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The objective was to determine the glycemic index (GI) of Nutritional product for Diabetes Mellitus through measuring glycemic responses to reference food (Glucose) and test among nutritional product 13 participants. The study was a self-controlled clinical trial with 13 qualified participants (8 men and 5 women). They were required to go through the study protocol with reference food and test food. For each individual, seven blood samples were taken in the fasting state and at 15, 30, 45, 60, 90 and 120 minutes after ingestion. Our results show that at all measurement points, the blood glucose levels after consumption of test food were lower than after consumption of reference food. The incremental area under the curve (iAUC) and a GI value of Nutritional product (NP) were calculated for each meal. Mean ± SD of GI value was calculated for test food for the combined group of subjects. Mean iAUC and GI value of Nutritional product were 62,1 ± 12,5 mmol·min/L and 44,9 ± 7,2, significantly lower to those of reference food, which were 132,6 ± 14,8 mmol·min/L and 100, respectively. Finding from the study demonstrated that Nutritional product (GI = 44,9) would be classified as a low – GI food.

In the world as well as in Vietnam, diabetes have shown bad effects and there is increasing number of deaths over years because of diabetes as one of three leading causes of deaths. Penalver et al (2016) stated to achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. The type of food tested was Nutritional product (Vietnam). Nutritional product solution with 83.3g diluted in 390 ml water. The food-to-water ratio followed the processing instruction from the manufacturer. In this study we discover a low GI of nutritional product, as of (48.2 ± 5.3). And also, we found out there is decrease (slow) of responses of mean blood glucose (Nutritional product) after 90 minutes (4.7 mmol/L) till 120 minutes (4.3 mmol/L). As we conduct this paper with younger subjects, comparing to older people, they can regulate blood sugar better. Finally, we also compare to other previous studies for literature review.

Vietnam has successfully reduced population stunting, but ethnic minority groups are being systematically left behind, limiting progress on national reductions. This mixed methods study aims to understand how policy drivers of stunting reduction differ between ethnic majority and minority communities. We used decomposition analysis to explain key determinants of stunting change between 2000 and 2010; and framework analysis to qualitatively assess changes in policy, actors and narratives that have underpinned these over decades. Our analysis shows that stunting reductions are associated with increased household wealth (accounting for 61% of change), improved access to specific health services (16%), and changes in level of maternal education (12%). Despite multiple actors involved in change and a large set of policies designed to address inequities, many among Vietnam’s defined ethnic minority groups are not finding themselves able to effectively engage with central government plans for their communities, and central policies often do not consider their preferences or limitations. This in turn impacts the nutrition of minority groups through the determinants above. Vietnam has achieved the easier portion of stunting reduction through national economic growth and sustained commitment to socially-oriented policy. In order to tackle the remaining pockets of high malnutrition, more attention, thought and funding will need to focus on marginalised ethnic minority communities. The current national development discourse aims to incorporate minorities into mainstream majority systems. This paper argues that policy should rather take into account their particular needs and preferences to address and overcome the identified determinants of malnutrition.

Objectives To evaluate the efficacy of fermented milk containing Lactobacillus casei strain Shirota (LcS) on the incidence of constipation, diarrhea, acute respiratory infections (ARI), and nutritional status of young Vietnamese children. Methods A controlled field trial was conducted with 1003 children (3–5 years old) in Thanh Hoa province in Vietnam. The probiotic group (n = 510) consumed fermented milk 65 mL/day containing 108 CFU/mL of LcS for the 12-week intervention period, whereas the control group (n = 493) was not given any. The incidence of constipation, diarrhea, ARI, and anthropometry in children was determined at baseline, after 4, 8, and 12-week intervention, and after the 4-week follow-up period. Results Probiotic drink decreased the incidence of constipation after the 12-week intervention period (12.0% vs. 32.0%, OR = 0.28 (95% CI: 0.21–0.40), p p = 0.068), and prevented the occurrence of ARI (15.9% vs. 24.5%, OR = 0.58 (95% CI: 0.42–0.79), p p Conclusions Daily intake of fermented milk containing LcS strongly prevented the incidence of constipation and ARI in Vietnamese children. This study also revealed the potential effects of the use of a probiotic drink on diarrhea prevention as well as nutritional status improvement.

