Household Dietary Diversity among the Ethnic Minority Groups in the Mekong Delta: Evidence for the Development of Public Health and Nutrition Policy in Vietnam

Abstract

Poor household dietary diversity has been linked to malnutrition in individuals, households, and cumulatively in populations. High rates of malnutrition among Khmer ethnic children aged five years and younger have been reported in Tri Ton district, Vietnam. This paper aims to further investigate household dietary diversity and associated factors among Khmer ethnic minority populations in Vietnam. A cross sectional study was conducted from October 2018 to April 2019 in Tri Ton District, An Giang Province. By employing a multistage sampling technique, a total of 402 (99.8% response rate) participants were interviewed to measure household dietary diversity using a structured and validated questionnaire developed by FAO. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with household dietary diversity. The results showed that the prevalence of low, medium and high dietary diversity scores were 21.4%, 70.4% and 8.2%, respectively. Male-headed households, literacy level, household income, exposure to mass media on nutrition and health information, and frequency of eating were positively associated with household dietary diversity (p < 0.05). However, owning a vegetable and rice farm was not statistically related to households’ dietary diversification. The paper concludes that the magnitude of household diversified dietary intakes was essentially low to medium in participants’ households. These findings have provided evidence to inform the development of the National Nutrition Strategy—2021–2030 in Vietnam, to be revised in 2045. This national strategy proposes appropriate interventions, programs and policies to improve socioeconomic status in ethnic groups and in mountainous areas to enhance populations’ health and well-being including controlling childhood malnutrition. In order to improve population health and wellbeing in Tri Ton District, further actions to address effective dietary practices including strengthening nutrition and health communication about the need to improve household dietary diversity to high levels are recommended.

Micronutrient deficiencies and the double burden of malnutrition in Vietnamese female adolescents: a national cross-sectional study in 2020

“…Conversely, haemolysis or contamination from adventitious zinc in the environment could mask low serum values. Notably, we found that MNDs were generally more prevalent among older adolescents (16)(17)(18) years old), which may reflect increased demands for both micro-and macronutrients during growth spurts and sex maturation during puberty. 24,25 In addition, repeated blood loss during menstruation will deplete iron stores particularly for females with limited access to iron-rich foods, or who have low iron absorption, which leads to ID with or without anaemia.…”

“…Minority groups are much more likely to live in moderate or severe food insecurity, and have less access to health care services including vaccinations, as well as the improved sanitation and water supply found in urban regions. 16,18 Ethnic minorities consequently have a higher prevalence of parasitic infections and diarrhea, leading to increased risk of stunting in early childhood (under 5 years of age). 19 Therefore, in the Vietnam Nutrition Strategy 2021-2030, ethnic minorities were seen as a critical target population to be individually evaluated for most nutrition targets.…”

“…22 Female adolescents from minority ethnic groups were more likely to have low serum zinc, likely related to both increased prevalence of food insecurity, infections, and diarrhea, as well as consumption of more staple and starchy foods that are lower in essential micronutrients. 18…”

“…22 Female adolescents from minority ethnic groups were more likely to have low serum zinc, likely related to both increased prevalence of food insecurity, infections, and diarrhea, as well as consumption of more staple and starchy foods that are lower in essential micronutrients. 18 Although with economic growth, the dietary pattern of Vietnamese has changed to include more meat, vegetables and less starchy food at a national level, stark differences in household expenditure on food groups exist between ethnic minority, rural, and poorer households. 6,18 Additionally, although the GNS 2020 followed international guidelines for defining MNDs (e.g., adjusting ferritin thresholds based on CRP and AGP measurements for inflammation, and adjusting cut-offs for low serum zinc depending on sample type (i.e.…”

Household environment associated with anaemia among children aged 6–59 months in Ethiopia: a multilevel analysis of Ethiopia demographic and health survey (2005–2016)

“…The finding was somewhat expected as children from poor households may have families who do not have latrines and do open defecation, and may not have access to foods high in iron, vitamin B12, and folic acid, given that poverty is usually linked to food insecurity, leading to increases the risk of developing anaemia. On the other hand, increased wealth increases food availability, access, and diversity in households, lowering the risk of anaemia in children [ 84 ]. The connections between household wealth and anaemia identified in this study further imply that socioeconomic factors directly influence children's haemoglobin levels.…”