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Prevalence of CED in Vietnam
During the period of 1981-1985, the weights and heights of 12800 rural adults in different age groups and ecological regions were collected. Results of Study I are presented in Tables 2 and 3, and show that:
Table 2. The mean (±SD) body mass index (BMI) of adults in a 10-state study of rural Vietnam
|
Age group (years) |
Men |
Women | ||
|
N |
BMI |
N |
BMI | |
|
18-25 |
1660 |
19.2 ± 1.9 |
2461 |
19.8 ± 1.9 |
|
26-40 |
1161 |
19.7 ± 1.7 |
1930 |
19.7 ± 1.8 |
|
41-60 |
1309 |
19.0 ± 1.8 |
2501 |
18.6 ± 2.0 |
|
>60 |
685 |
18.2 ± 2.2 |
1093 |
17.8 ± 2.2 |
|
Total |
4815 |
7985 | ||
Table 3. The proportion (%) of adults in different ages with different grades of chronic energy deficiency (CED)
|
Age group (years) | |||||||||
|
18-25 |
26-40 |
41-60 |
>60 | ||||||
|
CED grade |
BMI |
Men |
Women |
Men |
Women |
Men |
Women |
Men |
Women |
|
III |
<16 |
1.2 |
2.7 |
0.8 |
0.4 |
1.4 |
5.0 |
5.8 |
15.8 |
|
II |
16.0- 16.9 |
2.4 |
5.3 |
2.5 |
0.8 |
7.9 |
7.7 |
12.6 |
12.6 |
|
I |
17.0-18.4 |
22.4 |
20.5 |
18.3 |
16.6 |
28.4 |
29.7 |
32.6 |
36.8 |
|
Total <18.5 |
26.0 |
28.5 |
21.6 |
17.8 |
37.7 |
42.4 |
51.0 |
65.2 | |
These data are derived from the same 10-state study as that depicted in Table 2.
(a) The average values of BMI in the rural areas of Vietnam is low but changes with age: after 40 years of age, there is a gradual decrease in the average BMI but this fall is appreciably greater in women than in men (Table 2).
(b) The prevalence of CED is quite high in our country. The average percentage of subjects having BMI below 18.5 is ±40%. The highest percentage is shown in the oldest age group (Fig. 1).
Table 4. Food consumption (mean $ SD including those with zero consumption)
|
Foodstuffs |
Urban |
Rural |
Mountainous |
|
(n = 1655) |
(n = 9153) |
(n = 1634) | |
|
Rice |
421.29 ±112.25 |
457.06 ±133.90 |
497.97 ±129.21 |
|
Other cereals |
14.22 ±30.21 |
3.70 ±26.66 |
7.43 ±33.55 |
|
Tubers |
11.75 ±33.16 |
47.47 ±118.86 |
38.81 ±119.85 |
|
Beans and peas |
2.36 ±10.18 |
1.58 ±10.11 |
3.96 ±20.50 |
|
Tofu |
16.50 ±33.67 |
4.87 ±18.84 |
8.71 ±24.16 |
|
Nut and sesame |
4.18 ±10.61 |
2.96 ±12.95 |
9.44 ±20.83 |
|
Veg. Leaves |
108.53 ±77.27 |
145.23 ±113.92 |
168.97 ±106.31 |
|
Veg. Tubers |
39.44 ±49.17 |
49.40 ±87.32 |
68.45 ±78.74 |
|
Fruits |
10.17 ±33.83 |
1.24 ±13.09 |
0.18 ±3.65 |
|
Sugar |
1.76 ±6.85 |
0.13 ±2.78 |
0.09 ±1.19 |
|
Sauces |
22.25 ±25.80 |
30.22 ±31.70 |
23.53 ±34.83 |
|
Oil and fat |
6.38 ±9.77 |
2.62 ±6.55 |
2.71 ±8.30 |
|
Meats |
49.27 ±50.18 |
13.72 ±31.06 |
28.49 ±40.89 |
|
Eggs and milk |
9.59 ±18.63 |
1.38 ±6.59 |
1.96 ±11.15 |
|
Fishes |
62.22 ±81.07 |
29.26 ±40.77 |
8.08 ±18.06 |
|
Shellfish (incl. Crustaceans) |
7.82 ±16.40 |
8.76 ±21 13 |
1.79 ±8.31 |
During the period 1987-1989, we carried out a general nutrition survey of 12 789 households in different regions of the country including Hanoi and Ho Chi Minh cities. The survey in Study II included the measurement of household food consumption for 3 consecutive days by the weighing method, anthropometric measurement of the household members and an assessment of socio-economic factors (Ministry of Health of Vietnam, 1991).