Background. Uric acid is a powerful free-radical scavenger in humans, but hyperuricemia may induce insulin resistance and beta-cell dysfunction. The study aimed to evaluate the association between hyperuricemia and hyperglycemia, considering the confounding factors in a Vietnamese population. Methods. A population-based cross-sectional study recruited 1542 adults aged 50 to 70 years to collect data on socioeconomic status, lifestyle factors, and clinical patterns. Associations between hyperuricemia and hyperglycemia (isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), combined IFG-IGT, and type 2 diabetes (T2D)) were evaluated by multinomial logistic regression analysis in several models, adjusting for the confounding factors including socioeconomic status, lifestyle factors, and clinical measures. Results. Uric acid values were much higher in IFG, IFG-IGT, and T2D groups compared to those in the normal glucose tolerance (NGT) group. The significant association of hyperuricemia with IFG, IFG-IGT, and T2D was found in the model unadjusted and remained consistently in several models adjusted for socioeconomic status, lifestyle factors, and clinical patterns. In the final model, the consistent hyperglycemia risk was found in total sample (OR = 2.23 for IFG, OR = 2.29 for IFG-IGT, and 1.75 for T2D, P≤0.006) and in women (OR = 2.90 for IFG, OR = 3.96 for IFG-IGT, and OR = 2.49 for T2D, P<0.001) but not in men. Conclusions. It is the first report in Vietnamese population suggesting the significant association of hyperuricemia with IFG, IFG-IGT, and T2D; and the predominant association was found in women than in men, taken into account the confounding factors.

To sought for an easily applicable nomogram for detecting individuals at high risk of undiagnosed type 2 diabetes.The development cohort included 2542 participants recruited randomly from a rural population in 2011.The glycemic status of subjects was determined using the fasting plasma glucose test and the oral glucose tolerance test. The Bayesian Model Average approach was used to search for a parsimonious model with minimum number of predictor and maximum discriminatory power. The corresponding prediction nomograms were constructed and checked for discrimination, calibration, clinical usefulness, and generalizability in nationwide population in 2012.The non-lab nomogram including waist circumference and systolic blood pressure was the most parsimonious with the area under receiver operating characteristic curve (AUC) of 0.71 (95 %CI = 0.64-0.76). Adding low-density lipoprotein cholesterol in the non-lab nomogram generated the lab-based nomogram with significantly improved AUC of 0.83 (0.78-0.87, P 0.001). The nomograms had a positive net benefit at threshold probability between 0.01 and 0.15. Applying the non-lab nomogram to the national population yielded the AUC of 0.66 (0.63-0.70) and 0.68 (0.65-0.71) in the cohorts aged 40-64 and 30-69 years, respectively.The novel nomograms could help promote the early detection of undiagnosed diabetes in rural Vietnamese population.

Antibiotic-resistant bacteria have become a serious problem worldwide, caused in part by the excessive use and discharge of antibiotics into the environment. Ampicillin (ABPC) is a widely used antibiotic. However, this chemical rapidly decomposes in water containing divalent cations like Ca2+ and Mg2+, thus, detection of ABPC in environmental water is difficult. This study was carried out to evaluate the presence of 2-hydroxy-3-phenylpyrazine (HPP), one of the degradation products of ABPC and β-lactam antibiotics with an ABPC substructure, in environmental water. An analytical method for HPP monitoring in environmental water was developed using liquid chromatography/tandem mass spectrometry. The analyte was extracted from water samples and enriched using a solid-phase extraction cartridge. The quantification limit was 1 ng L−1. The HPP recovery rates from spiked water samples of 25 and 125 ng L−1 were 84.1 and 86.1%, respectively. The method was then used to determine HPP residue levels in 98 environmental water samples from rivers, household ponds, and aquacultural ponds in Vietnam. HPP residues were detected in 60 samples. The HPP detection rates in rivers and household ponds were 42 and 79%, respectively. HPP was not detected in aquacultural ponds. HPP residue concentrations in the samples ranged from 1.3 to 413.3 ng L−1. The residue levels in rivers flowing through city centres were higher than levels in other sampling locations. The findings of this study suggest that HPP is a promising marker for assessing the discharge of ABPC and β-lactam antibiotics with an ABPC substructure into the environment around sampling sites.

