg/l; P P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P P = 0·006), with the SUP group being intermediate (7·4 %). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.

Although environmental factors are important, there is considerable evidence that genes also have a significant role in the pathogenesis of obesity. We conducted a population-based study to investigate the relationship between candidate genes for obesity (UCP1, UCP2, ADRA2B, ADRB3, LEPR, VDR and ESR1) and adiposity measures (body mass index, body fat percentage, weight, waist circumference and waist-hip ratio) in terms of individual gene and gene x gene interaction in models unadjusted and adjusted for covariates (age, years since menopause, educational level and total energy intake). Postmenopausal women with TC genotype of ESR1 gene had higher body fat percentage than those with TT genotype in the models unadjusted and adjusted for the covariates (P = 0.006 in adjusted model). In multiple logistic regression analysis, BsmI and ApaI SNPs of VDR genes were significantly associated with overweight and obesity. The UCP2-VDR ApaI interaction to susceptibility of overweight and obesity was first observed from logistic regression analysis, and then confirmed in the multifactor dimensionality reduction method unadjusted and adjusted for the covariates. This interaction had 69.09% prediction accuracy for overweight and obesity (P = 0.001, sign test). In conclusion, the study suggests the significant association of ESR1 and VDR genes with adiposity measures and the UCP2-VDR ApaI interaction to susceptibility to being overweight and obesity in postmenopausal Vietnamese women.

To investigate whether an intervention including micronutrient-fortified complementary foods can improve iron status, we conducted a randomized controlled trial in 5-mo-old Vietnamese infants (n = 246). Villages (n = 29) were randomly divided into those receiving instant flour (FF) or a food complement (FC) both fortified with micronutrients or nothing [control (C)]. FF and FC infants received daily for 6 mo at least 2 meals of fortified complementary foods. Micronutrient status was assessed by measurement of hemoglobin (Hb) and plasma ferritin (PF), transferrin receptor, zinc, and retinol. Final Hb (mean 6 SD) was higher in the FF (112.5 6 8.0 g/L) and FC (114.0 6 7.0 g/L) groups compared with C (109.0 6 8.0 g/L; P = 0.006). PF (geometric mean [95% CI]) was also higher in FF (19.8 mg/L [17.5‐22.3]) and FC (20.8 mg/L [18.3‐23.6]) compared with C (11.1 mg/L [9.8‐12.5]; P , 0.0001). Anemia prevalence decreased more in the FC group (243.6%) compared with C (210.3%; P = 0.006). The change in prevalence of PF , 12 mg/L was different in the FF (216.4%) and FC (26.7%) groups compared with C (+30.4%; P , 0.01). Endpoint prevalence of iron deficiency (ID) and ID anemia (IDA) were lower in the FF (13.4 and 6.7%, respectively) and FC (15.2 and 3.8%) groups compared with C (57.5 and 37.5%) (P , 0.0001). Retinol and zinc concentrations did not differ among groups, but endpoint prevalence of zinc deficiency was lower in FF infants (36.1%) than in C infants (52.9%; P = 0.04). Micronutrient-fortified complementary foods significantly improved iron status and decreased the prevalence of anemia, ID, and IDA in Vietnamese infants and can be an important tool to reduce ID in infancy in developing countries. J. Nutr. 140: 2241‐2247, 2010.

Background: Both in vitro and in vivo studies have shown that calcitriol, the active form of vitamin D, is involved in hematopoiesis. Vitamin D receptor (VDR) gene has been suggested as one of the candidate genes for anemia. Objective: Investigate relationship between anemia and the commonly studied polymorphisms of VDR gene (FokI, BsmI, ApaI and TaqI) in terms of genotype and haplotype in Vietnamese. Methods: A case-control study including 132 postmenopausal women without chronic kidney diseases was designed to investigate the relationship between VDR polymorphism and anemia. Four single nucleotide polymorphisms (SNPs) FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236) were typed by polymerase chain reaction and restriction fragment length polymorphism method. Results: Genotype distributions of four SNPs were in Hardy-Weinberg equilibrium in both anemia and control groups. The SNPs at the 3’end of the VDR gene (BsmI, ApaI and TaqI) exhibited a strong linkage disequilibrium. There was no significant association between anemia and VDR polymorphism in terms of allele, genotype, and haplotype in the analyses unadjusted or adjusted for the covariates (age, body mass index, educational level, serum ferritin, iron and albumin). Conclusion: VDR gene did not influence anemia in postmenopausal women without chronic kidney disease. For further study on the association between VDR gene and anemia, the use of larger sample size, a prospective study design, and additional markers would enhance the reliability and validity of findings. Keywords: Anemia, association, haplotype, postmenopausal Vietnamese women, vitamin D receptor

ObjectiveTo characterize the relationship between serum carotenoids, retinol and anaemia among pre-school children.DesignA cross-sectional study was conducted in two groups: anaemic and non-anaemic. Serum levels of retinol, α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were measured in the study subjects.SettingSix rural communes of Dinh Hoa, a rural and mountainous district in Thai Nguyen Province, in the northern mountainous region of Vietnam.SubjectsA total of 682 pre-school children, aged 12–72 months, were recruited.ResultsGeometric mean serum concentrations of carotenoids (μmol/l) were 0·056 for α-carotene, 0·161 for β-carotene, 0·145 for β-cryptoxanthin, 0·078 for lycopene, 0·388 for lutein and 0·075 for zeaxanthin. The mean levels of Hb and serum retinol were 108·8 g/l and 1·02 μmol/l, respectively. The prevalence of anaemia and vitamin A deficiency was 53·7 % and 7·8 %, respectively. After adjusting for sex and stunting, serum retinol concentrations (μmol/l; OR = 2·06, 95 % CI 1·10, 3·86, P = 0·024) and total provitamin A carotenoids (μmol/l; OR = 1·52, 95 % CI 1·01, 2·28, P = 0·046) were independently associated with anaemia, but non-provitamin A carotenoids (μmol/l; OR = 0·93, 95 % CI 0·63, 1·37, P = 0·710) were not associated with anaemia.ConclusionsAmong pre-school children in the northern mountainous region of Vietnam, the prevalences of vitamin A deficiency and anaemia are high, and serum retinol and provitamin A carotenoids are independently associated with anaemia. Further studies are needed to determine if increased consumption of provitamin A carotenoids will reduce anaemia among pre-school children.

