Summary
FOOD PATTERN ANALYSIS OVER TIME AT HOUSEHOLD LEVEL IN VIETNAM 1 9 9 0 - 2 0 1 0
The traditional Vietnamese diet based primarily on foods of plant origin (rice, legume, vegeta- ble) and fish have several beneficial properties according to current knowledge of nutrition.
There has been a notable change in the proportion of total energy from protein, lipids, and car- bohydrate. In 1983, energy composition was made up of 11.2% from protein, 6.2% from lipids, and 82.6% from carbohydrate. Currently a more optimal ratio of energy intake has been ob- sen/ed with about 15.9% energy from protein, 17.8% from lipids, and 66.3% from carbohydrate.
The ratio of protein, lipid, and carbohydrate is now 15 9: 17.8: 66.3, which is considered optimal.
The resglts revealed that food consumption in the general population has improved remarkably since 1985. However, updated guidance on proper nutrition is now required in light of recent so- cial and economic changes, in order to prevent emerging trends of over consgmption that will affects on health. Immediately at hand, food consgmption amongst different target grogps and regions should be considered to properiy plan interventions and approaches to meet specific needs.
Key words: food pattern, ratio of .protein, lipid, and carbohydrate. National nutrition survey
TiNH TRANG DINH DU'O'NG TR^ DU'O'I 5 T U 6 l DAN TOG THAI TAI HUYEN QUAN S O N , THANH HOA GIAI DOAN 2007 - 2011
Trinh Xuan Thuy', Pham Van Phlf, Pham Tung Semi' ' Trung lam Y li huyen Quan San, Thanh Hoa, 'Tnrimg Dai hpe Y Ha Npi
Nghiin cUu nhim dinh gii linh trang dinh duang vi xu hudng thay ddi If ii suy dmh duang (SDD) ciia tri em dudi 5 tuii din tpc Thii d huyen Quan San - Thanh Hda trong 5 nam 2007 - 2011. Kit qui cho thiy tlnh trang dinh dudng tf ie SDD thi nhe can ii 26,1%. SDD ting din theo dp tuii tir 18% d nim tudi thir nhit vi eao nhit d nhdm tuii 48 - 59 thing (30,9%) SDD thi thip cdi trong 3 nam 2009-2010 ii 53,4%; eao nhil vao nam tuii thO 3 (57,5%) Trong 5 nim 2007 - 2011: SDD thi nhe ein nam 2008 so vdi 2007 khing nhirng khdng giim mi eon ed xu hudng tang thi SDD nay giim nhiiu vao nam 2009 nhung sau di lai ed xu hudng ling trd iai vio cie nam 2010 vi 2011. SDD thi thip edi lir nam 2009 din nSm 2011 cOng cd xu hudng ling din.
TCr khoa: Suy dinh dmmg tri em, Quan Sen, Thanh Hda
I. BiJlT V A N Bt WHO 2005) va nam 2011 Id 16,1% vd 27,9%
V Theo k i t qua didu tra cua vidn Dinh (typng irng). Tgy vay d mdt so khg vpic nhy dy&ng nam 2010 ty Id SDD d tre du'di 5 tgli Tay Nguyen, IVIiln Trung, Miln nui phia Bac theo ehi s l can ndng/tudi [1]: 17,5%; ehilu ty Id suy dinh dydng (SDD), dac bidt la SDD cao/tuli: 29,3% (theo q u i n t h i tham ehilu t h i thap cdi, van cdn d mire cao vd rlt eao
TCNCYH Phu tnmng 79 (2) - 2012
so vdi ngydng cua T l chirc Y t l T h i gidi (WHO).
