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Article

Prevalence of and Socio-Demographic Factors of Malnutrition Among Vietnamese Children and Adolescents: A Cross-Sectional Study

by
Ngan Thi Duc Hoang
1,2,*,
Nghien Thi Thao Hoang
3,
Duong Thanh Tran
1,2,
Hoa Anh Le
1,
Tuyen Danh Le
1,4,
Ewa A. Szymlek-Gay
5,
Hiep N. Le
2,
Hiep Thi Le
1,
Du Thi Doan Dang
1 and
Hai Phung
2
1
National Institute of Nutrition, 48B Tang Bat Ho, Pham Dinh Ho, Hai Ba Trung, Hanoi 100000, Vietnam
2
School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia
3
Department of Clinical Nutrition and Family Medicine, Faculty of Medicine, VNU University of Medicine and Pharmacy, 144 Xuan Thuy Street, Cau Giay District, Hanoi 100000, Vietnam
4
Vietnam Dietetics Association, 48B Tang Bat Ho, Pham Dinh Ho, Hai Ba Trung, Hanoi 100000, Vietnam
5
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC 3125, Australia
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(6), 612; https://doi.org/10.3390/healthcare13060612
Submission received: 6 February 2025 / Revised: 28 February 2025 / Accepted: 8 March 2025 / Published: 12 March 2025
Review Reports Versions Notes

Abstract

:
Background/Objectives: Limited data exist on the nutritional status of Vietnamese children aged 5 years and older. This study aimed to (1) determine the nutritional status and (2) assess the associations between malnutrition and socio-demographic factors among children and adolescents aged 5–19 years old in selected provinces in Vietnam. Methods: A cross-sectional study was conducted on 3055 children aged 5–19 years old. Children’s weight and height were collected to calculate BMI for Age Z-score and Height for Age Z-score to determine the prevalence of overweight/obesity, stunting, thinness/underweight, stunted-overweight, stunted-underweight, at least one type of undernutrition, and at least one type of malnutrition. Results: The prevalence of stunting and thinness/underweight was around 10%, overweight and obesity was 14.5%, while the prevalence of malnutrition was 36.5%, with 19.7% of children experiencing at least one form of undernutrition. Significant associations were found between malnutrition and socio-demographic factors such as age, ethnicity, and the number of household possessions. Stunting was more prevalent among older children and those from lower-income households, whereas overweight and obesity were more common in wealthier families. Conclusions: These novel findings highlight the need for targeted interventions addressing both undernutrition and obesity in Vietnam’s diverse demographic groups.

1. Introduction

Childhood malnutrition, encompassing both undernutrition (underweight, stunting, and wasting) and overnutrition (overweight and obesity), remains a significant global challenge, particularly in low- and middle-income countries [1]. Recent estimates highlight the coexistence of undernutrition [2] and overnutrition [3] among preschool children, a trend that continues into adolescence. Despite ongoing national policies, Vietnamese children continue to experience a significant dual burden of malnutrition, with both undernutrition and obesity on the rise. Notably, the prevalence of stunting among children under five remains a significant public health concern, reaching 19.6% in 2020 [4,5]. In addition, the rates of overweight and obesity among Vietnamese school children are alarming. For example, a 2016 study involving 2334 primary school children from rural areas in Vietnam found that 22.1% were overweight/obese, and 31.0% had abdominal obesity [6]. While previous research has focused on younger children, there are limited data on malnutrition among Vietnamese adolescents (5–19 years old). This study fills that gap by analyzing prevalence and socio-demographic associations across three provinces.
Undernutrition is a leading cause of child mortality [7,8] due to its impact on immune competence and susceptibility to infections such as pneumonia, diarrhea, and measles. Conversely, childhood obesity is a risk factor for adult obesity and is associated with chronic diseases like cardiovascular disease, type 2 diabetes, cancer, and other obesity-related disorders [9]. Meanwhile, parents’ demographic characteristics impact children’s eating habits in a positive way: parents with higher income and education were more likely to have children with healthier dietary behaviors [10]. Demographic elements are crucial for addressing child poverty from the nutrition perspective [11]. A good nutritional status and the absence of any type of malnutrition (under- and overnutrition) are important factors associated with the well-being of children [11,12]. Therefore, addressing this dual burden of malnutrition requires substantial efforts from the healthcare system.
Several policies and strategies have been implemented to address the nutritional challenges faced by children in Vietnam. The National Nutrition Strategy for 2021–2030, with a vision toward 2045, aims to improve Vietnamese people’s diet in terms of quantity and quality, reduce child malnutrition, and manage obesity/overweight [13]. This strategy emphasizes a multi-sectoral approach involving various stakeholders such as the Ministry of Health, Ministry of Agriculture and Rural Development, and international organizations like UNICEF and the World Bank. Vietnam has implemented national programs such as school meals and school milk programs to improve the nutritional status of school children. However, there is limited evidence of their effectiveness. Therefore, research focusing on older children (aged 5 years and older) is crucial to identify those at risk of malnutrition. This study aimed to (1) determine the nutritional status of children and adolescents aged 5–19 years old and (2) assess the associations between malnutrition and socio-demographic factors among children and adolescents aged 5–19 years old in selected provinces in Vietnam.