Mycotoxins in food are increasingly a food safety hazard concern in particular in developing countries. This study was performed to determine the occurrence and determinants of aflatoxin and fumonisin contamination in rice and maize and to assess health risks through dietary intake exposure among ethnic minority groups in northern Vietnam. A total of 111 rice and 102 maize samples, were tested for occurrence of fungi and mycotoxins, i.e. aflatoxins (AF’s) and fuminisin B (FB). Results showed that 107 (96.4%) rice and 84 (82.4%) maize samples were contaminated by fungi. Aspergillus flavus was found in 68 (61.3%) rice and 30 (29.4%) maize samples, Aspergilus parasiticus in 40 (36.0%) rice and 27 (26.7%) maize samples. AF’s - were detected in 27 rice (24.3%) and 27 maize samples (26.4%) at minimum and maximum levels in rice of 2.06 and 77.8 ng/g and 20.5 and 110 ng/g in maize, respectively. Nine (8.1%) rice and 24 (23.5%) maize samples contained FB at ranges of 2.3–624 ng/g in rice and 5.6–89.8 ng/g in maize. Data collected through interviews and observations in households showed that type of crop, storage duration and presence of fungi, particularly mycotoxigenic fungi were important risk factors for AF’s and FB contamination. Based on daily food consumption data, the estimated average exposure dose of aflatoxin B1(AFB1) from rice was 21.7 ng/kg bw/day for adults and 33.7 ng/kg bw/day for children. For FB, the rice based average exposure amounted to 536 ng/kg bw/day for adults and 1019 ng/kg bw/day for children. The calculated excess risk of liver cancer incidence by ingestion of cereals containing AFB1 was 1.5 per 100,000 adults and 2.3 per 100,000 children per year. The average intake of FB was calculated to be lower than the tolerable diet intake (TDI). Our findings highlight that rice and maize are contaminated with mycotoxins at levels representing actual health hazards for the ethnic minority groups consuming these stable cereals. Proper drying and storage conditions in households are likely to reduce the mycotoxin contamination.

Aflatoxins, fumonisins and ochratoxin A that contaminate various agricultural commodities are considered of significant toxicity and potent human carcinogens. This study took a total dietary study approach and estimated the dietary exposure of these mycotoxins for adults living in Lao Cai province, Vietnam. A total of 42 composite food samples representing 1134 individual food samples were prepared according to normal household practices and analysed for the three mycotoxins. Results showed that the dietary exposure to aflatoxin B1 (39.4 ng/kg bw/day) and ochratoxin A (18.7 ng/kg bw/day) were much higher than recommended provisional tolerable daily intake (PTDI) values mainly due to contaminated cereals and meat. The exposure to total fumonisins (1400 ng/kg bw/day) was typically lower than the PTDI value (2000 ng/kg bw/day). The estimated risk of liver cancer associated with exposure to aflatoxin B1 was 2.7 cases/100,000 person/year. Margin of exposure (MOE) of renal cancer linked to ochratoxin A and liver cancer associated with fumonisins were 1124 and 1954, respectively indicating risk levels of public health concern. Further studies are needed to evaluate the efficiency of technical solutions which could reduce mycotoxin contamination as well as to determine the health effects of the co-exposure to different types of mycotoxins.

In recent years, reports have described various roles of vitamin D in human health. Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Vietnamese context, it has been reported to be present in a majority of the population in spite of the wide availability of sunlight. Vitamin D and calcium are essential nutrients for bone health. The proposed health benefits of vitamin D and calcium have attracted increased interest from health care professionals, the media, and the public. The aim of this paper is to summarize the published data on vitamin D and calcium intake as well as on the prevalence of vitamin D deficiency in the Vietnamese population, and to provide recommendations for a proper strategy to control calcium and vitamin D deficiency in this population. The national authorities should adopt policies aimed at improving vitamin D and calcium status by using measures such as dietary recommendations, food fortification, vitamin D supplementation, and judicious sun exposure.

