Spicing it up to increase vitamin A consumption in Vietnam

In the sixth of her blog reports from Vietnam, Jessica Raneri, Nutrition Programme Specialist, explains possible new opportunities to increase vitamin A consumption from vegetable sources in Mai Son, by shifting condiments into dark green leafy vegetables.

Vietnamese food is characterized by a balance between different flavours, aromas, textures and colours. Even though there are typical regional dishes with Chinese, Thai and French influences, there are two constants in Vietnamese cuisine: fish sauce and fresh herbs and spices, often used to garnish and season soups and dishes, or used as a salad. These fresh herbs are often characterized by a rich, aromatic, strong flavour, and many are actually rich in vitamin A, and could be classified as vitamin A-rich sources of foods, if consumed in adequate quantities.

Apart from some exceptions, such as Chả Cá Thăng Long, a traditional dish with fish and dill as the main ingredients, many of these traditional dark green leafy vegetables are consumed in small amounts (less than 15 g/day).

Vitamin A refers to a group of fat-soluble compounds such as retinol (found in animal foods) and pro-vitamin A carotenoids (found in dark green leafy vegetables and red and orange-fleshed fruits and vegetables). It is a crucial vitamin for human health as it contributes to supporting immune function, vision, cell growth as well as foetal development. In recent years, Vietnam has made some progresses in lowering vitamin A deficiency, through programmes aimed at supplementing intake. However, in Son La, where the research is taking place, 19% of children under five are still suffering from vitamin A deficiency¹.

While calculating the Minimum-Dietary Diversity Score for Women² (M-DDW) from the dietary intake data collected, we identified a widespread lack of consumption of vitamin A-rich foods.

We found that women who reached the minimum Dietary Diversity Score (DDS) consumed more vitamin A-rich plant than women who did not reach minimum DDS, especially of dark green leafy vegetables. For all women and children (regardless of whether they met minimum dietary diversity or not) consumption of vitamin A-rich foods was low.

We identified that 36 different species of vitamin A-rich plant foods were consumed by people overall. In comparison to the number of different species consumed from other food groups, this was considered to be moderately low. Most of these 36 species came from home production or collection from the wild, with little exchange among community members and a low percentage purchased from the market.

A food is considered to be rich in vitamin A if it contains at least 60 RAE³/100 g. Despite this, to be counted as a food (and not a condiment) when calculating the M-DDW, at least 15 g need to be consumed.

We noted that 17 species that are categorized as condiments actually contained more than 60 RAE/100 g, and were mainly consumed in very small quantities (< 15 g).

Most of these species were herbs and other leafy vegetables. We propose that some of these species could be worth promoting in these communities to increase their consumption to at least 15 g/day, so that they can significantly contribute to vitamin A intake. If successful, this would then mean that these species would then be classified as a vitamin A-rich food (as a dark green leafy vegetables) instead of a condiment when calculating the M-DDW.

Out of these 17 species, 8 were classified as unlikely significant sources of vitamin A considering their very small consumption (1.6 g/day). It’s doubtful that it would be easy to increase the consumption of these species to meet the 15 g threshold without significant efforts to change dietary practices, given the often pungent and strong flavours of many of these ingredients which are used to season foods (e.g. balm mint, garlic leaves).

There were four other species with a daily mean consumption of about 7.4 g. We classified these as potential sources of vitamin A, as increasing their consumption could be feasible. Finally, only 3 species – piper lolot (Piper sarmentosum Roxb.), coriander (Coriandrum sativum L.), and dill (Anethum graveolens L.) – were classified as likely sources of vitamin A as their average intake was more than 10 g/day. We believe that it could be possible to achieve a small increase in daily consumption of these foods to reach at least 15 g/day, shifting from a ‘condiment’ to a significant source of vitamin A as a dark green leafy vegetable.

One way to encourage increased consumption of these species could be by working with communities to develop new recipes and cooking methods to integrate higher quantities of these foods into local dishes. Considering the often pungent taste of these varieties, larger doses may not be immediately palatable, especially by young children. One solution could be to pair these species with foods that are more appealing and tasty, which can be experimented with, by engaging the community in participatory cooking activities.

Written by Gaia Lochetti and Jessica E Raneri

Read previous blogs in the series:

1: Assessing the nutrition potential of diverse local foods in Vietnam

2: Bringing together best methods to assess food quality and dietary intake in Vietnam

3. Improving dietary quality and diversity through systems innovation

4.  Putting nutrition data to work in the community

5. Joining the diversity club - How village health workers in Vietnam are putting nutrition back on the menu

This work is carried out in collaboration with the CGIAR Research Program on Agriculture for Nutrition and Health and is supported by CGIAR Fund Donors.

1. National Institute Nutrition. 2010. GENERAL NUTRITION SURVEY. Hanoi, Vietnam.
2. FAO and FHI 360. 2016. Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO.
3. Retinol Activity Equivalents

 

Photo credits: Dark Green Leafy Vegetables, Vietnam. Credit: Bioversity International/J. Raneri