2. Materials and Methods

2.1. Study Design

A cross-sectional study was conducted between December 2020 and May 2021 on 3055 children aged 5–19 years old in three provinces in Vietnam.

2.2. Sample Size

The sample size was calculated using data from our previous study, where the prevalence of overweight/obesity was 22.1% [6]. With a 95% confidence interval, a 5% margin of error, a design effect of 3, and accounting for a 15% refusal rate, the desired sample size was 992 children per province, resulting in a total sample size of 2977 children across three provinces. At the end of the sampling stage, 3055 children agreed to take part in the study and signed the consent form.

2.3. Location Selection and Recruitment

Locations were randomly selected by a multistage random sampling strategy. Vietnam comprises three main geographical regions: Northern Vietnam, Central Vietnam, and Southern Vietnam. From the list of all provinces in each region, one province was randomly selected, and three districts were randomly selected from the list of districts in each province. These provinces were selected to capture diverse socioeconomic conditions and regional variations in malnutrition. In each district, the District Health Centre was invited to take part through written invitations followed by telephone calls and emails to explain the purpose of this study, confirm participation, and obtain written informed consent from the District Health Centre’s Director.
Subsequently, communes were conveniently selected. If a district or a commune declined to participate in this study, the next district or commune on the list was invited to ensure the desired sample size. By the end of the location selection stage, 18 communes had agreed to participate in the research.
The District Health Education and Training Department was contacted by the District Health Centre to obtain their agreement to organize the research in schools. Because the number of public high schools in each district was one to three schools, priority was given to selecting high schools and obtaining their consent first. Secondary schools, primary schools, and kindergartens, which were more numerous than high schools, were then selected until the desired sample size was reached in each district. If a District Health Centre or a school declined to participate, the next District Health Centre or school on the list was invited. By the end of the location section stage, 22 schools had agreed to participate in the research.

2.4. Participant Recruitment

Once a school agreed to participate in the research, all students at the school were invited to take part in the study. Teachers distributed the study information flyer and consent forms to the children to take home to their parents. Written consent from parents was then returned by the children to the teachers, who subsequently forwarded the consent forms to the research staff. Children were asked to provide their verbal assent. Children were excluded if they were younger than five or older than 19 years, if their parents or primary caregivers did not sign the consent form, if they had anthropometric abnormalities (e.g., severe scoliosis, which would not allow for the correct determination of height), if they had an intellectual impairment that would prevent them from understanding the aims of the study, or if they had chronic diseases that affected their ability to participate in anthropometric measurements and interviews.

2.5. Anthropometric Measures

Children were weighed in light clothing and without shoes with calibrated electronic body scales (SECA Robusta 813, SECA GmbH & Co. KG, Hamburg, Germany) and measured for height to the nearest 0.1 cm with a SECA stadiometer (SECA 222, SECA GmbH & Co. KG, Hamburg, Germany) according to standardized procedures [14].
BMI was calculated as weight in kg divided by height in meters squared. BMI for Age Z-score (BAZ) > +1 was used to define overweight and obesity, and BAZ < −2 was used to define thinness/underweight. Height for Age Z-score (HAZ) < −2 was used to define stunting [15]. Children were further classified as follows: stunted-overweight if they had HAZ < −2 and BAZ > +1, stunted-underweight if they had HAZ < −2 and BAZ < −2, experiencing at least one type of undernutrition if they had HAZ < −2 or BAZ < −2, or experiencing at least one type of malnutrition if they had HAZ < −2 or BAZ < −2 or BAZ > +1 [15].

