MICRONUTRIENT STATUS IN VIETNAM SIGHT AND L IFE | VOL. 26 (2) | 2012 TABLe 5: Anemia and iron status in Vietnamese children aged 6–75 months Variable n Mean/Prevalence SEM/SEP Hemoglobin (g/L) 358 125.3 0.1 Anemia % (Hb <110 g/L) 583 9.1 1.4 Ferritin μg/L 568 33.8 1.0 Iron deficiency % (Ferritin < 15 μg/L) 568 12.9 1.5 Iron deficient anemia % (Hb <120 g/L & Ferritin < 15 μg/L) 564 3.2 0.8 Table shows means and prevalences1 SEM: Standard error of the mean SEP: Standard error of the prevalence Vietnamese folate and vitamin B12 status The analysis of the Food Consumption Survey reported by DEPOCEN9 provided no data on folate or vitamin B12 status. Analysis of the plasma folate concentration in the Vietnamese women suggested that 25% of the population had marginal status (6.8– 13.4 nmol/L) but very few were at risk of deficiency (2.7%, <6.8 nmol/L). In the children, there were 6.4% with marginal status and <1% at risk of folate deficiency. Vitamin B12 status was only examined in a sub-sample of the women (n=550). The distribution appeared bimodal, with a risk of deficiency in 11.7% (<148 pmol/L), but only 3.8% with marginal status (148–220 pmol/L). 1. The prevalence of stunting in Vietnamese children is evidence of continuing malnutrition 2. Fortification of foods may be the best option, as dairy foods are not a part of traditional diets Vietnamese nutritional status The prevalence of stunting in the Vietnamese children (height for age Z score (HAZ) <-2) was 23.2% in the 2010 Micronutrients Survey.1 Although the proportion was slightly higher in the rural areas, the difference was not significant (Table 6). Stunting is an indicator of chronic undernutrition. It is the result of extended periods of inadequate food intake, poor dietary quality, high prevalence of morbidity, or a combination of these factors.2 A number of nutritional indices were obtained on the children in these studies, but no attempt was made to evaluate whether any of the different factors contributed to the stunting – even though the authors reported that several were of public health importance. According to WHO classifications, the prevalence of anemia suggested a mild public health problem (5–20%)18 in both the women and children. In addition, the authors also suggested that vitamin A deficiency was possibly a mild public health problem in children (<10% below 0.7 μmol/L).19 However, as previously noted, the data were not fully corrected for inflammation, so low retinol values may have been overestimated. CRP concentrations indicated that inflammation was present in 8% of the children, and plasma zinc concentrations in the Vietnamese children were low by international standards, with 51.9% of children at a risk of zinc deficiency (plasma zinc <9.9 μmol/L). Plasma zinc concentrations were significantly lower in rural as opposed to urban children. Plasma folate concentrations were also measured in the children. Although there was very little evidence of folate deficiency, an analysis of the variance in HAZ explained by the biochemical data – or a comparison of relationships in stunted and non-stunted children – would have been very interesting to see. The recent report by UNICEF on stunting in children under the age of five showed that the mean prevalence in South East (SE) Asia for the period 2006–2010 was 34%, and 31% in Vietnam (Table 7).20 In the 2010 Micronutrients Survey,1 the mean prevalence of stunting in Vietnam was 23.2% (Table 6), which is in line with the general trend downwards in time for stunting in all countries.21 The prevalence of stunting in Vietnam is slightly better than average, in comparison with other SE Asian countries. This would suggest that the large improvements in iron and vitamin A status may have had very little impact on stunting in Vietnam. Of the growth-limiting nutrients, zinc deficiency is widely believed to be of considerable importance in the etiology of stunting. Experimentally, withholding zinc restricts growth 61