General Diet/Summary   •   Nutrition Facts   •   Possible Deficiencies   •   Common Foods   •   Meal Patterns   •  Transition Foods   •  Recipes   •  Resources

Vietnam

General Diet/Summary:

While the common foods and ingredients of Vietnam are similar to all the mainland Southeast Asian countries, Vietnamese food is known for its fresh herb garnishes, healthful preparation, and beautiful presentation. Rice is the staple of the diet, and rice products such as noodles, paper, flour, and vinegar are used extensively. Pho is the name of the popular rice noodle broth-based soup. Fried noodles topped with meats and vegetables is also a favorite noodle dish. Fish and poultry are widely available, and religious prohibitions may influence which meats are consumed and when. In general, the traditional Southeast Asian diet is low in protein. Fruit and vegetables make up a considerable part of the diet – cooked in stir fries, stews, soups and uncooked in salads and pickles. Greens and leaves are used to wrap foods, and an abundance of herbs and spices are used to add bright color and flavor to many dishes. Dairy is not widely used, as many Vietnamese are lactose intolerant. Thus, soy milk is a popular beverage along with other soy products such as tofu and tempeh. Vietnamese cuisine is strongly influenced by the Chinese way of cooking including such techniques as stir frying and deep frying as well as the use of chopsticks. Neighboring countries have introduced various ingredients like beef, coconut milk, spices, and chili. The French colonization of Vietnam popularized French bread (baguettes), coffee with cream, potatoes, asparagus, and green beans.

Due to climate and geography, regional variations are prominent. Soups are a specialty in the North where winters are cold and harsh. Also popular are hot pots, stir fried foods, and chao (rice gruel similar to congee). The central region of Vietnam is known for seasonal cooking, gorgeous presentation, and sophisticated gastronomy. The tropical climate of the South calls for simpler cooking and strong seasonings. Clay pot cooking is common. Curries and peanut sauces are favorites as well as the use of coconut milk and caramel flavor.

Religious holidays dictate the serving of special meals. Buddhism is widespread throughout Vietnam, and as such, many Vietnamese do not eat meat, seafood, chicken or eggs on the first and middle days of each lunar month. The most important holiday is Tet, the New Year’s celebration. Offerings of cake, chicken, tea, rice, and money are made at family gravesites, and then the family picnics on the offerings. One belief during the new year is that when a watermelon is cut open, the redder the flesh, the more luck the family will have in the upcoming year. Many Vietnamese follow the yin yang theory of diet, and foods must be balanced within a meal.

Nutrition Facts:

Many traditional practices surround pregnancy, such as the avoidance ginger or the consumption of large amounts of salty foods. Vietnamese women may gain less weight during pregnancy and are careful not to overeat to have an easier birth. As such, infants are more likely to be low birth weight. Nearly all babies are breast fed for about one year, and solids are not introduced until about 8 months. Babies ages may be calculated on a lunar calendar, often starting with being one year old at birth, which means age may differ as much as two years from Western chronological age. Thus limiting the use of standardized growth curves as an assessment tool. Chronic hepatitis B is not uncommon in Southeast Asian people and may contribute to liver and renal disease. Lack of access to safe drinking water is also a health issue in Vietnam.

Possible Deficiencies:

• Calcium – Calcium is needed to build strong bones and teeth. It also plays a role in blood clotting, muscle contraction, and nerve-cell communication. In the long term, dietary intakes well below the recommended levels may impact bone development. Bones increase in size and mass during childhood and adolescence, therefore adequate calcium and vitamin D should be consumed throughout childhood into early adulthood.

• Folate – Folate is needed for making DNA in new cells and for the production of red blood cells and RNA in bone marrow. It is critical for spinal cord and brain development in embryos. Spina bifida and other neural tube defects have been associated with folate deficiency. Folate also contributes to heart health because it disposes of homocysteine, an amino acid that may lead to heart disease.

• Iodine – Iodine is needed for production of thyroid hormone. Deficiency of iodine can lead to development of an enlarged thyroid called a goiter, hypothyroidism, and mental retardation in children whose mothers were iodine deficient during pregnancy.

• Iron – Iron is necessary for oxygen delivery to cells and regulation of cell growth. Iron deficiency develops gradually and is commonly seen in women of childbearing age and children. A lack of iron results in an insufficient supply of oxygen to cells eventually causing anemia, fatigue, poor work performance, slow cognitive and social development in children, and decreased immunity.