2.6. Demographic and Socio-Demographic Data

Information on age, ethnicity, household size, the number of siblings, and household possessions was collected via a pretested questionnaire administered by the research staff to children and their parents. The possessions listed were as follows: computer, video compact disc player, digital video disc player, fridge, washing machine, air conditioner, motorbike, car, bicycle, and telephone.

2.7. Data Analysis

Data were collected from 3055 children; the response rate was 100%. Anthropometric data were analyzed using WHO Anthro Plus 2007 [16]. Data were cleaned and entered into EpiData (version 3.1) software.
Participants’ ages were categorized into quartiles (5 to <9 years old, 9 to <12 years old, 12 to <14 years old, and 14 to 19 years old). Ethnicity was categorized as Kinh or other groups. Household size was categorized as ≤3 people (2 parents and 1 child), 4 people (2 parents and 2 children), 5–6 people (2 parents, 2–3 children, and/or 1 other relative), and >6 people (parents, children, and other relatives). The number of siblings was categorized as ≤2 and >2 children. The household possessions variable was dichotomized at 6 based on the median split, ensuring an even distribution for analysis.
The prevalence of stunting, thinness/underweight, overweight and obesity, stunted-overweight, stunted-underweight, at least one type of undernutrition, and at least one type of malnutrition was estimated for the whole sample, and for the levels of the following factors: age, ethnicity, household size, number of siblings, and number of household possessions.
Generalized linear mixed models, with the school as a random effect, were used to estimate the association between binary outcomes (stunting, thinness/underweight, overweight and obesity, stunted-overweight, stunted-underweight, and at least one type of undernutrition or malnutrition) with socio-demographic variables. We report univariate associations, i.e., only one socio-demographic factor considered at a time, and adjusted associations estimated under models including all socio-demographic factors (i.e., age, ethnicity, household size, number of siblings, and number of household possessions).
Data completeness was verified before analysis, and missing values were managed using list-wise deletion to avoid bias.
All estimates are reported along with 95% confidence intervals (CI). Analyses were performed with Stata (version 14.0; StataCorp LP, College Station, TX, USA).

3. Results

3.1. Nutritional Status of Children Aged 5–19 Years Old in Some Provinces in Vietnam

The study included 3055 children, nearly 60% of whom were male. Approximately 8% of the children lived in households with fewer than two siblings, while the majority resided in families of four to six members (Table 1).
The prevalence of stunting was around 13%, while thinness/underweight affected approximately 9% of children. Importantly, around 40% of the children experienced at least one form of malnutrition, 20% were affected by undernutrition, and nearly 15% were classified as overweight/obese (Table 2).

3.2. Associations Between Malnutrition and Socio-Demographic Factors Among Children Aged 5–19 Years Old in Some Provinces in Vietnam

Results from univariate analyses revealed that stunting was significantly associated with ethnicity, age, number of siblings, and the number of household possessions. However, in the multivariate analysis, only age and the number of household possessions remained statistically significant (Table 3). The likelihood of being stunted increased with age but decreased with the number of household possessions.
Overweight and obesity were significantly associated with most of the defined factors in univariate analyses, except for household size. In the multivariate analysis, the number of siblings was not significantly associated (Table 4). Girls, children from other ethnic groups, and older children were less likely to be overweight or obese compared to boys, children from the Kinh ethnic group, and younger children. Conversely, children from families with more household possessions (indicative of better socioeconomic status) were at higher risk of being overweight or obese compared to those from families with lower socioeconomic status.
Other analyses for the associations of thinness/underweight, stunted-overweight, stunted-underweight, and at least one type of undernutrition or malnutrition with socio-demographic variables showed no significance.
While most findings were statistically significant, some associations such as ethnicity and overweight showed wide confidence intervals, suggesting variability across subgroups.

