Micronutrient Intakes among Women of Reproductive Age in Vietnam

Abstract

BackgroundMicronutrient deficiencies are a public health concern worldwide negatively affecting maternal and child health outcomes. The primary underlying causes of micronutrient deficiencies are insufficient intake and poor bioavailability of micronutrients. However, reliable data on micronutrient intakes are sparse. The objectives of this study were to identify the key local food sources providing the majority of micronutrients and assess the adequacy and determinants of micronutrient intakes.MethodsThe study used data from a survey of 4,983 rural women of reproductive age (WRA) participating in a preconception micronutrient supplementation trial in Vietnam. Micronutrient intakes were assessed using a validated 107-item semi-quantitative food-frequency questionnaire. Multivariate linear and logistic regression analyses were used to examine the association between socioeconomic status and micronutrient intakes.ResultsStarchy staples were the main source of iron and zinc (37% and 54%, respectively) with only a small proportion from meat (10% and 18%, respectively). The primary source of folate and vitamin A were vegetables; vitamin B12 came from meat and eggs. The proportion of the population with intakes below the estimated average requirement was 25% for iron, 16% for zinc, 54% for folate, 64% for vitamin B12 and 27% for vitamin A. Socioeconomic status was the main determinant of micronutrient intakes. WRA in the highest quintile consumed 26% more iron, 19% more zinc, 36% more folate, 82% more vitamin B12 and 47% more vitamin A compared to those in the lowest quintile. Women in the upper quintiles of SES were more likely to obtain nutrients from more nutritious and higher bioavailable foods than those in the lowest quintile.ConclusionsUnderprivileged women were at increased risk for insufficient micronutrient intakes due to poor diet quality. Targeted efforts to promote the consumption of local nutrient rich foods along with educational programs and social development are needed.

Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum: A Randomized Controlled Trial in Rural Vietnam

“…The low levels of iron-deficiency anemia at baseline in our study population may explain the lower potential to benefit from supplements compared to other settings where iron deficiency is the primary cause of anemia. This low level of iron deficiency was surprising given the poor dietary quality and high levels of underweight among women in this population [43]. Traditional Vietnamese diets are dominated by starchy staples (mainly rice), are lower in fat and despite increases in protein intake over past two decades only about a third of protein comes from animals sources foods (which have higher bioavailability for several micronutrients) [44].…”

Neither Preconceptional Weekly Multiple Micronutrient nor Iron–Folic Acid Supplements Affect Birth Size and Gestational Age Compared with a Folic Acid Supplement Alone in Rural Vietnamese Women: A Randomized Controlled Trial

“…All sites have commune health centers (CHCs), and >90% of births occur in district hospitals, which is typical of rural Vietnam. Limited data suggest that chronic inadequacies in energy and micronutrient intake are common (14).…”

“…Detailed obstetric and health history, anthropometric measurements, and venous blood samples were also obtained at baseline and the first prenatal visit. Dietary intake was assessed at baseline with the use of a semiquantitative FFQ that was developed by the Vietnam National Institute of Nutrition and administered by trained field workers (14). Maternal underweight was defined as BMI (in kg/m 2 ) <18.5.…”

The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam

“…Maternal 15 undernutrition is a key determinant of poor fetal growth, increased 16 infant morbidity and mortality, and has long-term adverse 17 consequences for child development and lifelong health [1]. 18 The Lancet 2013 series highlights the ''clear need'' for evidence 19 based interventions in the preconception period in countries with 20 a high burden of undernutrition. The importance of a woman's 21 preconceptual nutrition on infant and maternal outcomes is 22 gaining recognition but there remain several gaps in our 23 understanding [2-6].…”