We investigated whether pre-germinated brown rice bran extract containing acylated steryl glucosides (PSG) reduces the risk of atherosclerosis in post-menopausal Vietnamese women. A total of 60 post-menopausal Vietnamese women (45-65 y old) with high LDL cholesterol levels (over 140 mg/dL) were randomly divided into PSG (n=30) and placebo (n=30) groups. The subjects in the PSG group were assigned a daily intake of 6 capsules containing 50 mg PSG, and the subjects in the placebo group were assigned a daily intake of 6 capsules containing corn oil for 6 mo. Before baseline and after month 2, month 4, and month 6 of the intervention, we conducted anthropometric measurements, blood biochemical examinations, a nutrition survey, and physical activity, flow-mediated dilation (FMD), and cardio-ankle vascular index (CAVI) measurements. Serum LDL cholesterol concentrations were significantly reduced from 163.6±25.3 (mg/dL) to 135.9±26.8 (mg/dL) compared to the placebo group (p

Vietnam launched the national Expanded Program on Immunization in 1981. Since then, this program has contributed signi cantly to the improvement of child health and to the reduction of child mortality rate. Despite of the fact that the coverage of the national EPI keeps expanding, the number of children who complied with the recommended immunization schedule remains low. This article studies the progress of the timeliness childhood immunization compliance among children between 0-5 years of age in Vietnam from 2006 to 2014 and analyzes the socio-economic factors that account for the changes of the compliance rate during this period. The dataset is extracted from the Multiple Indicator Cluster Survey in 2006 and 2014. We rst identify the socio-economic factors that impact on the vaccination compliance rate using a logistic regression model. Next, we apply the decomposition method to determine the contribution of each factor on the evolution of the timeliness childhood immunization compliance. The progress of the timeliness childhood immunization has been positive and the major contribution comes from the structure e ect (unmeasured e ect). Rural areas show a stronger improvement as of 2014. Among the socio-economic factors, mother education and birth order are the ones that have the larger in uence on the childhood immunization compliance rate. However, these factors have di erent implications in urban and rural areas. These ndings are critical to the current context of Vietnam where the government is designing a strategy focusing on the e ectiveness rather than the traditional coverage indicator.

Childhood obesity is a rising health concern in Vietnam, however, research in this area is not extensive. The aim of this study was to determine the prevalence of childhood overweight and obesity, and to study associations between weight status and selected lifestyle factors, such as diet and physical activity levels, among children aged 6-10 years in Hai Phong City, Vietnam.Two hundred and seventy-six children from an urban and a rural primary school participated in this cross-sectional study. Data on weight, height and waist circumference were used to calculate BMI, and waist-height ratio to determine the proportion of children who were overweight, obese and had high central adiposity. Information on diet, physical activity and socioeconomic status of families was collected using questionnaires.Prevalences of overweight, obesity and high abdominal adiposity were 11.2%, 10.1% and 19.9%, respectively. Children who completed=60 minutes of physical activity daily were 50% and 80% less likely to be overweight and have high abdominal adiposity, respectively. Computer usage increased the odds of overweight and high abdominal adiposity by 4.5 and 3.9 times, respectively. Mothers with higher education and income levels increased the risk of their children being overweight (p0.05).Physical inactivity and high maternal education and income levels increased the risk of childhood overweight and obesity in this cohort. Future interventions should target parents and their children by providing both with educational modules centred on healthy eating habits, parental feeding practices and strategies for increasing physical activity.

We examined whether Escherichia coli isolates that produce CTX-M-9-type extended-spectrum β-lactamases (ESBL) are transferred between humans and chickens in a Vietnamese community. The phylogenetic group compositions, sequence types, antimicrobial resistance profiles, the prevalence of plasmid antibiotic resistance genes, and the plasmid replicon types generally differed between the human and chicken E. coli isolates. Our results suggest that transmission of the bla CTX-M-9 -positive E. coli between humans and poultry was limited.

