Nutritional status of lactating mothers and their breast milk concentration of iron, zinc and copper in rural Vietnam.

Breast milk is considered to be the best nutrient source for infants. However, nutritional compositions of breast milk in developing countries, especially among malnourished women, have not been fully investigated. This study aimed to assess nutritional status and nutrient composition of breast milk in lactating mothers in rural Vietnam. Sixty breastfeeding mothers at 6 to 12 mo postpartum, free from any medical disorder and/or medication, and not pregnant were randomly selected in Yen The, Bac Giang, Vietnam. Their nutritional status, breast milk concentration and dietary intakes were assessed. Among the study participants, anemia (39.0%) and low serum zinc concentration (55.4%) were frequently observed. Dietary assessment revealed lower intakes of iron (10.2+/-2.5 mg/d) and zinc (10.4+/-2.2 mg/d) than estimated requirements. The breast milk concentration of iron, zinc and copper was 0.43+/-0.15 mg/L, 0.56 (0.37, 0.82) mg/L and 0.19+/-0.05 mg/L, respectively. The breast milk concentration of iron, zinc and copper was not correlated to the serum concentration or dietary intakes. In conclusion, we uncovered a high prevalence of anemia and zinc deficiency in lactating mothers in rural Vietnam. The findings demonstrate a low breast milk zinc concentration among the participants, but need further investigation.

Association of low serum selenium with anemia among adolescent girls living in rural Vietnam.

OBJECTIVE: We investigated the prevalence of anemia and deficiency in trace elements in adolescent girls living in rural Vietnam. METHODS: Two hundred forty-five adolescent girls 11-17 y of age from three schools in rural province of Ha Nam, Vietnam, were assessed. RESULTS: The prevalence of anemia was 20.4%. The incidences of low serum selenium (Se), zinc, and copper in subjects were 15.9%, 26.5%, and 4.1%, respectively. The parameter significantly associated with anemia was the low serum levels of Se and vice versa (odds ratio [OR] 5.36, 95% confidence interval [CI] 2.57-11.18, P < 0.0001). Other risk factors for anemia were a body mass index <17.00 kg/m(2) (OR 2.72, 95% CI 1.37-5.37, P = 0.004) and years of age (OR 1.35, 95% CI 1.14-1.59, P < 0.001). A body mass index <17.00 kg/m(2) (OR 2.65, 95% CI 1.25-5.61, P = 0.011) was also found to be a risk factor for low serum Se. CONCLUSION: The findings of the present study demonstrate that low serum Se is independently associated with anemia in adolescent girls living in rural Vietnam. Interventions are required to gain insight into the potential role of Se on prevention and control of anemia.

Micronutrient deficiencies and anemia among preschool children in rural Vietnam.

The prevalence of trace elements deficiencies, vitamin A deficiency, anemia, and their relationships were investigated in a cross sectional study involving 243 children aged from 12 to 72 months in rural Vietnam. Serum levels of copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometer and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The prevalence of deficiencies in zinc, selenium, magnesium, and copper was 86.9%, 62.3%, 51.9%, and 1.7%, respectively. On the other hand, 55.6% were anemic and 11.3% had vitamin A deficiency. Deficiency in two or more micronutrient was found in 79.4% of the children. Parameters associated significantly with anemia were selenium deficiency (OR 2.80 95% CI 1.63-4.80, p=0.0002) and serum retinol<1.05 micromol/L (OR 1.83, 95% CI 1.10-3.05, p=0.021). Magnesium deficiency (OR 3.09 95% CI 1.36-7.03) was found to be a risk factor for zinc deficiency and vice versa. The results indicate that micronutrient deficiencies are prevalent among preschool children in Vietnam. In addition, the results also demonstrate a strong relationship between selenium deficiency and anemia. Clearly, sustainable strategies are urgently required to overcome the problems in the country.

Relationship of low serum selenium to anemia among primary school children living in rural Vietnam.

A cross-sectional study of 292 primary school children was conducted in rural Vietnam to investigate the relationship among micronutrient deficiencies, and other risk factors for anemia. Serum levels of iron, copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometry and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The incidence of low serum zinc, selenium, magnesium, and copper in the children was 91.4, 75.6, 59.5, and 8.6%, respectively. Forty-five percent of the children were anemic and 11.3% suffered from vitamin A deficiency. A parameter significant associated with anemia was low serum selenium and vice versa (OR 1.85, 95% CI 1.06-3.24, p<0.05). Other factors associated with anemia were serum retinol <1.05 micromol/L (OR 2.05, 95% CI 1.25-3.36, p<0.01), and age in years (OR 1.59, 95% CI 1.16-2.18, p<0.01). The study showed that low selenium is associated with anemia among school children in Vietnam. Interventions are required to gain insight into the potential role of selenium on prevention and control of anemia.

Sub clinical vitamin A deficiency and anemia among Vietnamese children less than five years of age.

The objective of the study was to assess the prevalence of sub clinical vitamin A deficiency and anemia in Vietnamese children. For this, a cross-sectional survey was conducted in 40 villages (clusters) of four ecological regions in Vietnam during Apr-May 2001. In total 1657 children less than 5 years old were included by a cluster random sampling method. The prevalence of sub clinical vitamin A deficiency (serum retinol <0.70 mumol/l) was 12.0% and the prevalence of anemia (hemoglobin <110g/l) was 28.4 %. 35.1%. In the children under 6 months the prevalence of sub clinical vitamin A deficiency was 35.1 % whereas the prevalence of anemia in this group was as high as 61.7%. The prevalence of children with both sub clinical vitamin A deficiency and anemia was 6.1%. Sub clinical vitamin A deficiency and anemia prevalence differed significantly across the regions, with highest prevalence in the Northern Mountainous areas for vitamin A deficiency and in the Northern Mountainous area and Mekong River Delta for anemia. It is concluded that sub clinical vitamin A deficiency and anemia are still important public health problems in Vietnam. Sustainable strategies for combating vitamin A deficiency and nutritional anemia are needed and should concentrate on target groups, especially infants and malnourished children in high risk regions.

Serum levels of trace elements and iron-deficiency anemia in adult Vietnamese.

This study was aimed at assessing the serum levels of vitamin A, copper, zinc, selenium, and iron among adult Vietnamese with and without iron-deficiency anemia. Blood was collected from adult Vietnamese living in the midland of northern Vietnam. One hundred twenty-three subjects in the age range 20-60 yr were included in the study. Anemia, where the concentration of hemoglobin in whole blood is less than 120 g/L in females and 130 g/L in males, was found in 30% (37/123) of the study population. The levels of vitamin Aand selenium in the sera of anemic subjects (n = 37) were significantly lower than that in nonanemic group (n = 86). On the other hand, no significant differences were observed in the concentrations of copper and zinc between the two groups. This study was the first to show serum levels of trace elements in adult Vietnamese, providing useful baseline information for further studies.