The latest evidence on Vietnam’s nutritional situation suggests that the country is in a transitional period, having experienced significant recent improvement in micronutrient nutrition. The commentary by David Thurnham provides some insights into the progress of the country’s eff orts to counteract micronutrient deficiencies among women and young children over the previous two decades, with a particular focus on a publication fr om 2012.1 My reflections on the commentary follow below. Micronutrient status and intake I am in agreement that the eradication of vitamin A deficiency as a significant public health problem in Vietnam is the result of a concerted national program of supplementation, fortification and dietary diversification – the VAC farming method – which has increased the supply of animal meat, fish and vegetables. In children, the risk of vitamin A deficiency (based on serum retinol) has declined markedly to only 10%, while 47% had marginal vitamin A status. However, the issue of comparing identical arithmetic mean values of serum retinol concentrations between Vietnamese children and British pre-school children (Table 1) should take into account whether this was a normal distribution or a skewed one. Ideally, a sub-sample measurement of the vitamin A stores of Vietnamese children would be used to verify the status. Regarding the lower plasma vitamin A concentrations in Vietnamese women compared to those of British or American women, Dr Thurnham speculated that this may be due to hormonal factors – especially the effect of estrogenic hormones. This point requires supportive evidence, since the differences in plasma retinol could represent the usual wide range of normal concentrations under homeostatic control.
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