4. Discussion

4.1. Nutritional Status of Children and Adolescents Aged 5–19 Years Old

This study highlights the dual burden of malnutrition (DBM) among Vietnamese children aged 5–19 years old, with the prevalence of stunting and thinness/underweight at 9–13% and of overweight and obesity at 15%. These findings are similar to data for school children aged 12–15 years old in South Asian countries (approximately 10% of children are affected by thinness, stunting, or overweight) [17]. Other countries in Asia, especially those experiencing rapid urbanization and economic growth, such as India [18], China, Nepal, Indonesia, and Pakistan [19,20], are also grappling with this issue. However, the children in this study appear to be at higher risk of malnutrition compared to those in other South Asian countries, with approximately one-fifth facing at least one type of undernutrition and two-fifths facing at least one type of malnutrition. Meanwhile, a research study that comprised data from the Demographic and Health Survey in Bangladesh, India, Nepal, Pakistan, Myanmar, Timor, Maldives, and Cambodia (from 2007 to 2017) of 798,961 households found the pooled prevalence of at least one type of DBM (overweight or obese, wasted, underweight, stunted mothers and/or children) at 12.0% [21]. Although it is challenging to compare the data from the two studies due to differences in sample sizes and sampling methods, the findings from our study have raised an alert for public health nutrition in Vietnam, particularly for childhood overweight and obesity. Our research was conducted in three poor and remote provinces; however, the prevalence of overnutrition was still 15%, which is similar to the national level (19%) [4].
Vietnam has been on track with two indicators from Sustainable Development Goal 3 for child health and well-being [22], but the DBM has been clearly observed since the 2000s in children under five years of age [23]. This has been reported in different studies in children aged 0.5–11.9 years old in three geographic areas (2011) [24], as well as in primary school children in megacities such as Hai Phong City (2016) [6] and Ho Chi Minh City (2014–15) [25]. Results from the general nutrition survey in Vietnam in 2020 reported a prevalence of stunting and overweight/obesity among children aged 5–19 years old at 15% and 19%, respectively [4]. Collectively, the data demonstrate that the DBM tracks from preschool to school children in Vietnam and persists despite the nation’s efforts to improve nutritional status of its population.
This research demonstrates the presence of DBM among Vietnamese children aged 5–19 years old. Findings from our study indicate a widespread prevalence of DBM across the nation. A heightened risk of at least one form of malnutrition was reported despite ongoing national efforts to improve nutrition. The persistence of DBM highlights the urgent need for more targeted public health interventions to address both undernutrition and obesity in Vietnam’s evolving nutritional landscape.

