FOOD FORTIFICATION DEVELOPMENT IN VIETNAM

Micronutrient malnutrition, especially among young children and women of child-bearing age, continues to be a major public health concern in many low-income countries, including Vietnam. Although Vietnam has made significant progress in addressing some micronutrient problems, especially vitamin A deficiency (VAD) among infants and young children and iodine deficiency disorders (IDD), much remains to be done. The government decision to ratify the National Nutrition Strategy for 2001-2010 underscores the high priority given to continued focus on the reduction of anemia, VAD, IDD, and other micronutrient deficiencies among the population (MOH National Nutrition Strategy, 2001). Iron deficiency anemia (IDA) is the most common nutritional deficiency in the world and is still a public health issue in Vietnam. Besides an iron supplementation program and nutrition education on diet diversification, food fortification was launched in Vietnam during the 1990s to improve iron status and prevent IDA among the high-risk groups of the population.

A field survey on fish sauce (FS) manufacturing process in 1998 indicated that fortification can be done with minor modification of the process prior to the bottling of the FS; and the price is affordable (adding 0.02 USD/L). The NaFeEDTA is selected as the best Fe fortificant to fortify FS. The fortified FS is stable and acceptable at least for 6 months.

The efficacy study was conducted in 2000 by the National Institute of Nutrition (NIN) in collaboration with ILSI CHP Japan and IRD. The aim was to evaluate the efficacy of fortified FS with 1 mg iron (as NaFeEDTA)/ml FS/person/day (6 days per week) on iron status of non-pregnant anemic women, 17-49 years old. It was concluded that the regular consumption of iron-fortified FS improved significantly the iron status of and thus reduced the prevalence of anemia among anemic women.

The effectiveness trial (double-blind randomized trial) was carried out during the period of 2001-2003 by NIN, IRD, ILSI CHP Japan to evaluate the effectiveness of fortified FS at level of 0.5 mg iron (as NaFeEDTA) in 1 ml FS on iron status of women of child-bearing age (17-49 yrs). It was found that daily consumption of fortified FS during 18 months significantly improved iron status of women of reproductive age. All studies and tests have been completed with successful results; and food fortification was considered as an effective strategy to control IDA in Vietnam. It is time to implement the strategy on a larger scale and the GAIN project on iron-fortified FS was started in 2005 in Vietnam. The project aims to make iron-fortified FS available at an affordable cost to all Vietnamese who are at risk to IDA, and reduce the prevalence of IDA by increasing the daily dietary intake of absorbed iron.

Efficacy studies on vitamin A-fortified sugar in lactating women and vitamin A-fortified cooking oil on the nutritional status of children 36-60 mos. old were also conducted in Vietnam. Both studies showed positive results and “Sugar A” is now produced by Bien Hoa Sugar Company; and cooking oil fortified with vitamin A is produced by Tuong an Company.

Some other activities as micronutrient-fortified biscuits and noodles were started and implemented in the framework of the PEM control program in Vietnam.

The Flour Fortification Initiatives (FFI) has assisted the NIN to convene the first workshop on micronutrient flour fortification on 24 February 2005 in Hanoi. At the completion of the first workshop, we have had the chance to visit and work with several flourmills in Vietnam. Two other workshops on flour fortification were held in Hanoi and Ho Chi Minh City in February 2006. In the forthcoming period, the National Strategy and Action Plan for Micronutrient Flour Fortification in Vietnam will be set up. In addition, efficacy and effectiveness of rice fortification will be carried out in the coming months and, it is expected that such approach may be an appropriate solution for mountainous and midland areas in Vietnam.

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