Bone mass decreases along with aging, especially for women after menopause because of lower estrogen secretion together with low calcium intake. This study was conducted to study the effect of eggshell calcium supplementation on bone mass in 54 postmenopausal Vietnamese women living in a farming area about 60 km from Hanoi, Vietnam. Sets of 3 subjects matched by age, bone mass, BMI and calcium intake were divided randomly into 3 groups with 18 subjects in each group. The eggshell calcium group was administered 300 mg/d calcium from eggshell, the calcium carbonate group 300 mg/d calcium from calcium carbonate and the placebo group received no calcium supplementation. Bone mass (Speed of Sound (SOS)) was measured at the beginning (the baseline), the middle (6th month) and the end of the study (12th month) by the single blind method. SOS of the eggshell group increased significantly at 12 mo (p0.05) and was significantly higher than that of the placebo and calcium carbonate groups at 12 mo (p0.05). The SOS of the calcium carbonate group tended to be higher than that of the placebo group but without a significant difference (p0.05). In conclusion, eggshell calcium was more effective in increasing bone mass than calcium carbonate in postmenopausal Vietnamese women.

To determine the nutritional status of patients with esophageal cancer, and to investigate its relationship with performance status and prognosis.This clinical, cross-sectional study was conducted from August 2014 to February 2015 at National Cancer Hospital, Hanoi, Vietnam. Stage III/IV esophageal cancer patients were assessed for their nutritional status (patient-generated subjective global assessment (PG-SGA) and SGA scores, BMI, mid-arm circumference (MAC), energy and protein intakes, weight changes, Karnofsky and Eastern cooperative oncology group performance scores (KPS/ECOG), and Glasgow prognostic score (GPS).Sixty-four male patients were enrolled. The mean ± standard deviation of PG-SGA score was 9.88±4.41. SGA revealed 44% as class B and 6.2% as class C. The BMI revealed 43.8% of patients were underweight. MAC measurement revealed 29.7% of undernourished patients. Patients with an energy intake25 kcal/kg/d comprised 54.7%, and 48.4% with1 g/kg/day of protein. Totally, 68.8%, 84.4% and 92.2% patients exhibited weight loss past 2-weeks, one-month and six-months, respectively. The PG-SGA and SGA strongly correlated with the KPS (r=-0.717 and 0.632, both p0.001) and ECOG (r=0.672 and 0.626, both p0.001), but were weakly correlated with the GPS (r=0.332 and 0.278, p0.01 and 0.05). The KPS, ECOG, BMI, MAC, energy and protein intakes, and weight change were not correlated with the GPS.Malnutrition, weight change, and insufficient intake were noteworthy in esophageal cancer patients. The PG-SGA and SGA were strongly correlated with the performance status, but weakly correlated with prognostic indices.

Fortified rice has the potential to improve the micronutrients status of vulnerable populations. However, fortified rice has to have acceptable organoleptic––the sensory properties of a particular food––qualities. Few data exist on the acceptability of fortified rice in Asia. To assess the acceptability of two types of fortified rice (cold and hot extruded) in Vietnam and Cambodia, triangle tests were conducted in Vietnam (53 women) and Cambodia (258 adults), testing fortified rice against conventional rice, with participants being asked to score the organoleptic qualities. In addition, Cambodian schoolchildren (n = 1700) were given conventional rice and two types of fortified rice for two week periods as part of a World Food Program school meal program, with intake monitored. Fortified rice differed significantly in organoleptic qualities from conventional rice, with most subjects correctly identifying fortified rice (P < 0.001). However, fortified rice was found to be highly acceptable in both countries. In Cambodia, schoolchildren consuming fortified rice had higher intakes than when consuming conventional rice (176 g/child/day and 168 g/child/day, respectively; P < 0.05). This study shows that fortified rice is acceptable in two countries in Southeast Asia. However, specific information is needed to explain the organoleptic qualities of fortified rice as perceived by end-users.

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。.