The aim of this study was to investigate the prevalence and genetic diversity of Staphylococcus aureus and staphylococcal enterotoxins (SEs) in ready-to-eat foods marketed in Hanoi, Vietnam. Out of 212 samples tested, 45 were contaminated with this bacterium and 18 contained strains having classical SEs. Among different food products, the bacterial occurrence ranged between 12.5% and 35.4% and milk samples had the highest prevalence. The production of SEs varied according to the food types and 26 different ribotype patterns were observed among the 45 strains. Our dendogram analysis showed the existence of many clones without clear-cut affiliation to any particular food type indicating both diverse primary and secondary contamination sources. The SEs also occurred in a wide variety of genetically different S. aureus strains which might facilitate the bacterium with better ecological fitness to cause epidemics. It can be concluded that Vietnamese ready-to-eat foods pose a high risk of contamination by toxigenic S. aureus population urging the need of implementing proper hygienic practices.

Difructose anhydride III (DFAIII) is an indigestible disaccharide and has been shown to enhance iron absorption in animal studies; however, the effect has not been investigated in anemic subjects. We investigated the efficacy of co-administration of DFAIII with water-insoluble iron in the treatment of iron deficiency anemia in Vietnamese women. One hundred sixty-eight moderately anemic women (80 g/Lhemoglobin (Hb)120 g/L) participated in a double-blinded, placebo-controlled study with daily supplementation of iron for 6 mo. The volunteers were randomly assigned into four groups, i.e., Group A: received 15 mg Fe as ferric pyrophosphate; Group B: received 15 mg Fe as ferric pyrophosphate and 1.25 g DFAIII; Group C: received 15 mg Fe as ferrous sulfate; Group D: received a placebo. Hb and iron status were measured at baseline and after 2, 4 and 6 mo of intervention. The ratio of transferrin receptor to ferritin was used to estimate stored and functional body iron (BI). One hundred sixteen (69.0%) women completed the trial. After 6 mo, mean (+/-SE) Hb concentration was higher in Group A (121.6+/-1.7 g/L), Group B (126.4+/-1.5 g/L) and Group C (126.8+/-1.6 g/L) compared to Group D (107.0+/-1.7 g/L, p0.0001). Mean change in BI was twofold greater in Group B (5.0+/-0.5 mg/kg) than that in Group A (2.5+/-0.6 mg/kg, p=0.008). The percentage of anemia was significantly reduced in Group B (18.8%) compared to Group D (95.8%, p0.0001) and Group A (39.1%, p=0.033). Co-administration of DFAIII enhances Hb concentration and iron stores more than single administration of water-insoluble iron in anemic Vietnamese women.

Breast milk is considered to be the best nutrient source for infants. However, nutritional compositions of breast milk in developing countries, especially among malnourished women, have not been fully investigated. This study aimed to assess nutritional status and nutrient composition of breast milk in lactating mothers in rural Vietnam. Sixty breastfeeding mothers at 6 to 12 mo postpartum, free from any medical disorder and/or medication, and not pregnant were randomly selected in Yen The, Bac Giang, Vietnam. Their nutritional status, breast milk concentration and dietary intakes were assessed. Among the study participants, anemia (39.0%) and low serum zinc concentration (55.4%) were frequently observed. Dietary assessment revealed lower intakes of iron (10.2+/-2.5 mg/d) and zinc (10.4+/-2.2 mg/d) than estimated requirements. The breast milk concentration of iron, zinc and copper was 0.43+/-0.15 mg/L, 0.56 (0.37, 0.82) mg/L and 0.19+/-0.05 mg/L, respectively. The breast milk concentration of iron, zinc and copper was not correlated to the serum concentration or dietary intakes. In conclusion, we uncovered a high prevalence of anemia and zinc deficiency in lactating mothers in rural Vietnam. The findings demonstrate a low breast milk zinc concentration among the participants, but need further investigation.

We investigated the prevalence of anemia and deficiency in trace elements in adolescent girls living in rural Vietnam.Two hundred forty-five adolescent girls 11-17 y of age from three schools in rural province of Ha Nam, Vietnam, were assessed.The prevalence of anemia was 20.4%. The incidences of low serum selenium (Se), zinc, and copper in subjects were 15.9%, 26.5%, and 4.1%, respectively. The parameter significantly associated with anemia was the low serum levels of Se and vice versa (odds ratio [OR] 5.36, 95% confidence interval [CI] 2.57-11.18, P0.0001). Other risk factors for anemia were a body mass index17.00 kg/m(2) (OR 2.72, 95% CI 1.37-5.37, P = 0.004) and years of age (OR 1.35, 95% CI 1.14-1.59, P0.001). A body mass index17.00 kg/m(2) (OR 2.65, 95% CI 1.25-5.61, P = 0.011) was also found to be a risk factor for low serum Se.The findings of the present study demonstrate that low serum Se is independently associated with anemia in adolescent girls living in rural Vietnam. Interventions are required to gain insight into the potential role of Se on prevention and control of anemia.

Community-based social marketing and mobilization increased knowledge and participation in preventive weekly iron-folic acid supplementation among women of reproductive age in Vietnam. Rates of buying and taking the weekly supplement containing 60 mg elemental iron and 3.5 mg folic acid among non-pregnant women of reproductive age was between 55% and 92%. Free distribution to pregnant women of the weekly supplement containing 120 mg iron and 3.5 mg folic acid covered almost all pregnant women during the project. In developing countries where community women's groups and health networks are strong, preventive supplementation can be successfully promoted to encourage active participation in the prevention and control of iron-deficiency anemia.

