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Journal of Nutrition. 2004 May; 134(5):1175-1180.The WHO recently conducted, within its Global Burden of Disease 2000 Study, a Comparative Risk Assessment (CRA) to estimate the global health effect of low fruit and vegetable intake. This paper summarizes the methods used to obtain exposure data for the CRA and provides estimates of worldwide fruit and vegetable intakes. Intakes were derived from 26 national population-based surveys, complemented with food supply statistics. Estimates were stratified by 14 subregions, 8 age groups, and gender. Subregions were categorized on the bases of child mortality under age 5 y and 15- to 59-y-old male mortality (A: very low child and adult mortality; B: low child and adult mortality; C: low child, high adult mortality; D: high child and adult mortality; E: high child, very high adult mortality). Mean intakes were highest in Europe A [median = 449 g/(person • d)] and the Western Pacific Region A. They were lowest in America B [median = 192 g/(person • d)], and low in Europe C, the South East Asian Regions B and D, and Africa E. Children and elderly individuals generally had lower intakes than middle-aged adults. SDs varied considerably by region, gender, and age [overall median = 223 g/(person • d)]. Assessing exposure levels for the CRA had major methodological limitations, particularly due to the lack of nationally representative intake data. The results showed mean intakes generally lower than current recommendations, with large variations among subregions. If the burden of disease attributable to dietary factors is to be assessed more accurately, more countries will have to assess the dietary intake of their populations using comparable methods. (author's)
INDOCHINA ISSUES. 1988 Jan; (78):1-7.A campaign promoting "1 or at most 2 children" was launched officially in 1982 in Vietnam, a country which ranked 12th most populous in the world in 1987, with the 7th largest annual growth rate. Although major municipalities have registered less than 1.7% annual growth rates, in rural areas, particularly in the southern provinces, the growth rate ranges from 2.3-3.4%; 80% of the population resides in such locales. In April 1986, the Hanoi City People's Committee issued regulations designed to encourage the practice of birth control. Cash awards were offered to couples with only 1 child and payments for sterilization after the birth of a 2nd child. The birth of a 3rd child triggers higher maternity clinic charges, and an escalating scale of birth registration fees has been introduced to discourage failure to practice family planning. The most significant statistic to emerge from the birth control program is the gradual increase in the number of family planning acceptors over the past 5 years, slightly over 1 million couples estimated in 1981 to 4.5 million acceptors estimated for 1987. Between 1981-87 there was more than a doubling of acceptors for sterilization and IUD insertion. The IUD is used by 75% of couples practicing birth control, followed in popularity by the condom. Agencies in a UN triumvirate with special population concerns in Vietnam include the UN Fund for Population Activities (UNFPA), the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO). In the 3 years preceding 1987, several new UNICEF-supported public information projects were implemented, including the creation of an extensive maternal and child care network. This network was used to train cadres from the Women's Union as family planning motivators. In mid-1986, an experimental and innovative pilot project on "family life" or "parenting information" was initiated by UNICEF, UNFPA, and the Vietnamese Committee for the Protection of Mothers and the Newborn (CPMN). The desired growth rate of 1.1% by 2000 will have to rely on a variety of current program innovations. Surveys now being conducted in various regions of Vietnam reveal attitudinal problems in promoting smaller families. A survey of the members of 300 farming cooperatives in various areas of Vietnam in 1986 found that 60% of those questioned believed that the more children they had the better it would be for their family economy. Cooperative Vietnamese and UN efforts, particularly the innovative surveys and field research, represent valuable approaches, but considerable need remains for improvement in birth control knowledge and application and in the means to reduce child morbidity and mortality rates.