Qgan Spn Id mdt huydn viing cao bidn gidi, nam phia Tdy Bae eCia tfnh Thanh Hda, dja hinh d l i niii hilm trd, nguin thu nhdp chinh eua ngydi ddn la ndng nghidp vd khai thac Idm san, dilu kidn kinh t l xa hdi edn r l t nhilu khd khdn. Ody Id npi ddn ey phln Idn la ngydi ddn tOc Thai (88,3%) vdi van hda, truyin thing, phong tgc tdp qudn h l u nhy cdn giO nguyen nhCrng net ddc tryng cua ddn tOc ndy Tgy vdy vide chdm soc dinh dydng - sire khde cho bd me, trd em dydi 5 tuli cung da cd thay d l i nhyng v i n con nhilu hgn c h l , ty Id SDD d day edn d mire eao. Oe ed nhyng s l lieu lam cp sd cho vide d l xgit cdc gjai phap can thidp phii hpp eho thdi gian tdi, nghien eiru "Tinh trang dinh duung tre duui 5 tuoi dan tic Thai tai huyen Quan Son- Thanh Hia gial doan 2007 - 2011" da dypc tiln hdnh nham muc tieu:
Danh gia tlnh trang dinh duung cua tre em duul 5 tuoi din tpc Thii o huyin Quan Son - Thanh Hoa.
Danh gia xu huung thay doi ty li suy dinh duung tre duul 5 tuoi din tpc Thai Irong gial doan 2007-2011.
II. B G I TU'ONG VA PHU'ONG P H A P NGHIEN CI>U
1. D6I typ'ng nghien cyu: Tre em dydi 5 tuli ngydi dan tpc Thai.
2. Phyang phap, thdi gian nghidn cii'u Sir dgng thiet ke nghidn eiru eat ngang md ta, dypc tien hdnh tai huyen Quan Son hang nam trong 5 nam lien tuc 2007 - 2011,
3. Cd mlu, each ehon mdu: Chpn m i u chii dich va Idy mdg toan bp
4. Phycng phap thu thdp sd lieu
Cdn nang ciia tre dypc thu thdp b i n cdn Seca cd dd chinh xac 0,1kg; can ndn thg thdp d y p c d t i t ea cdc ndm. Chilu ca d y p c do bang thydc Microtoise, ehilu d<
d y p c do b l n g thydc do chilu dai n l m cu UNICEF ed dp chinh xac la 0,1 em; ehii eac/ehilg ddi chl thu thdp dypc trong ndm g i n ddy T u l i , gidi d y p c l l y tCr phili tidm chung eua tre
5. Xip ly sd llfu: Tinh trang dinh dypni eua tre dypc xir ly bang phln m i m Anthn 2005 vdi q u i n t h i tham chilu WHO 2005 di xdc djnh cac t h i SDD nh? can (CN/T thip t h i t h i p edi (CC/T thip) vd t h i g l y com (CN CC thip) S6 Ij0u dypc phdn tich dya vdi phln m i m EPI-lnfo 6 04 vdi cac test thin;
ke thdng thydng.
III.
K£TQUA
1. Tinh trang dinh diromg (TTDD) cui tre dydi 5 tudi
Bang 1 cho thay ty Id SDD theo chi tjdi can nang/tuli ciia tre em ddn tpc Thai dydi t tuli d huydn Quan Spn, Thanh Hda li 26,1%. SDD tang d i n theo dd t u l i tir 18,0°/
d nam t u l i thir nhlt vd eao nhlt d nhdm tuo 36 - 47 thdng (31,2%). Nam d lira tuli < St thdng ludn co ty Id SDD eao hpn nir, nhync ttr 36 thang t g l i trd len, ty I? SDD d nO' lai cc xu hydng cap hpn d nam. Tpng eho ea liri t u l i dydi 5 tuli, SDD can nang/tudi ciia nair (26,9%) cao hpn cua nO (25,1%).