A cross-sectional study of 292 primary school children was conducted in rural Vietnam to investigate the relationship among micronutrient deficiencies, and other risk factors for anemia. Serum levels of iron, copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometry and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The incidence of low serum zinc, selenium, magnesium, and copper in the children was 91.4, 75.6, 59.5, and 8.6%, respectively. Forty-five percent of the children were anemic and 11.3% suffered from vitamin A deficiency. A parameter significant associated with anemia was low serum selenium and vice versa (OR 1.85, 95% CI 1.06-3.24, p

To evaluate the FAO/WHO/UNU equations for predicting resting metabolic rate (RMR) in Vietnamese adolescents. A cross-sectional study involving healthy subjects was carried out at the Basic Nutrition Department, National Institute of Nutrition, Vietnam. The RMR was measured by indirect calorimetry and anthropometric indices were recorded. Equations derived by linear regression of RMR and body weight were compared to the FAO/WHO/UNU (1985) predictive equations. A total of 110 subjects who had normal body mass index (5–85 percentile) and divided into two groups by sex. Mean RMRs (MJ/kg/day) were 0.1146±0.0054 for males and 0.1062±0.0103 for females. Compared to the FAO/WHO/UNU equation, our findings were 7.8% and 11.7% lower in the two groups, respectively (P

The community mobilization and social marketing program promoting a preventive approach of weekly iron-folic acid supplementation in women of reproductive age improved iron status of non-pregnant women in Vietnam. Three to six months of weekly pre-pregnancy supplementation and regular weekly intake of supplements during pregnancy allowed women to achieve good iron and hemoglobin status during the two first trimesters of pregnancy. In the third trimester, iron deficiency and anemia were notably present but low birth weight prevalence was low. This demonstrates the effectiveness and safety of the preventive approach as implemented here to prevent and control iron deficiency and anemia in women of reproductive age before and during pregnancy.

To evaluate the effect of combined iron-zinc supplementation on micronutrient status, growth and morbidity.Randomized, double-masked, placebo-controlled supplementation trial.Rural district of Que Vo, in the Red River Delta in Vietnam.A total of 915 breast-fed infants aged 4-7 months were included and 784 completed the study.The Fe-group received daily and for a 6-month period 10 mg of iron, the Zn-group 10 mg zinc, the Fe-Zn group 10 mg iron+10 mg zinc and the placebo group a placebo. Hemoglobin (Hb), serum ferritin (SF) and zinc (SZn), and anthropometry were measured before and at the end of the intervention. Morbidity was recorded daily.Changes of Hb and SF were higher in both Fe and Fe+Zn groups (respectively 22.6 and 20.6 g/l for Hb; 36.0 and 24.8 microg/l for SF) compared to Zn and placebo groups (Hb: 6.4 and 9.8 g/l; SF: -18.2 and -16.9 microg/l, P0.0001). SZn increased more in Zn group (10.3 micromol/l) than in Fe+Zn group (8.0 micromol/l, P=0.03) and more in these groups compared to Fe and placebo groups (1.6 and 1.2 micromol/l, P0.0001). Weight gain was higher in the Zn group. No significant effects of supplementations on growth in length or morbidity.Combined iron-zinc supplementation had a positive effect on iron and zinc status in infants. However, the positive effect of zinc alone on SZn and weight would indicate a negative interaction of iron when added to zinc supplements.UNICEF New York.

One cost-effective strategy for controlling iron deficiency is the fortification of staple foods or condiments with iron. We evaluated the effectiveness of fortifying fish sauce with NaFeEDTA for improving iron status in women of childbearing age in Vietnam in a double-blind intervention with randomization by village. All families in the selected villages were supplied with fish sauce that was either unfortified (Group C, 10 villages) or fortified with NaFeEDTA [9 mmol (500 mg) Fe/L, Group F, 11 villages] for 18 mo. The effect of fortification was assessed in the 576 women (n = 288/group) by measuring hemoglobin and serum ferritin (SF) at 6, 12, and 18 mo. Analysis of the group x time interaction using a repeated-measures test for each response demonstrated a significant effect of fortification on hemoglobin (P = 0.039) and log SF (P < 0.0001) in Group F with no significant changes in Group C. The prevalence of iron deficiency (SF < 12 microg/L) decreased from 22.3 to 4.0% and the prevalence of anemia (hemoglobin < 120 g/L) from 24.7 to 8.5% in Group F with no significant changes in Group C. NaFeEDTA fortification of fish sauce is an effective method for reducing the prevalence of iron deficiency in women in Vietnam.

Anemia is still the major nutritional problem among pregnant women in Southeast Asia. The objective of this study was to measure hemoglobin status and reduction of underweight in a group of pregnant women who received iron-fortified or nonfortified milk, and another group who received iron supplements (tablets) or placebo. The 44 women in the iron-fortified milk group received 15 mg of iron per day per 400 ml of milk, and 41 women received placebo. The 40 women in the iron supplement group received 60 mg of iron per day, and 43 women received nonfortified milk. During this intervention trial, all women were supervised from the 14th to the 18th week of gestation until delivery. Blood was sampled at 0, 5, 10, and 16 weeks of intervention. After the 16th week of intervention, the changes in hemoglobin (ΔHb) concentrations in both treatment groups (the iron-fortified milk and the iron tablet groups) were not significantly different (ΔHb: −0.5 ± 0.9 and −0.3 ± 0.9 g/L, respectively), but the changes were significantly greater in the nonfortified milk and placebo groups (ΔHb: −1.2 ± 0.9 and −1.1 ± 0.8 g/L, respectively; p < .01). The change in transferrin saturation (ΔTS) in the iron-fortified milk group (ΔTS: 3.4 ± 12.9%) was greater than that in the placebo and nonfortified milk groups (ΔTS: −10.1 ± 9.8% and −11.6 ± 10.7 %, respectively) (p < .01). The weight gain of the subjects during intervention did not differ significantly in the fortified and nonfortified milk groups (Δweight: 5.0 ± 2.0 and 5.8 ± 2.1 kg, respectively), but was higher than in the iron tablet group (Δweight: 4.6 ± 3.1 kg p < .05) and the placebo group (Δweight: 3.8 ± 2.5 kg; p < .001). Iron supplementation and fortification were seen to be effective in promoting weight gain in pregnant Vietnamese women. For women who are underweight, the administration of iron-fortified milk has additional benefits to those of supplementation, most likely due to additional energy and nutrient inputs.