The survey results are presented in Tables 4-8 and Figs 2 and 3. They show that in rural and mountainous areas the pattern of BMI is similar to each other but different from the BMI of the urban group. This fact may relate to differences in the population's food intake, energy expenditure and lifestyle in these regions. Table 4 shows that the dietary pattern is different in urban, rural and mountainous areas. In our survey, only the average dietary intakes of household members are available. Taking the group of 25-39 years of age as a sample, we did not find a correlation between the average energy per capita of the household and the BMI of the young adults within the household. In general, the average of fat energy per cent in the diet of those living in urban areas is higher than those from mountainous and rural areas (14.0%, 8.3% and 6.8% respectively). The average height and weight of urban inhabitants is generally also higher than in the rural and mountainous areas.
Table 5. Nutritive value of the diet (per capita per day mean and SD, including zero intake) in three Vietnamese environments
|
Nutrients |
Urban |
Rural |
Mountainous |
|
(n = 1655) |
(n = 9153) |
(n = 1634) | |
|
Total proteins (g) |
62.5 ±19.8 |
53.8 ±18.6 |
57.7 ±18.2 |
|
Animal protein (g) |
22.7 ±14.6 |
11.2 ±12.4 |
7.8 ±9.9 |
|
Lipids (g) |
28.7 ±17.5 |
13.9 ±12.3 |
18.8 ±15.5 |
|
Lipids of vegetable origin (g) |
7.0 ±7.8 |
6.6 ±6.6 |
10.3 ±9.61 |
|
Carbohydrates (g) |
336.2 ±85.4 |
375.4 ±102.2 |
411.0 ±93.7 |
|
Energy (kcal) |
1905.2 ±485.2 |
1892.8 ±524.4 |
2101.5 ±498.2 |
|
Calcium (mg) |
464.6 ±266.6 |
553.0 ±471.9 |
408.3 ±216.6 |
|
Phosphorus (mg) |
789.0 ±229.2 |
702 5 ±223.2 |
758.8 ±229.8 |
|
Iron (mg) |
9.8 ±2.8 |
9.5 ±3.1 |
10.3 ±3.4 |
|
Vitamin A (mg) |
0.1 ±0.4 |
0.0 ±0.1 |
0.0 ±0.1 |
|
Carotenes (mg) |
2.1 ±1.9 |
2.8 ±3.1 |
2.6 ±2.7 |
|
Vitamin B1 (mg) |
0.8 ±0.3 |
0.7 ±0.3 |
0.8 ±0.3 |
|
Vitamin B2 (mg) |
0.5 ±0.2 |
0.3 ±0.2 |
0.4 ±0.2 |
|
Niacin (mg) |
10.7 ±3.8 |
9.7 ±3.5 |
11.4 ±4.8 |
|
Vitamin C (mg) |
48.7 ±43.9 |
61.2 ±59.4 |
73.7 ±55.8 |
Table 6. Nutrient proportions in the diet of adults living in three Vietnamese environments
|
Nutrients |
Urban |
Rural |
Mountainous |
|
(n = 1655) |
(n = 9153) |
(n = 1634) | |
|
Energy (kcal) |
1905 ±485 |
1893 ±524 |
2101 ±498 |
|
Protein (% energy) |
13.5 |
11.7 |
11.3 |
|
Fat (% energy) |
14.0 |
6.8 |
8.3 |
|
Carbohydrate (% energy) |
72.3 |
81.3 |
80.2 |
|
|
1.04 |
0.58 |
0.74 |
|
|
(%) 36.3 |
20.9 |
13.6 |
|
|
(%) 24.4 |
47.9 |
54.8 |
|
|
0.59 |
0.79 |
0.54 |
|
Vitamin B1 (mg) per 1000 kcal diet |
0.49 |
0.37 |
0.43 |
BMI of mothers and the nutritional status of children <5 years of age
Based on data of Study II, an attempt was made to assess the relationship between the BMI of mothers and the nutrition status of their <5-year-old children. We found that there is a significant relationship between the two parameters (Table 9). Weight-for-age was used to assess the nutritional status with NCHS as the reference population (Hop et al., 1991). Children were classified as having different degrees of malnutrition: 1st degree below -2 SD; 2nd degree for those below -3 SD and the 3rd degree group was below ± SD of the NCHS value.