• Magnesium – Magnesium is a mineral important in the structure of bone and vital for energy metabolism in the body. Magnesium participates in over 300 chemical reactions in cells and also influences nerve and muscle function.

• Selenium – Selenium is an essential mineral that acts as an antioxidant in the body and regulates thyroid hormone. Selenium deficiency is common in areas where soil concentration of selenium is low and often accompanies iodine deficiency. Keshan disease is a cardiac problem that can occur in selenium-deficient children and mothers. Low serum selenium levels may also be associated with anemia.

• Vitamin A – Vitamin A plays a critical role in healthy vision, growth and development, and immune function. Vitamin A deficiency is common in developing countries and is often accompanied by zinc deficiency. Symptoms of deficiency include blindness, diminished ability to fight infections, decreased growth rate, and slow bone development. Vitamin A helps mobilize iron from its storage sites, so a deficiency of vitamin A limits the body’s ability to use stored iron. This results in an “apparent” iron deficiency because iron levels in the blood are low even though body stores are normal.

• Vitamin E – Vitamin E is one of several antioxidants needed to protect cells from damaging free radicals.

• Zinc – Zinc is involved in many important processes in the body. Symptoms of zinc deficiency include delayed growth, loss of appetite, impaired immune function, hair loss, diarrhea, delayed sexual maturation, eye and skin lesions, delayed wound healing, taste abnormalities, and mental fatigue.

Common Foods:

• Milk/Milk products – sweetened condensed milk, whipping cream

• Meat/Poultry/Fish – beef, lamb, pork, goat, venison, variety meats, chicken, duck, quail, pigeon, sparrow, doves, almost all varieties of fresh and saltwater seafood

• Eggs/Legumes – chicken eggs, duck eggs, fish eggs, chickpeas, lentils, mung beans, soybeans, winged beans

• Cereals/Grains – rice (long and short grain, sticks, noodles), wheat (French bread, cakes, pastries)

• Fruits – apples, banana, cantaloupe, coconut, custard apple, dates, durian, figs, grapefruit, guava, jackfruit, jujube, lemon, lime, litchi, longans, mandarin orange, mango, orange, papaya, peach, pear, persimmon, pineapple, plum, pomegranates, pomelo, raisins, rambutan, roselle, sapodilla, star fruit, soursop, strawberries, tamarind, watermelon

• Vegetables – amaranth, arrowroot, artichokes, asparagus, bamboo shoots, banana leaves, betel leaves, beans, bitter melon, breadfruit, broccoli, cabbage, calabash, carrot, cassava, cauliflower, celery, chayote squash, Chinese chard, chrysanthemum, corn, cucumber, daikon, eggplant, leeks, lotus root, mushrooms, mustard greens, okra, peas, peppers, potato, pumpkin, spinach, squash, sweet potatoes, taro, tomatoes, turnips, water chestnuts, water lily greens, water convolvulus, was gourd, yams

• Seasonings – allspice, alum, basil, black pepper, borax, cayenne pepper, chili pepper, chives, cinnamon, coconut milk, coriander, curry powder, fennel, galanga, garlic, ginger, kaffir lime leaves, lemon, lemon grass, lily, lotus seed, mint, MSG, fermented fish sauces, paprika, saffron, star anise, vinegar

• Nuts/Seeds – almonds, betel nuts, cashews, chestnuts, macadamia nuts, peanuts, pili nuts, walnuts, pumpkin seeds, sesame seeds, watermelon seeds

• Beverages – coffee, tea, soy milk, a wide variety of fruit and bean drinks, hot water, hot soup/broth

• Fats/Oils – bacon, butter, lard, margarine, peanut oil, vegetable oil

• Sweeteners – cane sugar, candy

Meal Patterns:

Vietnamese people eat two or three meals a day with the amount of food consumed often based on income. Snacking between meals is uncommon, however, street vendors selling hand held snacks and “fast foods” are common in urban areas. In general, specific foods are not associated with a particular meal. For example, soup or broth may be eaten with every meal. Breakfast is typically large and may consist of soup with rice noodles topped with meat or poultry; a boiled egg with meat and pickled veggies on French bread; rice gruel with bits of meat and veggies; or boiled sweet potatoes with sugar, coconut, and chopped roasted pecans. Lunch and dinner include similar foods such as rice, fish or meat, a vegetable dish, and a broth. Fish sauce, fresh and pickled vegetables, and other condiments accompany the meal. All items are served at once and diners serve themselves whatever food they wish over a portion of rice and garnish with condiments as desired. Hot tea is the preferred beverage and is served before and after meals but not during the meal. In late afternoon, tea or coffee may be enjoyed with a sweet treat or piece of fruit.