K i t qua cho t h i y ty Id SDD theo ehi tidi ehilu cao/tgoi d tre dydi 5 tuoi ehung trong ^ dpt do tir nam 2009 - 2010 Id 53,4%. Nga) trong nam tuoi ddu tidn ty Id SDD thdp edi di la 39,2% tang Idn r l t nhanh vdo nam tuoi till theo 51,3%; tang cao nhlt vdo nam tuli thi 3 (57,5%) sag dd giam ddn nhyng d i n nan tuoi thir 5 ty le t h i p cdi vdn la 46,7%. 0 tri
232
nam, lira t u l i < 36 thdng cQng ludn cd ty Id t h i p cdi cao hpn nii', nhyng ttr 36 thang tgli trd len, ty Id thip edi d ny eung Igi cd xu hydng eao hpn d nam. Tong cho ca lira t g l i dydi 5 tgdi, SDD thip cdi cga nam (54,8%) t h i p hpn ciia nir (51,9%).
Bang 1. TTDD cua tre theo chi tieu can nang/tuli theo nhom t u l i va gidi Nhom t u l i (thang)
0 - 1 1
1 2 - 2 3
2 4 - 3 5
3 6 - 4 7
4 8 - 5 9
0 - 5 9
Gio-i Nam N i i Chung Nam NO Chung Nam NO- Chung Nam Nu- Chung Nam NO- Chung Nam NO Chung
n 958 836 1793 1049 969 2018 1109 962 2071 1106 927 2033 984 875 1859 5206 4568 9774
Binh t h u ' d n g {%) 79,3 86,2 82,0 73,9 79,2 76,4 70,3 75,0 72,6 71,4 68,8 70,2 71,0 66,9 69,1 73,1 74,9 73,9
SDD (%) 20,7 14,9 18,0 26,1 20,9 23,6 29,7 25,1 27,6 28,6 31,2 29,8 29,0 33,1 30,9 26,9 26,1 26,1 Bang 2. TTDD eua tre theo chi tieu chidu cao/tuli theo nhdm tudi va gidi Nhom tuoi (thing) Gidi n Binh thydng (%) SDD (%)
Nam 368 65,9 44,1 0-11 Nu; 323 66^3 33.8 Chung 681 60^8 39,2 iviSIii 369 45^3 ' 54,7 Chung
Chung
Chung 733 W _ Nam 335 57,9~
" N O 324 48,6~
Chung 669 63,3 Nam 1799 45,3
51.3
57,6 49,7
TCNCYH Phu tnmng 79 (2) - 2012
Bang 3. TTDD ciia trd edn n$ng/chilu cao theo nhdm t u l i va gldi Nhom t u l i (thdng) Gldi n BT (%) SDD (%)
Nam 358 95,3 4,8 0-11 _N0 323 91;6 8,4 Chung 681 93,5 6,5
3 3 ^
Chung 707 24-35
36-47
48-69
0-59
Nam Nff Chung Nam NO Chung Nam NO Chung Nam NO Chung
361 347 708 376 357 733 335 324 659 1799 1689 3488
95,0 94,5 94.8 90,2 91,6 90.9 91,6 95,1 93,3 93,4 93.7 93,6
5,0 5,5 5.2 9,8 8,4 9,1 8,4 4.9 6.7 6,6 6,3 6,6 Ty le SDD gay cdm cua tre duo'i 5 tuoi la 6,5%. Ty lp SDD cao nhat a nhdm tuoi 36 - 47 thang (9,1%). Ty le SDD giu-a nam va nu trong moi nhom tu6i ndi chung khdng khac nhau
nhilu. ' Bang 4. SLP khdc biet TTDD giira ta-e trai va gai
TT Z-Score WAZ HAZ WHZ -
Gidi Trai Gai Trai Gdi Trai Gdi
n 5206 4568 1799 1689 1799 1689
X ±SD -1,44 ±1,03 -1,38 ±1,02 -2,22 ±1,15 -2,08 ±1,15 -0,08 ±1,32 -0,15 ±1,29
P (t - test)
So sanh tinh trang dinh dydng cOa 2 gidi cho thiy ea WAZ va HAZ a tre trai d l u thip hon d tre gdi ed y nghTa thing ke vdi p < 0,01 vd 0,001 (typng irng).