Urban areas often have more allergy than rural areas. Dietary patterns and parasite infection have been suggested as possible related factors. This study evaluated the prevalence of allergy in school children in one rural and suburban area of Vietnam where parasite infection is common. A total of 195 children aged 9 to 13 years old completed a self-administered allergy questionnaire and provided blood and stool samples for analysis. Nutritional status, dietary intake and parasite infection were determined in all participants. Allergy was more common in girls (10.7% vs. 7.6%), suburban children (11.8% vs. 6.9%), children with weight-for-age (16.7% vs. 6.0%) and height-for-age (14.8% vs. 4.9%) in the 10th to 75th percentile compared to

During the 1980s and early 1990s Vietnam was classified among the group of poor countries in the world having a relatively high rate of poverty households. Compared to other developing countries undernutrition among Vietnamese children is still a serious public health problem. On 16 September 1995 the Government of Vietnam ratified the National Plan of Action for Nutrition (NPAN) for the period 1995–2000. Poverty reduction is one of the basic social policies given special attention. In this regard the Hunger Eradication and Poverty Reduction programme (HEPR) has been executed by Ministry of Labour Invalid and Social Affairs since 1992 with special emphasis on supports for poor communes and poor households. The present paper will begin by looking at the trends of undernutrition and the achievements of poverty reduction in Vietnam over the past decades. For the past few years the HEPR has achieved great outcomes. Vietnam is evaluated by the international community as one of the countries with the best performance in poverty reduction. The gross domestic product per head in 2000 was 1.8-fold against that in 1990. The percentage of hunger and poor households declined rapidly from approximately 40% in 1985 to nearly 30% in the early 1990s to 20% in 1995 and 11% in the year 2000. It has been shown that after 5 years of implementation of the NPAN1 (1995–2000) the nutritional status of people in Vietnam has considerably improved and important nutrition goals (including micronutrient deficiencies food supply etc.) were achieved by the year 2000. It could be concluded that the HEPR and the NPAN in Vietnam during the last decade have been successfully implemented. (authors)

Vitamin A deficiency is one of the major nutritional deficiencies in Vietnam. the first survey, conducted in 1985–1988 showed that the prevalence of severe xerophthalmia was seven times higher than the cutoff point established by the World Health Organization (WHO) to define vitamin A deficiency as a public health problem. the result of this survey strongly convinced the government to launch a program to control vitamin A deficiency, which started in 1988. the program strategies included nutrition education, universal distribution of high-dose vitamin A capsules to children aged 6 to 36 months in combination with national immunization days, and promotion of production and consumption of vitamin A–rich foods at the family level. the implementation network was set up based on the existing preventive health structure at all administrative levels. Organizations such as the women's union and other social sectors have participated actively in the program. Surveys conducted in 1994 and 1998 showed that the prevalence of clinical xerophthalmia was significantly lower than that identified in the baseline survey and below the WHO criteria for a public health problem. the achievements of our program have demonstrated that an effective vitamin A supplementation program can be implemented successfully by the preventive health network with active community participation. in the coming years, it will be important for our program to develop approaches other than vitamin A supplementation in order to maintain the past achievements.

Background Ingestion of contaminated water or food is a major contributor to childhood diarrhea in developing countries. In Vietnam, the use of community-based information, education and communication (IEC) activities could be a sustainable strategy to improve food hygiene and food safety behaviors. This study thus examined the long-term impact of community-based IEC activities on food hygiene and food safety behaviors. Methods In this longitudinal study, we interviewed caregivers of children aged between six months and four years in suburban Hanoi. Baseline data were collected in January 2006 (n = 125). After conducting IEC interventions, we collected a 1st set of evaluation data in January 2007 (n = 132). To examine the long-term impact of the interventions, we then collected a 2nd set of evaluation data in January 2008 (n = 185). Changes in childhood diarrhea prevalence, IEC coverage, and food hygiene and food safety behaviors were assessed over a two-year period using bivariate and logistic regression analyses. Effective IEC channels were determined through multiple linear regression analysis. Results Childhood diarrhea was significantly reduced from 21.6% at baseline to 7.6% at the 1st post-intervention evaluation (P = 0.002), and to 5.9% at the 2nd evaluation. Among 17 food hygiene and food safety behaviors measured, a total of 11 behaviors were improved or maintained by the 2nd evaluation. Handwashing after toilet use was significantly improved at both evaluation points. Overall, 3 food safety behaviors and 7 food hygiene behaviors were found to have significantly improved at the 1st and at the 2nd evaluations, respectively. Flip chart communication administered by community groups was identified to be the most effective IEC channel for effecting behavior change (P = 0.018). Conclusions Flip chart communication administered by community groups is effective for improving multiple food hygiene and food safety behaviors in sustainable ways, and should be included in water and health promotion programs.

Targeted fortification programs for infants and young children are an effective strategy to prevent micronutrient deficiencies in developing countries, but the role of large-scale fortification of staple foods and condiments is less clear. Dietary modeling in children aged 6–60 months was undertaken, based on food consumption patterns described in the 2009 national food consumption survey, using a 24-h recall method. Consumption data showed that the median intake of a child for iron, vitamin A and zinc, as a proportion of the Vietnamese Recommended Dietary Allowance (VRDA), is respectively 16%–48%, 14%–49% and 36%–46%, (depending on the age group). Potential fortification vehicles, such as rice, fish/soy sauces and vegetable oil are consumed daily in significant amounts (median: 170 g/capita/day, 4 g/capita/day and 6 g/capita/day, respectively) by over 40% of the children. Vegetable oil fortification could contribute to an additional vitamin A intake of 21%–24% of VRDA recommended nutrient intake, while fortified rice could support the intakes of all the other micronutrients (14%–61% for iron, 4%–11% for zinc and 33%–49% of folate requirements). Other food vehicles, such as wheat flour, which is consumed by 16% of children, could also contribute to efforts to increase micronutrient intakes, although little impact on the prevalence of micronutrient deficiencies can be expected if used alone. The modeling suggests that fortification of vegetable oil, rice and sauces would be an effective strategy to address micronutrient gaps and deficiencies in young children.

Micronutrient deficiencies are associated with impaired growth and cognitive function. A school-based fortification program might benefit schoolchildren but a high prevalence of parasite infestation might affect effectiveness. A randomized, double-blind, placebo-controlled 2 × 2 factorial trial was conducted to assess the efficacy of multi-micronutrient fortified biscuits with or without de-worming on growth, cognitive function, and parasite load in Vietnamese schoolchildren. Schoolchildren (n = 510), 6-8 years of age were randomly allocated to receive albendazole or placebo at baseline and four months of multi-micronutrient fortified biscuits (FB) or non-fortified biscuits. Children receiving FB for four months scored higher on two cognitive tests: Raven's Colored Progressive Matrices and the Digit Span Forward test. Children receiving albendazole plus FB had the lowest parasite load after four months. In children receiving FB, mid-upper arm circumference was slightly improved (+0.082 cm) but there were no differences in other indexes of anthropometry. Combining multi-micronutrient fortified biscuits with de-worming is an effective strategy.

