On February 26, in Hanoi, the Viet Nam Union of Science and Technology Associations (VUSTA) in collaboration with the Party Central Committee’s Commission for Communications and Education and former National Assembly Members Club organized the workshop on promoting the implementation of Decree 09/2016/ND-CP of the Government for Vietnamese health and stature. Dr. Sc. Nghiem Vu Khai - Vice President of VUSTA; Assoc. Prof. Dr. Pham Ngoc Linh - Director of Department of Science, Technology and Environment, Central Committee’s Communications and Education Commission; Mr. Vu Mao - Former Chairman of the National Assembly Office, Chairman of former National Assembly Members Club co-chaired the seminar.
Dr. Sc. Nghiem Vu Khai - Vice President of VUSTA delivered an opening speech
On his opening remarks Dr. Sc Nghiem Vu Khai said that in 2019, the Ministry of Health have conducted a survey at some businesses which produce fortified foods and use fortified foods as materials then assessed the impact of the Decree on those enterprises. Survey results shown that micronutrient fortification caused a slightly increase of costs but it was at acceptable level, similar to an increase of 50,000-200,000 VND/ton of iodized salt (current price fluctuates from 2.8-3 million VND/ton). The enterprises reported not to face any technological difficulties, if any additional expenses were incurred, they would be included in the production costs.
According to the results of 34 scientific studies on the effects of iodized salt, there is no evidence that the use of iodized salt causes adverse organoleptic changes of consumers or product quality changes.
With the above-mentioned research and evaluation results, the Ministry of Health recommended to continue the implementation of Decree No. 09/2016 because of the proven scientific benefits of micronutrient fortified foods on the physical growth and the healthy life of the community, Dr. Khai added.
Micronutrient deficiency in Vietnam
According to Dr. Tran Khanh Van - National Institute of Nutrition the survey results demonstrate that anemia is 29% in children 0-5 years old, 29% in women of reproductive age, 36% in pregnant women; vitamin A deficiency is 13% in children 0-5 years old; Zinc deficiency is 69.4% in children 0-5 years old, 65% in women of reproductive age, 80% in pregnant women.
Dr. Tran Khanh Van - National Institute of Nutrition
Currently, Vietnam is one of 14 countries in the world that does not intake enough iodine, therefore, adding iodine to salt is recommended as the most effective solution to prevent iodine deficiency; micronutrient fortification is also recommended as a precautionary measure; and wheat flour used in food processing should be fortified with iron and zinc. Adding iron to wheat flour to prevent and control the iron deficiency anemia and overcome retardation in growth, malnutrition and lower mental development; adding zinc to wheat flour to promote growth and contribute to improving human height, prevent and control several metabolic disorders, cell differentiation, bacterial infections, bone growth disorders and sexual dysfunctions.
Speaking at the workshop, Dr. Phan Huong Duong, Deputy Director of National Hospital of Endocrinology revealed that the first nationwide survey of iodine deficiency was conducted in 1993. The results shown that 94% of Vietnam's population were at risk of iodine deficiency, goiter among children 8-10 years old was 22.4%. Iodine deficiency status appeared not only in mountainous areas but also in plains and coastal areas. Under these circumstances, the Party and the Government have directed the Ministry of Health to carry out activities to prevent CRLTI.
Dr. Phan Huong Duong, Deputy Director of National Hospital of Endocrinology
Dr. Duong added that after 2005, the National health target Program for CRLTI prevention became a regular activity of the Ministry of Health with the goal of maintaining the achievements accomplished in 2005. However, due to many different reasons, the situation of iodine deficiency has returned. The survey results of the National Hospital of Endocrinology and UNICEF illustrated that the porportion of households consuming iodized salt dropped steeply to 69.5%; goiter in children at 8-12 years old was 9.8%. Iodine Global Network has ranked Vietnam among top iodine-deficiency countries.
Continue to implement the Government's Decree No. 09/2016/ND-CP specifies the mandatory fortification of micronutrients in foods
M.A. Nguyen Man Ha Anh, Deputy Head of the Legal Department, Vietnam Food Administration, Ministry of Health said, Decree No. 09/2016/ND-CP specifies salt directly used in serving meals, or salt used for processing of food must be supplemented with iodine; wheat flour used for processing of food must be supplemented with iron and zinc; vegetable oil containing must be supplemented with vitamin A (except for the vegetable oil used for processing of food by employing the industrial processing method). In order to create favorable conditions for organizations and individuals to implement this Decree, the Government has prescribed a compulsory one-year roadmap (March 15, 2017) for iodized salt and two-year (March 15, 2018) for iron and zinc wheat flour and vitamin A. This gives organizations and individuals who are subjects of application of the Decree sufficient time for technical preparation and production and business arrangement.
M.A. Nguyen Man Ha Anh, Deputy Head of the Legal Department, Vietnam Food Administration
Up to now, all production establishments of salt, flour and cooking oil (11/11 establishments) have produced micronutrient-fortified foods. These establishments can manufacture in the long term because they have been operating smoothly causing no difficulties for investing in main machinery, trading micronutrients and staffing for deployment. Survey results have proved export products accounted for a small proportion compared to the domestic market. There is only one food production company with the highest export rate presenting 10% of the total production. Adding micronutrients to food is a humane policy that brings multiple benefits to the growth, development and maintenance of healthy living of the community. In the coming time, the Ministry of Health will launch a communication program on raising awareness of micronutrient fortification for each target groups and coordinate with relevant ministries and branches to provide dialogues in order to support enterprises in the implementation process, she added.
It can be said that Decree 09/2016 has translated into practice and is an effective measure to achieve and maintain CRLTI eradication in Vietnam. Instead of investment of tens of billions VND each year to achieve this goal (before 2005, state budget allocated up to 40-60 billion VND/year for this issue), the elimination of CRLTI will contribute to maintaining and improving the intelligence of young Vietnamese generations, Dr. Duong admitted.
View of the seminar
At the seminar, many scientists made many comments which were basically agreed on above opinions. To avoid iodine deficiency in Vietnam, it is necessary to continue strengthening the implementation of Decree 09/2016; enhancing communication programs on the importance of prevention of iodine deficiency disorders, especially for women and students and the use of iodine supplements to maintain and raise the intelligence of generations of Vietnamese people.
For businesses producing salt and salt alternatives, it is needed to proactively study new iodine supplements which are suitable to the current tastes and needs of consumers. A research of the National Hospital of Endocrinology in 2018 found that the percentage of households using table salt was 33.1%, the rest consuming salt other non-salt substitutes, such as soup powder, seasoning powder, fish sauce...
Workshop participants also suggested that State related agencies should intensify the inspection of salt and salt alternatives in term of quality in order to ensure effectiveness of disease prevention as well as the rights and fairness among enterprises in protecting people's health.