Qua cac nam eho thiy, SDD t h i nhe can ndm 2008 so vdi 2007 khdng nhu'ng khdng giam ma cdn cd xu hydng tang, t h i SDD nay giam nhilu vao nam 2009 nhyng sau dd lai ed xu hydng tang trd l^i vao cdc ndm 2010 va 2011. SDD t h i t h i p cdi tir nam 2009 d i n nam 2011 eung cd xu hydng tang dan.
234
B a n g 5. T h a y d l i ty Id S D D t r o n g !
Nam didu tra Thd SDD
2007 Cdn/tuli
n 2169
TCNCYH Phu tnmng 5 n a m 2 0 0 7 - 2 0 1 1
BT (% ) 73,7
79 (2) - 2012
SDD (%) 26,3 Cdn/tuli
Cdn/tuli Cao/tuli
2010
Cdn/cao Cdn/tu6i Cao/tu6i Cdn/cao Cdn/tuli Cao/tuli Cdn/cao
1064 1892 1316 1316 1787 1108 1108
92,8 76,0 47,2 94,5 72,7 44,5 93,2
7,2 25,0 52,8 6,6 27,3 65,6 6,8
IV. BAN LUAN
Kit qua cho thiy ty Id SDD thd nhe can cua tre em dydi 5 t u l i ddn tpc Thai tai huydn Quan Son la 26,1% Ty Id ndy cao hon so vol ty Id SDD Chung ciia tinh (22,9%) va cua toan qude (16,1%).
Neu dya theo phdn loai cua Td chire Y t l Thi gidi thi day Id khu vyc ed ty Id SDD cao.
Mae dti so vdi dan tpc thilu sd a mgt s l nghidn cu'u khae thi dan tgc Thai a huydn Quan Spn tinh Thanh Hda ed ty Id SDD thip hon so vdi dan tdc San Chay d Thai Nguyen (40,8%) [2], dan tgc E Od, M'Ndng d Dae Lac (41,2%) [3], dan tdc Niing d Ha Giang (41,2%) [4] va mgt s6 dan tgc thilu s l khac d khu vyc miln nui phia Bae (40,7%) [5]. Thyc tr^ng trdn chg thiy tinh trang suy dinh dydng thd nhe can ciia tre em dan tgc Thai taJ huydn Quan Son v l n con cao vd y nghTa sire Ichde cdng ding.
Vdi SDD the t h i p cdj: Day dypc coi Id chi tidu phan anh sy phat t n i n ciia xa hdi, phan anh tinh trang thilg dinh dydng kdo dai hoac SDD trong qua khCr lam cho tre bj cdi cgc, vd Id ch! s l danh gia hag qua ciia sy ddi ngheo.
can (26,1%) va t h i g l y cdm (6,4%), chirng td tinh trang SDD man tinh dang p h i biln d khu vyc nay Nhyng tinh trang SDD thdp cdi a day thdp hpn so vdi SDD thdp cdi d tre em dan tdc Dao tai Thai Nguyen nam 2004 la 58,7% [6] nhyng cao hpn SDD thip cdi d tre em khu vyc miln ndi phia Bac nam 2004 la 45,2% [5] va cao hffn nhilu so vdi kdt qga nghien ciru ciia Ld Th| Hypng d trd em tai mgt hgydn midn ngi tinh Thanh Hda nam 2009 (28,3%) [7]. Theo Z-Score, tai dja phyong nay SDD ca hai thd nhe can vd thip edi d tre trai deg trim trgng hon d tre gdi W/\Z d trai la - 1,44 ± 1,03 vd d gai -1,38 ± 1,02; HAZ d tre trai - 2,22 ± 1,15 va d tre gdi -2,08 ± 1,15; trong khi mdt vai nghien eirg ciia cac tdc gia khdc nhy Nggydn Thj Hai Anh laj khdng thiy cd sy khae biet ty Id SDD thdp edi d tre traj va tre gai [8, 9].