Although environmental factors are important, there is considerable evidence that genes also have a significant role in the pathogenesis of obesity. We conducted a population-based study to investigate the relationship between candidate genes for obesity (UCP1, UCP2, ADRA2B, ADRB3, LEPR, VDR and ESR1) and adiposity measures (body mass index, body fat percentage, weight, waist circumference and waist-hip ratio) in terms of individual gene and gene x gene interaction in models unadjusted and adjusted for covariates (age, years since menopause, educational level and total energy intake). Postmenopausal women with TC genotype of ESR1 gene had higher body fat percentage than those with TT genotype in the models unadjusted and adjusted for the covariates (P = 0.006 in adjusted model). In multiple logistic regression analysis, BsmI and ApaI SNPs of VDR genes were significantly associated with overweight and obesity. The UCP2-VDR ApaI interaction to susceptibility of overweight and obesity was first observed from logistic regression analysis, and then confirmed in the multifactor dimensionality reduction method unadjusted and adjusted for the covariates. This interaction had 69.09% prediction accuracy for overweight and obesity (P = 0.001, sign test). In conclusion, the study suggests the significant association of ESR1 and VDR genes with adiposity measures and the UCP2-VDR ApaI interaction to susceptibility to being overweight and obesity in postmenopausal Vietnamese women.

In order to assess secular trends in growth of the Vietnamese population following a period of rapid economic growth, a follow-up study on physical growth and nutritional status of adults was carried out in a rural section of the Red River delta, Vietnam 30 years after the original study. The initial study in 1976 found that average height and weight of Vietnamese adults was similar to data collected by French experts Huard and Bigot in 1938. Hence, no noticeable secular trends were observed in almost 40 years. However, the 2006 follow-up study revealed a positive secular trend in growth of adults, aged 16-60 years. The average increased rate in height of males was up to 1.1 cm/decade in the age group 26-40 years and up to 2.7 cm/decade in the age group 16-25 years. Nutritional status, as indicated by body mass index, increased in both sexes and in all age groups between 1976 and 2006.were observed. In 2006, average dietary intake of fat and animal protein was higher than that found in 1976. The percentage of energy from fat in the diet increased from 6% in 1976 to 16% in 2006. This study shows that Vietnam is entering the nutrition transition period.

Objective : To assess the prevalence of undernutrition, incidence of infectious diseases and the situation of feeding practices to determine the risk factors for undernutri- tion among children aged 6 to 18 months in rural Vietnam. Design : A cross-sectional study was conducted among one hundred eighty-eight mother-child pairs in Bac Giang, Viet- nam. Weight and height of the children were measured and referred to data from the WHO/CDC/NCHS. Incidence of infectious diseases was diagnosed based on the WHO Rec- ommended Surveillance Standards. Data on socio-demographic variables and feeding practices were obtained through a structured questionnaire. Result : The prevalence of underweight, stunting and wasting was 19.7% 23.4% nd 5.3% respectively. The incidence of diarrhea and acute respiratory infections (ARIs) during the last 14 days of the inter- view was 12.2% and 20.2% respectively. Although 99% of the children were breastfed, the prevalence of exclusive breastfeeding in the first 4 mo was 21.3% Non-exclusive breast- feeding in the first 4 month (OR 3.95, p=0.025) and low birth weight (OR 4.38, p=0.009) were associated with underweight in the children, while incidence of infectious disease was not (OR 1.16, p=0.734). Conclusion : Undernutrition is highly prevalent in the study site and non-exclusive breast feeding is one of the risk factors. J. Med. Invest. 57 : 45-53, February, 2010

A cross-sectional study was conducted to investigate the potential factors of food-hygiene practices of mothers on the prevalence of diarrhoea among their children. Mothers who had children aged 6 months-5 years were recruited in a hamlet in Viet Nam. The food-hygiene practices included hand-washing, method of washing utensils, separation of utensils for raw and cooked food, and the location where foods were prepared for cooking. A face-to-face interview was conducted, and data on 206 mothers were analyzed. The risk of diarrhoea was significantly higher among children whose mothers prepared food for cooking somewhere other than the table (typically on the ground) compared to children whose mothers prepared food on the table (adjusted odds ratio = 2.85, 95% confidence interval 1.11-7.28). The results indicate that food-hygiene practices of mothers, such as avoiding preparing food for cooking on the ground, has a potential impact in preventing diarrhoea among children in Viet Nam.

Background: Out-of-home (OH) eating in developed countries is associated with suboptimal dietary intakes, but evidence is scarce on the situation in developing countries. Objective: The objective of this study was to determine the nutritional contribution of OH eating and related socioeconomic determinants in Vietnamese adolescents. Design: A 24-h recall was used to collect food intake data in a cross-sectional study of 1172 adolescents living in urban and rural areas. Multilevel analysis compared the mean daily intakes of energy, energy density, energy from fat, food groups, vitamin A, iron, and zinc in low, middle, and high consumers of OH food. Socioeconomic associations of OH eating were analyzed in a subsample of 870 adolescents. Results: OH foods contributed 42% of fruit and vegetables, 23% of sodium, 21% of energy, 21% of vitamin A, 21% of iron, and 21% of zinc consumed per day. OH eating was negatively associated with total energy intake and energy density and positively associated with dietary diversity, energy contribution from fat, and consumption of sugar products. In rural areas, OH eating was positively associated with iron, fruit, meat, poultry, and offal intake. Female sex (P < 0.001), residence in urban areas (P < 0.001), and amount of pocket money (P < 0.001) were positively associated with consumption of OH foods. Conclusions: OH eating added a number of desirable foods and nutrients but was also associated with higher consumption of energy from fat and sugar products. Independent of household wealth and locality, pocket money and sex are important determinants of OH eating. Am J Clin Nutr 2009;90:1648-55.

