Development of the Vietnamese Healthy Eating Index

Abstract

Poor dietary quality is a major contributor to malnutrition and disease burden in Vietnam, necessitating the development of a tool for improving dietary quality. Food-based dietary guidelines (FBDGs) have been proposed to do this by providing specific, culturally appropriate and actionable recommendations. We developed the Vietnamese Healthy Eating Index (VHEI) to assess the adherence to the 2016-2020 Vietnamese FBDGs and the dietary quality of the general Vietnamese population. This VHEI consists of eight component scores, 'grains', 'protein foods', 'vegetables', 'fruits', 'dairy', 'fats and oils', 'sugar and sweets' and 'salt and sauces', representing the recommendations in the FBDGs. Each component score ranges from 0 to 10, resulting in a total VHEI score between 0 (lowest adherence) and 80 (highest adherence). The VHEI was calculated using dietary intake data from the Vietnamese General Nutrition Survey 2009-2010 (n = 8225 households). Associations of the VHEI with socio-demographic characteristics, energy and nutrient intakes and food group consumptions were examined. The results showed that the mean and standard deviation score of the VHEI was 43⋅3 ± 8⋅1. The component 'sugar and sweets' scored the highest (9⋅8 ± 1⋅1), whereas the component 'dairy' scored the lowest (0⋅6 ± 1⋅6). The intake of micronutrients was positively associated with the total VHEI, both before and after adjustment for energy intake. In conclusion, the VHEI is a valuable measure of dietary quality for the Vietnamese population regarding their adherence to the FBDGs.

Keywords: A4NH, The CGIAR Research Program on Agriculture for Nutrition and Health; AFE, Adult Female Equivalent; AME, Adult Male Equivalent; Dietary quality; E %, energy percentage; FBDG, food-based dietary guidelines; FCT, Food Composition Table; Food-based dietary guidelines; GNS 2009–10, Vietnamese General Nutrition Survey 2009–2010; Healthy Eating Index; NCDs, non-communicable diseases; NIN, National Institute of Nutrition; RAE, Retinol Activity Equivalent; T, tertile; VHEI, Vietnamese Healthy Eating Index; Vietnamese adults; sd, standard deviation.

Fig. 1.

Graphical presentation of the Vietnamese Healthy Eating Index for (a) adequacy category, (b) moderation category and (c) optimum category

Fig. 2.

Mean component scores across tertiles of the Vietnamese Healthy Eating Index (Tertile 1 = lowest score = lowest adherence = lowest dietary quality), mean values adjusted using sample weights