Vdi SDD thd g l y cdm (CN/CC) k i t qua eho thay ty Id SDD thd gdy cdm la 6,5%, typng t y so vdi SDD gdy com cga ca tinh Thanh Hda cung nhy cua toan qude (6,8% vd 6,9%), nhyng thap han ty Id SDD gay cdm d tre em dan tgc San Chay tai Thai Nggydn nam 2008 (12,6%) [10], dan tgc Niing nam
TCNCYH Phu tnmng 79 (2) - 2012
Theo nhdm t u l i , SDD tre em d ddn tpc Thai xult hidn sdm ngay trong nhyng thdng d l u d ca 3 t h i t h i p edi, nhe cdn vd g l y cdm vd dat mire cao nhlt d lira t u l i 36 - 47 thdng (SDD nhe cdn) vd 25 - 34 thdng (SDD t h i p cdi), d l i vdi SDD g l y cdm thi ty 1$ eao nhlt 6- lira tuli 36 - 47 thdng.
Sy thay d l i ty Id sgy dinh dydng: Qga cdc ndm, SDD t h i nhg edn ndm 2008 so vdi 2007 khdng nhO-ng khdng giam md edn cd xg hydng tdng. t h i SDD nay giam nhilu vdo ndm 2009 nhyng sau do l^i cd xu hydng tdng trd l^i vdo cdc nam 2010 vd 2011. SDD t h i thip cdi tir nam 2009 d i n ndm 2011 cQng cd xu hydng tdng d i n . Oilu ndy d n cd nhyng nghidn ciru sdu thdm vi cung cd t h i do trong nhO'ng ndm g i n ddy hopt dgng theg ddi tdng tnrdng eiia y te dia phyong ngdy cang t i t hpn, s l tre bi bd sdt ngay cdng it di, ba me eung cd ^ thirc han trong vide dya tre di can do. Dgc bigt, tryde ddy cac ba me ngydi Thai ed eon bj SDD thydng mac cam, khdng eho eon di can, do r l t p h i bien. Hien nay hign typng nay khdng cdn nhilu, con cang ed bieu hign khdng Idn, khdng tang trydng, bd me cang chii y dya tre d i n y t l d l kilm tra, do vdy cung la mdt ly do lam tang ty Id SDD d dan tgc nay.
V. KfiT LUAN
Tinh trang dinh dydng ty Ig SDD t h i nhg can la 26,1%. SDD tdng d i n theo dg tuli ttr 18,0% d ndm t u l i thir nhlt va eao nhlt d nhdm tgli 48 - 59 thang (30,9%). SDD t h i thip cdi trong 3 nam 2009 - 2010 la 53,4%; d nam tgli d i g tidn ty Ig t h i p cdi da la 39,2%
tang len r l t nhanh vdo nam t g l i tiep theo 51,3%; tang eao nhlt vao nam t u l i thir 3 (57,5%). So sanh tinh trang dinh dydng ciia 2 gidi cho thiy ca WAZ va HAZ d tre trai d l u kdm hpn rd ret so vdi tre gai.
Sy thay d l i ty Id suy dinh dydng trong giai dogn 2007 - 2011: SDD t h i nhe cdn ndm 2008 so vdi 2007 khdng nhO-ng khdng giam md cdn cd xu hydng tang, the SDD ndy gidm nhilu vdo ndm 2009 nhyng sau dd Igi ed xu hydng tdng trd Igi vdo cdc ndm 2010 vd 2011. SDD t h i t h i p cdi tir ndm 2000 din ndm 2011 cOng cd xu hydng tang d i n .
T A I LIEU THAM K H A O 1. VDD - UNICEF (2011). Tinh hinh dinh dydng Vidt Nam ndm 2009 - 2010; NXBYH; ft
2. Nguydn Minh Tudn (2010). Huy ddng nguin lyc cdng d i n g c h i m sdc dinh dydng tre em dydi 5 t u l i dan tgc San Chay tgi Thdi Nguydn, Ludn dn t i l n sy y hgc, Vien Vd sinh djch t l Trung ypng, 61 - 72.