This is a follow-up study to an investigation on the prevalence of malnutrition and micronutrient deficiencies among Vietnamese primary schoolchildren. A total of 454 children aged 7 to 8 years attending three primary schools in the Northern delta province of Vietnam were either provided with regular milk, milk fortified with vitamins, minerals and inulin or served as a reference control group. Children were monitored for anthropometrics, (micro)-nutritional status, faecal microbiota composition, school performance, and health indices. Both weight-for-age (WAZ) and height-for-age (HAZ) significantly improved during 6 months of milk intervention; and underweight and stunting dropped by 10% in these groups. During intervention the incidence of anemia decreased and serum ferritin levels increased significantly in all groups. Serum zinc levels increased and consequently the incidence of zinc deficiency improved significantly in all three groups. Serum retinol levels and urine iodine levels remained stable upon intervention with fortified milk whereas in the control group the incidence of iodine deficiency increased. Bifidobacteria composed less than 1% of the total faecal bacteria. After three months of milk intervention total bacteria, bifidobacteria and Bacteroides sp. increased significantly in both milk and inulin fortified milk groups. Children in the milk consuming groups had significantly better short-term memory scores. Parent reported that health related quality of life status significantly improved upon milk intervention. In conclusion, (fortified) milk consumption benefited the children in rural Vietnam including lowering the occurrence of underweight and stunting, improving micronutrients status and better learning indicators as well as improving the quality of life.

Concurrent micronutrient deficiencies are prevalent among Vietnamese school children. A school-based program providing food fortified with multiple micronutrients could be a cost-effective and sustainable strategy to improve health and cognitive function of school children. However, the efficacy of such an intervention may be compromised by the high prevalence of parasitic infestation. To evaluate the efficacy of school-based intervention using multi-micronutrient-fortified biscuits with or without deworming on anemia and micronutrient status in Vietnamese schoolchildren, a randomized, double-blind, placebo-controlled trial was conducted among 510 primary schoolchildren, aged 6-8 y, in rural Vietnam. Albendazole (Alb) (400 mg) or placebo was given at baseline. Nonfortified or multi-micronutrient-fortified biscuits including iron (6 mg), zinc (5.6 mg), iodine (35 microg), and vitamin A (300 microg retinol equivalents) were given 5 d/wk for 4 mo. Multi-micronutrient fortification significantly improved the concentrations of hemoglobin (+1.87 g/L; 95% CI: 0.78, 2.96), plasma ferritin (+7.5 microg/L; 95% CI: 2.8, 12.6), body iron (+0.56 mg/kg body weight; 95% CI: 0.29, 0.84), plasma zinc (+0.61 micromol/L; 95% CI: 0.26, 0.95), plasma retinol (+0.041 micromol/L; 95% CI: 0.001, 0.08), and urinary iodine (+22.49 micromol/L; 95% CI: 7.68, 37.31). Fortification reduced the risk of anemia and deficiencies of zinc and iodine by >40%. Parasitic infestation did not affect fortification efficacy, whereas fortification significantly enhanced deworming efficacy, with the lowest reinfection rates in children receiving both micronutrients and Alb. Multi-micronutrient fortification of biscuits is an effective strategy to improve the micronutrient status of Vietnamese schoolchildren and enhances effectiveness of deworming.

The present work aimed to provide a basis for examination of intake of selected food items determined with a semi-quantitative food frequency questionnaire (SQFFQ) and planned-food selection (PFS). From February to July of 2003, ninety one cancer patients and 90 matched (same sex and age within 5 years) non-cancer patients were directly interviewed by trained interviewers using the designed questionnaire at the inpatient-department of Viet Duc hospital, Ha Noi City, Viet Nam. Study subjects consumed more SQFFQ-food items than PFS-food items, so that the latter method might not accurately reflect dietary habits regarding estimation of nutrient intake, especially vitamins. Because these are beneficial factors acting against cancer development at many sites, the absence of food items selected by SQFFQ may result in a poor database regarding possible confounding factors. For futher clarification we then focused on vitamin C contributions of Vietnamese food and analyzed data of the National Nutritional Household Survey in 2000: 7,686 households throughout the country (vitamin C intake status) and 158 households with 741 persons of the population of Hanoi city (individual food items contributing to vitamin C). Direct interview using a validated questionnaire with an album of current Vietnamese food items-recipes and weighing checks was conducted to obtain information regarding all types of food intake over the last 24-hours. Contribution analysis using the Nutritive Composition Table of Vietnamese Foods, revision 2000, and stepwise regression analysis was applied. Average intake adjusted by ages of vitamin C per person per day was estimated. In total, the study subjects were found to currently consume 184 food items. Average intake of vitamin C was 72.5 mg per person per day at the national level: 57.9% from leafy vegetables, 33.4% from fresh fruits, and 6.4% from non-leafy vegetables. For vitamin C contribution, the highest 25 food items contributed to a cumulative 95.3% of vitamin C intake with a cumulative R2=0.99.

It has been well acknowledged that Vietnam is undergoing a nutrition transition. With a rapid change in the country's reform and economic growth, food supply at the macronutrient level has improved. Changes of the Vietnamese diet include significantly more foods of animal origin, and an increase of fat/oils, and ripe fruits. Consequently, nutritional problems in Vietnam now include not only malnutrition but also overweight/obesity, metabolic syndrome and other chronic diseases related to nutrition and lifestyles. The recognition of these shifts, which is also associated with morbidity and mortality, was a major factor in the need to review and update the Recommended Dietary Allowances (RDA) for the Vietnamese population. This revised RDA established an important science-based tool for evaluation of nutrition adequacy, for teaching, and for scientific communications within Vietnam. It is expected that the 2007 Vietnam RDA and its conversion to food-based dietary guidelines will facilitate education to the public, as well as the policy implementation of programs for prevention of non-communicable chronic diseases and addressing the double burden of both under and over nutrition.