4.2. Associations Between Malnutrition and Socio-Demographic Factors Among Children and Adolescents Aged 5–19 Years Old

The results from this research revealed statistically significant associations between malnutrition and children’s age, sex, ethnicity, and the number of household possessions (a proxy for household wealth).
The positive associations between stunting and children’s age, and negative associations between stunting and the number of household possessions, were similar to other research in Vietnam [6,26]. It is widely agreed that stunting in adolescents results from an accumulation of multiple factors such as inadequate nutrient intakes; early childhood stunting; poor maternal health during early pregnancy; chronic infections and diseases; poor water, sanitation, and hygiene; socioeconomic and cultural factors; and inappropriate physical activity levels [27,28,29]. Therefore, the risk of stunting increases with age in children. Meanwhile, children can be protected from stunting if their households have higher levels of economic conditions (as indicated by an increased number of household possessions). A higher economic status can ensure an adequate food supply and sustain proper care for children [30]. Moreover, household wealth also influences mothers’ cognitive health and decision-making process, including food choices for their children and the identification of potential risks in their current nutrition care practices [31]. These findings confirm the need to maintain or improve the current nutrition strategies in Vietnam for childhood stunting control, prioritizing early interventions (for children under five), and targeting children from lower socioeconomic backgrounds, particularly those in remote and poor areas or ethnic groups [13].
In contrast to stunting, overweight and obesity had positive relationships with the number of household possessions, which is consistent with other research in Vietnam [6,24,32,33] but opposite to the figures in developed countries [34]. The higher the socioeconomic status of the family, the more likely it is to ensure household food security and increase access to food; therefore, the higher the risk of children becoming overweight or obese. Furthermore, Vietnamese parents prefer “rounder” or “chubby” children [35], which may also increase the risk of children consuming excess energy. Indeed, these findings were further reflected in the associations between overweight/obesity and ethnicity. Minorities in Vietnam usually live at a lower socioeconomic status [36] compared to the Kinh group, which accounts for 85.3% of the Vietnamese population [37] and, thus, experiencing a lower prevalence of overweight and obesity. Whether childhood overweight/obesity and household socioeconomic status have a causal relationship cannot be determined, as this is a limitation of our current cross-sectional study. Therefore, further well-designed research studies are needed.
Age was found to be negatively associated with childhood overweight and obesity. Adolescents tend to be more physically active than preschoolers, as they focus more on their physique. They experience a growth spurt during puberty, which significantly changes their body composition with an increase in muscle mass, particularly in boys. Older children acquire more knowledge about balanced and age-specific nutrition obtained through public health programs and are also likely to be influenced by peer pressure and other social factors, particularly social media, leading to more conscious weight management behaviors (e.g., exercise and food choices). However, it is also noted that social media can have a negative influence on older children. It has been reported that social media may lead to eating behavior such as eating disorders (anorexia nervosa or bulimia nervosa) and poor dietary habits (increased fast food and sweetened beverages consumption) [38,39]. While early childhood obesity is common [40], as children get older, these factors, along with improved healthy eating practices, can reduce the risk of obesity.
Girls were less likely to be overweight and obese compared with boys. This result supports findings reported by other research in Vietnam [6] and many other countries, such as Canada [41], China [42], and Thailand [43]. The influences of sex (biology: body composition, sex hormones, leptin concentration, etc.) and gender (socio-culture: food choices, weight-related concerns, physique preferences, sedentary behaviors, and physical activity patterns, etc.) have been proposed to account for the differences in adiposity between girls and boys [44]. The Vietnamese have a preference for boys; therefore, girls may be less prioritized compared to boys [45]. Girls are more concerned with being thin, slim, good at house chores, and preparing to take care of the family compared to boys [44].
Nutrition education and behavior change, school-based interventions, fortification and supplementation programs, and the regulation of unhealthy foods are some possible approaches to addressing these issues [46,47]. However, multi-sectoral strategies are usually challenging due to economic disparities, urban-rural divides, and entrenched eating behaviors. Rapid urbanization and changing food systems further hinder efforts to address these issues simultaneously. Additionally, there is a concern about the effectiveness of coordination between sectors, including agriculture, health, and education, which is necessary for implementing effective nutrition strategies.
Vietnam has implemented several national nutrition programs and policies aimed at addressing childhood malnutrition. The National Nutrition Strategy for 2021–2030, with a vision to 2045, focuses on reducing stunting, wasting, and micronutrient deficiencies while also addressing the rising prevalence of overweight and obesity [13]. This strategy emphasizes the importance of multi-sectoral collaboration involving various stakeholders such as the health, education, agriculture, and social protection sectors. Notably, UNICEF supports Vietnam’s efforts by promoting nutrition-specific and nutrition-sensitive interventions, including supplementation, food fortification, and the integration of nutrition education into school curricula [48]. The strategy also highlights the need for robust monitoring and evaluation systems to track progress and ensure the effectiveness of interventions. Existing national programs, such as school meal initiatives, require rigorous evaluation to assess their effectiveness. Future interventions should prioritize early prevention strategies targeting both stunting and obesity, and multiple strategies can be used to address this critical public health concern.
  • Strengths and Limitations
This study has strengths and limitations worth noting. One of the strengths is its large sample size, which enhances the generalizability of the findings. The research had no cases of refusal. Additionally, the study’s focus on a wide age range (5–19 years old) provides a comprehensive overview of the nutritional challenges faced by children and adolescents in Vietnam.
However, there are several limitations to consider. As this was a cross-sectional study, causality cannot be inferred. Additionally, using household possessions as a wealth indicator may not fully capture socioeconomic disparities. Longitudinal studies are needed to better understand the temporal dynamics of these associations. Furthermore, the reliance on self-reported data for some variables may introduce bias, and future studies should aim to include more objective measures.
Despite the limitations, our study contributes novel valuable data on DBM among children aged 5–19 years old in remote areas of Vietnam. Future research should focus on longitudinal studies to explore the causal pathways between socio-demographic factors and malnutrition. Additionally, there is a need for intervention studies to evaluate the effectiveness of existing public health programs, such as the school meal and milk programs, in improving the nutritional status of schoolchildren. Research should also investigate the impact of culturally tailored interventions that address the unique dietary practices and preferences of different ethnic groups.

5. Conclusions

These findings underscore the urgent need for tailored public health interventions to combat both stunting and obesity, particularly among vulnerable socioeconomic groups in Vietnam. Insights from this study can guide policymakers and public health practitioners in developing effective strategies to improve the nutritional status and overall health of children in Vietnam.