3. Trln Thi Mai (2004). Mgt s l y l u t l anh hydng d i n tinh trgng dinh dydng tre em ddn t i e 6 Od, M'Ndng tgi 2 xa tinh Oac Ldc ndm 2004, Lugn v i n thgc sy y te cdng cdng, Trydng Ogi hpc Y Hd Ngi, 40.
4. Nguyin Trln Tudn (2003). Nghidn cinj thyc trgng dinh du'dng, benh tgt vd mgt s l y l u t l lien quan d ba me va tre em dydi 5 t u l i tgi x i Viet L i m , huydn Vj Xuyen, tinh Ha Giang, Ludn v i n thgc sy y hgc, tnfdng Ogi hgc Y khoa Thdi Nguyen, 46.
5. Nguydn Minh Tudn, Hoang Khai Lgp (2004). Nghidn cCru tinh trgng sire khde, bdnh tdt vd dinh dydng ciia phu nir vi tre em miln nui phia Bae Viet Nam, Bdo eao ting k i t d l tai nghidn eiru d p bg, Ma so B2002 - 04 - 27, 39, 48 - 52, 67 - 68.
6. Nguyin Dinh Hpc (2004). Nghidn ei>u phdt triln t h i ehlt, md hinh bgnh t i t v i mdt s l y l u t l anh hydng d tre em d i n tdc Dao Bae Thai, Lugn an t i l n sy y hgc, Trydng Dgi hpc Y Hd Ngi, 62 - 65.
236
7. Le Thj Hyo'ng (2009). Kiln thirc thyc hdnh dinh dydng cug cdc b i mg va tinh trang dinh dydng cua tre tgi mpt huydn miln niii Thanh Hda, Tgp ehi y hpc thyc hanh, 8 (669): 88.
8. Nguydn Thj Hal Anh (2005). Md ta tinh trgng dinh dydng vd mgt s l y l u t l lidn qgan den suy dinh dypng eua tre em dypi 5 tuli tinh Lag Cai, nam 2005. Lugn van thgc sy y t l cdng cgng, Trydng Dgi hgc Y t l cdng cgng, 22 - 55.
9. Lyong Thj Thu Ha (2008). Nghidn ciru thyc trgng suy dinh dydng thilu protein, nang lypng d tre em dydi 5 tuli tgi 2 xa ciia huydn Phil lypng, tinh Thai Nguyen. Luan van thgc sy y hgc dy phdng, Tru'dng OH Y khoa Thai Nguydn. 26 - 42.
10. hioang Khai Lap, Nguydn Minh Tudn, Ld Nggc Bao (2008). Tinh trgng dinh dydng va m l i lien quan vdi tgp qudn ngdi du-dng tre em dydi 5 tgli ddn tdc San Chay tgi Thai Nguydn, Tap chi Dinh dydng & Thyc phim, 4 (3 + 4): 22 - 30.
Summary
NUTRITION STATUS OF THAI CHILDREN UNDER 5 YEARS OLD IN QUAN SON DISTRICT, THANH HOA PROVINCE IN PERIOD 2007 - 2011
The aims of study were to investigate the nutrition status and the change of malnutrition prev- alence among Thai ethnic children under 5 years old in Qgan Son district, Thanh Hoa province from 2007 to 2011. The results showed that: unden/veight prevalence was 26.1%. Undeniveight prevalence increased from 18.0% in the first year of age to highest one (30.9%) in the age of 48 -59 months old. Stunted prevalence within 3 years 2009 - 2011 was 53.4%; highest in the third year of age (57.5%). From 2007 to 2011, the prevalence trends of unden«eight and stunted both were increased.
Keywords: Malnutrition of children, Quan Son, Thanh Hoa