The International Collaborative Epidemiological Study of Host and Environmental Factors for Stomach and Colorectal Cancers in Southeast Asian Countries (SEACs) has been conducted in Viet Nam from 2003 to 2008 on a case-control basis. For further effective primary prevention, we examined gastric and colorectal cancer mortality nationwide in eight regions of Viet Nam in 2005-06.Both demographic data and lists of all deaths in 2005-06 were obtained from all 10,769 commune health stations in Viet Nam. Five indicators included name, age, sex, date of death and cause of death was collected for each case. We selected only communes having the list of deaths with clear cause for each case and crude mortality rate for all causes from 300-600/100,000 as published by the Ministry of Health for a reasonable accuracy and completeness. Obtained data for all causes, all cancers, stomach and colorectal cancer deaths as well as demographic information were processed using Excel software and exported to STATA 8.0 for estimation of world age-standardized cancer mortality rates per 100,000.Data were available for 1,246 gastric cases, (819 male and 427 female) with age-standardized mortality rates from 12.7 to 31.3 per 100,000 in males and from 5.9 to 10.3 per 100,000 in females in the 8 regions of the country. For colorectal cancers, 542 cases (268 male and 274 female) gave mortality rates from 4.0 to 11.3 per 100,000 in males and from 3.0 to 7.8 per 100,000 in females.Stomach cancer mortality in males in the region of North East in the North Viet Nam (2005-06) was higher than that in Japan (2002) (31.3 versus 28.7 per 100,000) while colorectal cancer in Viet Nam was lower. While prevalence of Helicobacter pyloris infection in Viet Nam was from 70-75% in both males and females, the stomach cancer rate in males was significantly higher than in females, 31.3 versus 6.8 per 100,000, suggesting an influence of other environmental risk factors. Whether protective factors are operating against colorectal cancer in Viet Nam now needs to be explored.

ObjectiveTo examine the effect of community-based nutrition education intervention on calcium intake and bone mass in Vietnamese postmenopausal women.DesignA controlled trial was conducted in two groups as intervention and control. The intervention group was given nutrition education during 18 months to improve calcium intake, while the control subjects had the usual diet. Calcium intake and bone mass were evaluated every 6 months. Bone mass was assessed by speed of sound (SOS) at calcaneus, referred to as quantitative ultrasound measurement. Anthropometric indices and serum parathyroid hormone (PTH) were determined at baseline and at the end of intervention.SettingTwo rural communes of Hai Duong province located in the Red River Delta in Vietnam.SubjectsA total of 140 women aged 55–65 years, who were more than 5 years postmenopausal and with low calcium intake (ResultsCalcium intake in the intervention group had increased significantly (P < 0·01) while it had no significant changes in controls. SOS values were not changed significantly in the intervention subjects while it decreased significantly by 0·5 % in the controls (P < 0·01). The intervention led to a decrease in serum PTH by 12 % (P < 0·01). In the controls, there was an increase in serum PTH by 32 % (P < 0·001).ConclusionNutrition education intervention was effective in improving calcium intake and retarding bone loss in the studied subjects.

In addition to the burden of undernutrition, many recent studies in Vietnam demonstrate that overweight/obesity and a number of nutritionally- related chronic diseases (NRCD) (hypertension, diabetes, cardio-vascular diseases) are on the rise at an alarming rate. This could be the result of dietary and life style changes. The double burden of malnutrition (DBM) - a typical phenomenon during nutrition transition in developing countries, has been clearly reported in our country. Controlling nutritional deficiencies and newly emerging nutrition problems to reduce the double burden of malnutrition in Vietnam requires comprehensive and appropriate measures as set out in the National Nutrition Strategy 2001 - 2010, as well as a greater research effort on transitional nutrition.

This study was done to develop a Food Frequency Questionnaire (FFQ) for assessing calcium intake in Vietnamese based on data from the National Nutrition Survey in 2000. From the data, a total of 36 calcium-rich food items were selected for the FFQ by ranking food items according to their contribution to the population intake of nutrients. The FFQ was validated in 140 postmenopausal women by comparing estimates of calcium intake from the FFQ with those from multi-pass 24 h recalls. The results showed that the Pearson correlation coefficient between the 2 methods was 0.84 (p0.001), and that the weighted kappa value was 0.44. Cross-classification analysis indicated that 82.1% of subjects were classified into the same or adjacent quartile by both methods. No subject was grossly misclassified by the FFQ. There is no significant difference of calcium intake between the 2 methods (by paired t test, p0.05). A reproducibility study also presented good correlation between 2 administrations of the FFQ, with Pearson correlation coefficient being 0.93 (p0.001) and weighted kappa value being 0.67. In conclusion, this FFQ is useful and reliable for estimating calcium intake in population-based epidemiological studies in postmenopausal Vietnamese women.

The prevalence of trace elements deficiencies, vitamin A deficiency, anemia, and their relationships were investigated in a cross sectional study involving 243 children aged from 12 to 72 months in rural Vietnam. Serum levels of copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometer and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The prevalence of deficiencies in zinc, selenium, magnesium, and copper was 86.9%, 62.3%, 51.9%, and 1.7%, respectively. On the other hand, 55.6% were anemic and 11.3% had vitamin A deficiency. Deficiency in two or more micronutrient was found in 79.4% of the children. Parameters associated significantly with anemia were selenium deficiency (OR 2.80 95% CI 1.63-4.80, p=0.0002) and serum retinol1.05 micromol/L (OR 1.83, 95% CI 1.10-3.05, p=0.021). Magnesium deficiency (OR 3.09 95% CI 1.36-7.03) was found to be a risk factor for zinc deficiency and vice versa. The results indicate that micronutrient deficiencies are prevalent among preschool children in Vietnam. In addition, the results also demonstrate a strong relationship between selenium deficiency and anemia. Clearly, sustainable strategies are urgently required to overcome the problems in the country.

Objective: To describe the household intakes of retinol and carotenoids and social economic factors determining their intakes. Subjects: Data on a total of 1001 households (771 in rural areas and 230 in urban areas) were used in the analyses. Interviewed person was household food preparer. Results: Mean (s.d.) intake of carotenoids was 4178 (3154) mu g/capita/day in rural and 4208 (3408) mu g/capita/day in urban areas and intake of retinol was 101 (275) mu g/capita/day in rural and 201 (470) mu g/capita/day in urban areas. Multivariate analyses show that the subjects in households with four or more members consume about 700 mu g carotenoids less compared to households with less than three members. Households with a higher expenditure (fourth quartile) consumed about 100 mg retinol/day more than those with a lower expenditure (first quartile). Conclusion: Carotenoids from plant food sources is the main source of vitamin A intake of the population and its main determinants are household expenditure and size of household. Food fortification and dietary diversification with special emphasis on promotion of consumption of animal foods should be key strategies for overcoming vitamin A deficiency in Vietnam.