Proper etiquette is to serve the eldest person first, wait until everyone else has been served, then ask him or her for permission to start eating. Refusing food is considered rude, but only small amounts should be taken from each dish. An empty plate or cup indicates that a diner is still hungry or thirsty, so leaving a small amount of food or beverage signals satiety and completion of the meal. Dining is done around a low table with family gathered around sitting on mats. Both hands should rest on the table during the meal and conversation should be limited. Chopsticks are the most common utensil, however, spoons and fingers are considered appropriate for certain foods. The use of forks are becoming more common in urban areas.

Transition Foods

The transition diet is one you develop to help bridge the gap between your child’s native diet and what eventually will become his or her regular diet at home. The transition diet often includes recipes and foods from the native diet. A good way to start the transition process is to ask exactly what foods your child ate in the orphanage or foster home, using that as a base for your cooking at home. As one parent put it, “I would encourage all parents to adapt the foods they present to mimic what the child had at the orphanage during the first months home. It is an easy adaptation that parents can make to create a more familiar environment during what can be a hard transition.” It may also be helpful to watch the caregivers feed your child at least one meal before returning home. Simple things such as the temperature or texture of foods may be important to your child. One mother wrote, “Our daughter was on formula at the orphanage but they gave it to her very, very hot. It took us a while to realize she wanted everything HOT and would cry hysterically if it wasn’t hot.” Even if you don’t know exactly what your child ate previously, incorporating native foods into his or her diet is a great way to help your child transition to a new culture, as well as preserve traditions from his or her first culture.

Congee, a mushy rice dish, is a very common Vietnamese food served in the orphanages; however, younger children will probably only know formula. To help your Vietnamese child transition, start with simple or familiar foods such as rice and bananas. One parent offered this advice: “find a native person from the country from which you are adopting and ask them first if they have had kids and then to cook whatever they would feed their children at this age.”

Resources:

• Kittler PG, Sucher KP (2008). Food and culture, Fifth Edition. Belmont, CA: Thomson Wadworth.

• Bodo K and Gibson N. Childbirth customs in Vietnamese traditions. Canadian Family Physicians 1999; 45: 695-7.

• Fuentes-Afflick E and Hessol NA. Impact of Asian ethnicity and national origin on infant birth weight. American J Epid 1997; 145(2): 148-55.

• Gopalan C. Current food and nutrition situation in south Asian and south-east Asian countries. Biomed Environ Sci 1996; 9(2-3): 102-16

• Hershman JM, Due DT, Sharp B, et al. Endemic goiter in Vietnam. J Clin Endocrinol Metab 1983; 57(2): 243-9.

• Khan NC, Huan PV, Nhien NV, et al. Relationship of serum carotenoids and retinol with anaemia among pre-school children in the northern mountainous region of Vietnam. Public Health Nutr 2010; 13(11): 1863-9

• Khan NC, Khoi HH, Giay T, et al. Control of vitamin A deficiency in Vietnam: achievements and future orientation. Food Nutr Bull 2002; 23(2): 133-42.

• Nguyen PH, Nguyen KC, Le Mai B, et al. Risk factors for anemia in Vietnam. Southeast Asian J Trop Med Public Health 2006; 37(6): 1213-23.

• Seshadri S. Prevalence of micronutrient deficiency particularly of iron, zinc, and folic acid in pregnant women in South East Asia. Br J Nutr 2001; 85 (Suppl 2): S87-92.

• Ta TM, Nguyen KH, Kawakami M, et al. Micronutrient status of primary school girls in rural and urban areas of South Vietnam. Asia Pac J Clin Nutr 2003; 12(2): 178-85.

• Van Nhien N, Khan NC, Ninh NX, et al. Micronutrient deficiencies and anemia among preschool children in rural Vietnam. Asia Pac J Clin Nutr 2008; 17(1): 48-55.

• Van Nhien N, Khan NC, Yabutani T, et al. Relationship of low serum selenium to anemia among primary school children living in rural Vietnam. J Nutr Sci Vitaminol (Tokyo) 2008; 54(6): 454-9.

• http://www.foodbycountry.com/Spain-to-Zimbabwe-Cumulative-Index/Vietnam.html