Table 7. The mean ±SD body mass index of men in different age groups
|
Age group (years) |
Total population studied |
Urban areas |
Rural areas |
Mountainous areas |
|
15-17 |
17.9 ±2.81 |
17.4 ±2.01 |
18.0 ±3.11 |
18.4 ±2.05 |
|
n = 2236 |
n = 394 |
n = 1488 |
n = 333 | |
|
18-24 |
19.4 ±1.94 |
18.8 ±2.12 |
19.4 ±1.90 |
19.9 ±1.72 |
|
n = 3006 |
n = 483 |
n = 1975 |
n = 520 | |
|
25-29 |
19.7 ±1.79 |
19.3 ±1.91 |
19.7 ±1.72 |
19.9 ±1.94 |
|
n = 2322 |
n = 239 |
n = 1653 |
n = 400 | |
|
30-39 |
19.6 ±1.91 |
19.5 ±2.09 |
19.6 ±1.89 |
19.5 ±1.89 |
|
n = 3213 |
n = 363 |
n = 2347 |
n = 459 | |
|
40-49 |
19.5 ±2.70 |
19.7 ±4.13 |
19.4 ±1.90 |
19.4 ±1.95 |
|
n = 1908 |
n = 515 |
n = 1142 |
n = 224 | |
|
50-59 |
19.1 ±2.02 |
19.7 ±2.34 |
19.0 ±1.94 |
19.0 ±1.77 |
|
n = 1989 |
n = 368 |
n = 1341 |
n = 265 | |
|
60-69 |
18.8 ±3.06 |
19.0 ±2.41 |
18.8 ±3.37 |
18.4 ±1.86 |
|
n = 1338 |
n = 154 |
n = 949 |
n = 226 | |
|
>70 |
17.9 ±2.28 |
17.9 ±2.42 |
18.1 ±2.15 |
17.5 ±2.59 |
|
n = 711 |
n = 95 |
n = 495 |
n =119 |
Table 8. The mean ±SD body mass index of women in different age groups
|
Age group (years) |
Total population studied |
Urban areas |
Rural areas |
Mountainous areas |
|
15-17 |
18.3 ±2.26 |
17.6 ±2.00 |
18.3 ±2.36 |
18.9 ±2.36 |
|
n = 2303 |
n = 461 |
n = 1501 |
n = 331 | |
|
18-24 |
19.6 ±1.99 |
18.7 ±1.96 |
19.72 ±1.96 |
19.8 ±1.90 |
|
n = 4312 |
n = 605 |
n = 3031 |
n = 636 | |
|
25-29 |
19.6 ±1.89 |
19.0 ±2.01 |
19.7 ±1.86 |
19.6 ±1.81 |
|
n = 2856 |
n = 337 |
n = 2086 |
n = 381 | |
|
30-39 |
19.4 ±1.98 |
19.4 ±2.20 |
19.4 ±1.93 |
19.2 ±1.91 |
|
n = 3921 |
n = 611 |
n = 2781 |
n = 469 | |
|
40-49 |
19.2 ±2.07 |
19.5 ±2.23 |
19.2 ±1.93 |
18.8 ±2.33 |
|
n = 2320 |
n = 590 |
n = 1446 |
n = 261 | |
|
50-59 |
18.7 ±2.16 |
20.0 ±2.56 |
18.6 ±2.07 |
18.6 ±2.23 |
|
n = 2271 |
n = 278 |
n = 1691 |
n = 294 | |
|
60-69 |
18.2 ±2.27 |
19.0 ±2.62 |
18.2 ±2.15 |
18.0 ±2.37 |
|
n = 1591 |
n = 199 |
n = 1166 |
n = 219 | |
|
>70 |
17.7 ±2.33 |
18.3 ±2.72 |
17.6 ±2.28 |
17.4 ±2.04 |
|
n = 920 |
n = 142 |
n = 639 |
n = 134 |
Relation between BMI of women and the economic status of the family
The economic status of families was classified into three categories (low, middle and high) according to the nature of their main property, because income is not easy to collect accurately in our circumstances. There was no significant relationship between BMI of women and the economic status of the families.
Table 9. Relation between body mass index (BMI) of mothers and nutritional status of children under 5 years of age
|
Weight by age of children | ||||||||||
|
BMI classification of mothers |
Normal |
1st degree |
2nd degree |
3rd degree |
Total | |||||
|
% |
n |
% |
n |
% |
n |
% |
n |
% |
n | |
|
Normal |
53.2 |
1162 |
32.4 |
707 |
12.9 |
281 |
1.6 |
4 |
70.2 |
2184 |
|
CED I |
48.1 |
324 |
33.6 |
226 |
16.3 |
110 |
1.9 |
3 |
21.6 |
673 |
|
CED II |
44.0 |
77 |
35.4 |
62 |
17.7 |
31 |
2.9 |
5 |
5.6 |
175 |
|
CED III |
44.3 |
35 |
29.1 |
23 |
24.1 |
19 |
2.5 |
2 |
2.5 |
79 |
|
Total |
51.4 |
1598 |
32.7 |
1018 |
14.2 |
441 |
1.7 |
54 |
3111 | |