application/pdf, 学術雑誌論文, To elucidate the effect of a typical Vietnamese diet including a high content of white rice on postprandial blood glucose levels, the present study was designed. Thirty healthy female subjects with a similar body mass index, 10 each in their twenties, forties and sixties, were recruited. Four meals with a similar protein energy percentage (13-15%) but different energy ratios of fat and carbohydrate (FC ratio) and vegetable contents were provided by cross-over design. Meal A was designed according to the commonly consumed diet in Vietnam. The FC ratio was 14:71 and 84 g of carbohydrate was from rice. Meal B contained carbohydrate in a lower ratio than meal A by fat replacement and its FC ratio was 30:57. Meal C was similar to meal A except lacking vegetables. The energy of meal A, B and C was about 2.1 MJ. Meal D was designed to match the amount of carbohydrate and fat within A and B, respectively. The FC ratio of meal D was 26:61 and the energy was about 2.4 MJ. Fasting blood glucose was measured before consumption of a test meal. Postprandial blood glucose was measured every 30 min for 2 h. Areas under the curve\ (AUC) were calculated to compare the glycemic response among the four test meals. There was no significant difference in AUC among the four test meals in the subjects in their twenties. In the subjects in their forties, the AUC of meal A tended to be lower than that of meal C (p=0.07). In the subjects in their sixties, the AUC of meal A was significantly higher than that of meal B (p

Reduction in childhood malnutrition in Vietnam between 1990 and 2004 was assessed using data from 5 national surveys. The prevalence of malnutrition, including stunting, declined significantly for underweight from 45% in 1990 to 26.6% in 2004. While the average reduction was 1.3% per year in the period from 1990 to 2000, it was 1.8% per year in the period from 2000 to 2004. The prevalence of stunting declined from 56.5% in 1990 to 30.7% in 2004, with an average reduction of 2% per year in the period from 1990 to 2000 and 1.5% per year in the period from 2000 to 2004. There were clear differences in the decrease in malnutrition prevalence between urban, rural and mountainous areas, the reduction being highest in the urban regions and lowest in the mountainous areas. Regression analysis showed that the nutrition status of the child is positively related to better household living conditions and to the educational level of the father, but not the mother. Stunting is higher in children whose parents are farmers and higher in households with more children. Stunting prevalence is lower in households with safe water access and hygienic toilets. In future , the dramatic reduction is childhood malnutrition as seen in the period 1990 to 2004 might not continue. More comprehensive apptoaches will be needed to lower childhood malnutrition in Vietnam further.

The objective of the study was to assess the prevalence of sub clinical vitamin A deficiency and anemia in Vietnamese children. For this, a cross-sectional survey was conducted in 40 villages (clusters) of four ecological regions in Vietnam during Apr-May 2001. In total 1657 children less than 5 years old were included by a cluster random sampling method. The prevalence of sub clinical vitamin A deficiency (serum retinol0.70 mumol/l) was 12.0% and the prevalence of anemia (hemoglobin110g/l) was 28.4 %. 35.1%. In the children under 6 months the prevalence of sub clinical vitamin A deficiency was 35.1 % whereas the prevalence of anemia in this group was as high as 61.7%. The prevalence of children with both sub clinical vitamin A deficiency and anemia was 6.1%. Sub clinical vitamin A deficiency and anemia prevalence differed significantly across the regions, with highest prevalence in the Northern Mountainous areas for vitamin A deficiency and in the Northern Mountainous area and Mekong River Delta for anemia. It is concluded that sub clinical vitamin A deficiency and anemia are still important public health problems in Vietnam. Sustainable strategies for combating vitamin A deficiency and nutritional anemia are needed and should concentrate on target groups, especially infants and malnourished children in high risk regions.

More information is needed on the efficacy of carotenoids from plant foods in improving vitamin A status.We aimed to quantify the efficacy of provitamin A-rich vegetables and fruit in improving vitamin A status.Breastfeeding women in 9 rural communes in Vietnam were randomly allocated to 1 of 4 groups: the vegetable group (n = 73), which ingested 5.6 mg beta-carotene/d from green leafy vegetables; the fruit group (n = 69), which ingested 4.8 mg beta-carotene/d from orange or yellow fruit; the retinol-rich group (n = 70), which ingested 610 microg retinol/d from animal foods and 0.6 mg beta-carotene/d; and the control group (n = 68), which ingested 0.4 mg beta-carotene/d. Meals of groups 1, 2, and 4 contained30 microg retinol/d. Lunch and dinner were provided 6 d/wk for 10 wk.Mean (95% CI) changes in serum retinol concentrations of the vegetable, fruit, retinol-rich, and control groups were 0.09 (0.03, 0.16), 0.13 (0.07, 0.19), 0.25 (0.17, 0.33), and 0.00 (-0.06, 0.06) micromol/L, respectively. Mean (95% CI) changes in breast-milk retinol concentrations were 0.15 (0.04, 0.27), 0.15 (0.02, 0.28), 0.48 (0.32, 0.64), and -0.06 (-0.21, 0.09) micromol/L, respectively. According to these findings, the equivalent of 1 microg retinol would be 12 microg beta-carotene (95% CI: 8, 22 microg) for fruit and 28 microg beta-carotene (17, 84 microg) for green leafy vegetables. Thus, apparent mean vitamin A activity of carotenoids in fruit and in leafy vegetables was 50% (95% CI: 27%, 75%) and 21% (7%, 35%), respectively, of that assumed.The bioavailability of carotenoids from vegetables and fruit is less than previously assumed.

Background/Aims: To evaluate the FAO/WHO/UNU equations for predicting resting metabolic rate (RMR) in elderly Vietnamese. Methods: A cross-sectional study involving healthy and elderly subjects was carried out at the Basic Nutrition Department, National Institute of Nutrition, Vietnam. A total of 75 subjects who had a normal body mass index (BMI) were divided into two groups according to sex. The RMR was measured by indirect calorimetry and anthropometric indices were recorded. Equations derived by linear regression of RMR and body weight were compared to the FAO/WHO/UNU (1985) predictive equations. Results:The mean age of males and females were 65.03 ± 4.0 and 66.48 ± 4.61 years, respectively. Mean RMRs (MJ/kg/day) were 0.0963 ± 0.0121 for males and 0.0925 ± 0.0117 for females. Compared to the FAO/WHO/UNU equations, our findings were 10.9 and 11.1% lower in males and females, respectively (p < 0.05). Conclusion:Our findings suggest that the FAO/WHO/UNU equations may overestimate RMR in elderly Vietnamese. Further studies to find out the most appropriate equation or to establish new predictive equations for RMR in elderly Vietnamese should be conducted.