Author Contributions

Conceptualization, N.T.D.H. and T.D.L.; methodology, N.T.D.H., T.D.L., H.P. and N.T.T.H.; software, H.P.; validation, D.T.T., H.N.L., H.T.L. and D.T.D.D.; formal analysis, N.T.D.H., E.A.S.-G., H.P., T.D.L. and D.T.T.; investigation, N.T.T.H. and H.A.L.; resources, N.T.D.H., T.D.L. and D.T.T.; data curation, N.T.T.H., H.N.L. and H.A.L.; writing—original draft preparation, N.T.D.H. and E.A.S.-G.; writing—review and editing, N.T.D.H., E.A.S.-G., H.P., T.D.L. and D.T.T.; visualization, H.P.; supervision, T.D.L. and H.P.; project administration, H.T.L. and D.T.D.D.; funding acquisition, N.T.D.H. and T.D.L. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Vietnam Ministry of Science and Technology, grant number “KC4.0-13/19-25”.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the National Institute of Nutrition–Ministry of Health, Vietnam (Decision number 1915/QD-VDD dated 12 October 2020) for studies involving humans.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available upon request from the corresponding author due to private and legal regulations of the Ministry of Science and Technology (funder) and the National Institute of Nutrition–Ministry of Health, Vietnam (organization in charge of the research) regarding their research data.

Acknowledgments

We acknowledge the support of the local health departments in three provinces for organizing the field data collection, as well as the colleagues from the National Institute of Nutrition and the Ministry of Science and Technology, Vietnam, for their assistance with administrative and technical matters.

Conflicts of Interest

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abbreviations

The following abbreviations are used in this manuscript:
BAZBMI for Age Z-score
DBMDouble Burden of Malnutrition
HAZHeight for Age Z-score
UNICEFUnited Nations Children’s Fund
WHOWorld Health Organization