Aflatoxins, fumonisins and ochratoxin A that contaminate various agricultural commodities are considered of significant toxicity and potent human carcinogens. This study took a total dietary study approach and estimated the dietary exposure of these mycotoxins for adults living in Lao Cai province, Vietnam. A total of 42 composite food samples representing 1134 individual food samples were prepared according to normal household practices and analysed for the three mycotoxins. Results showed that the dietary exposure to aflatoxin B1 (39.4 ng/kg bw/day) and ochratoxin A (18.7 ng/kg bw/day) were much higher than recommended provisional tolerable daily intake (PTDI) values mainly due to contaminated cereals and meat. The exposure to total fumonisins (1400 ng/kg bw/day) was typically lower than the PTDI value (2000 ng/kg bw/day). The estimated risk of liver cancer associated with exposure to aflatoxin B1 was 2.7 cases/100,000 person/year. Margin of exposure (MOE) of renal cancer linked to ochratoxin A and liver cancer associated with fumonisins were 1124 and 1954, respectively indicating risk levels of public health concern. Further studies are needed to evaluate the efficiency of technical solutions which could reduce mycotoxin contamination as well as to determine the health effects of the co-exposure to different types of mycotoxins.

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.

Background In Vietnam, malnutrition remains a public health problem, even though much progress has been made in the last decades. The number of cases of severe acute malnutrition (SAM) is more than 200,000 per year. To accelerate the treatment of SAM, community-based treatment with ready-to-use-therapeutic foods (RUTFs) is preferred. However, a locally available and acceptable RUTF for the treatment of SAM was lacking. Objective In a joint effort by the National Institute of Nutrition, UNICEF, and the Institut de Recherche pour le Développement, a local RUTF was developed and tested. Methods The product was optimalized for impact and acceptability. At the same time, capacity for the Integrated Management of Acute Malnutrition (IMAM) was developed. Results The local product was found to be highly acceptable and effective. After training of health staff, the product could be introduced in the IMAM program. Conclusions The IMAM program was highly successful in treating children with SAM, with more than 90% of the children recovering. Production capacity of the factory is currently being increased to enable up-scaling of the IMAM program and potential export of the product to countries in the region.

With a global economic crisis, undernourished peoples in South East Asia, as elsewhere, face even greater food insecurity. Future challenges to food availability include increasing food prices, increasing population size and climate change. National policies are required which emphasise improved intersectoral coordination, enhanced government credibility and accountability, as well as a shift in food aid to investment in agriculture and the empowerment of independent institutions.

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.

Tatsuya Nakayama,1 Shuhei Ueda,2 Bui Thi Mai Huong,3 Le Danh Tuyen,3 Chalit Komalamisra,4 Teera Kusolsuk,4 Itaru Hirai,2 Yoshimasa Yamamoto1,5 1Global Collaboration Center, Osaka University, Osaka, Japan; 2Faculty of Medicine, University of The Ryukyus, Okinawa, Japan; 3National Institute for Nutrition, Hanoi, Vietnam; 4Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 5Osaka Prefectural Institute of Public Health, Osaka, Japan Abstract: Recent studies have reported a widespread distribution of extended-spectrum β-lactamase (ESBL)-producing bacteria, not only in the nosocomial setting, but also in the community; some local communities in Southeast Asia have been reported to show a high prevalence of ESBL-producing bacteria. However, the details regarding the quantitative/qualitative state of ESBL-producing bacterial spread in Southeast Asia are currently unclear. Thus, the aim of this study was to assess the state of ESBL-producing bacterial spread in community residents from the Indochinese peninsula, as a representative region of Southeast Asia. In order to achieve this aim, local community residents in Laos and Vietnam were examined for fecal carriage of ESBL-producing Enterobacteriaceae, and the findings were compared with data from a previous study in Thailand which was conducted in the same manner as this study. Between 47.0%–70.2% of the Laotian and Vietnamese residents carried ESBL-producing CTX-M genotype Enterobacteriaceae. The most common sub-genotypes of CTX-M were CTX-M-1 (33.0%–47.5%) and CTX-M-9 (47.5%–64.1%), and these rates were similar among all three countries. Taken together, these results confirmed that ESBL-producing Enterobacteriaceae are widely disseminated in Indochinese countries, such as Thailand, Laos, and Vietnam. Keywords: extended-spectrum β-lactamase (ESBL), rural residents, Indochinese peninsula, fecal carriage