References

  1. UNDP. Discussion Paper: Addressing the Social Determinants of Noncommunicable Diseases; UNDP: New York, NY, USA, 2013. [Google Scholar]
  2. WHO. Global and regional trends by UN Regions, 1990–2025. In Global Health Observatory Data Repository; WHO: Geneva, Switzerland, 2016. [Google Scholar]
  3. UNICEF-WHO-WB. Joint child malnutrition estimates 2017 (UNICEF-WHO-WB). In Global Health Observatory Visualizations; UNICEF-WHO-WB: Geneva, Switzerland, 2016. [Google Scholar]
  4. Bộ Y tế Công bố Kết Quả Tổng điểu Tra Dinh Dưỡng Năm 2019–2020. Available online: https://moh.gov.vn/hoat-dong-cua-lanh-dao-bo/-/asset_publisher/TW6LTp1ZtwaN/content/bo-y-te-cong-bo-ket-qua-tong-ieu-tra-dinh-duong-nam-2019-2020 (accessed on 1 February 2025).
  5. de Onis, M.; Dewey, K.G.; Borghi, E.; Onyango, A.W.; Blössner, M.; Daelmans, B.; Piwoz, E.; Branca, F. The World Health Organization’s global target for reducing childhood stunting by 2025: Rationale and proposed actions. Matern. Child Nutr. 2013, 9, 6–26. [Google Scholar] [CrossRef] [PubMed]
  6. Hoang, N.; Orellana, L.; Le, T.; Gibson, R.; Worsley, A.; Sinclair, A.; Szymlek-Gay, E. Anthropometric Status among 6–9-Year-Old School Children in Rural Areas in Hai Phong City, Vietnam. Nutrients 2018, 10, 1431. [Google Scholar] [CrossRef]
  7. Fishman, S.C.L.; de Onis, M.; Blössner, M.; Hyder, A.A.; Mullany, L.; Black, R.E. Childhood and maternal underweight. In Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors; Ezzati, M., Lope, A.D., Rodgers, A., Murray, C.J.L., Eds.; WHO: Geneva, Switzerland, 2004; in press. [Google Scholar]
  8. Müller, O.; Krawinkel, M. Malnutrition and health in developing countries. CMA J. 2005, 173, 279–286. [Google Scholar] [CrossRef] [PubMed]
  9. WHO. Obesity and Overweight. Available online: http://www.who.int/mediacentre/factsheets/fs311/en/ (accessed on 21 April 2024).
  10. Keçïlï, M.Ç.K. Effect of Socioeconomic Status of Parents on Nutrition Habits Among Children: Türkïye Child Survey Application. Child Indic. Res. 2024, 1–16. [Google Scholar] [CrossRef]
  11. Leriou, E. Understanding and measuring child well-being in the region of Attica, Greece: Round Four. Child Indic. Res. 2022, 15, 1967–2011. [Google Scholar] [CrossRef] [PubMed]
  12. Leriou, E. Understanding and measuring Child Well-being in the region of Attica, Greece: Round five. Child Indic. Res. 2023, 16, 1395–1451. [Google Scholar] [CrossRef]
  13. Thủ tướng Chính phủ. Quyết định 02/QĐ-TTg của Thủ Tướng Chính Phủ Phê Duyệt Chiến Lược Quốc Gia về Dinh Dưỡng Giai đoạn 2021–2030 và Tầm Nhìn đến 2045; Thủ tướng Chính phủ: Hanoi, Vietnam, 2022. [Google Scholar]
  14. National Center for Health Statistics. NHANES: Anthropometry Procedures Manual; Revised; National Center for Health Statistics: Hyattsville, MD, USA, 2004.
  15. WHO. Body Mass Index—BMI. Available online: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index (accessed on 30 June 2024).
  16. WHO. Growth Reference Data for 5–19 Years. Available online: https://www.who.int/tools/growth-reference-data-for-5to19-years (accessed on 1 July 2022).
  17. Estecha Querol, S.; Iqbal, R.; Kudrna, L.; Al-Khudairy, L.; Gill, P. The double burden of malnutrition and associated factors among south Asian adolescents: Findings from the global school-based student health survey. Nutrients 2021, 13, 2867. [Google Scholar] [CrossRef]
  18. Nguyen, P.H.; Scott, S.; Headey, D.; Singh, N.; Tran, L.M.; Menon, P.; Ruel, M.T. The double burden of malnutrition in India: Trends and inequalities (2006–2016). PLoS ONE 2021, 16, e0247856. [Google Scholar] [CrossRef]
  19. Gao, L.; Bhurtyal, A.; Wei, J.; Akhtar, P.; Wang, L.; Wang, Y. Double burden of malnutrition and nutrition transition in Asia: A case study of 4 selected countries with different socioeconomic development. Adv. Nutr. 2020, 11, 1663–1670. [Google Scholar] [CrossRef]
  20. Hu, X.; Jiang, H.; Wang, H.; Zhang, B.; Zhang, J.; Jia, X.; Wang, L.; Wang, Z.; Ding, G. Intraindividual double burden of malnutrition in Chinese children and adolescents aged 6–17 Years: Evidence from the China health and nutrition survey 2015. Nutrients 2021, 13, 3097. [Google Scholar] [CrossRef]
  21. Biswas, T.; Townsend, N.; Magalhaes, R.S.; Hasan, M.; Mamun, A. Patterns and determinants of the double burden of malnutrition at the household level in South and Southeast Asia. Eur. J. Clin. Nutr. 2021, 75, 385–391. [Google Scholar] [CrossRef] [PubMed]
  22. UNICEF. Achieving Sustainable Development Goals in Viet Nam: Assessing Progress and Estimating Required Efforts—An Average Annual Rate of Reduction (AARR) Analysis Across Social Sectors; UNICEF: Geneva, Switzerland, 2022. [Google Scholar]
  23. Khan, N.C.; Khoi, H.H. Double burden of malnutrition: The Vietnamese perspective. Asia Pac. J. Clin. Nutr. 2008, 17, 116–118. [Google Scholar]
  24. Le Nguyen, B.K.; Le Thi, H.; Thuy, N.T.; Huu, C.N.; Do, T.T.; Deurenberg, P.; Khouw, I. Double burden of undernutrition and overnutrition in Vietnam in 2011: Results of the SEANUTS study in 0· 5–11-year-old children. Br. J. Nutr. 2013, 110, S45–S56. [Google Scholar] [CrossRef] [PubMed]
  25. Mai, T.M.T.; Pham, N.O.; Tran, T.M.H.; Baker, P.; Gallegos, D.; Do, T.N.D.; van der Pols, J.C.; Jordan, S.J. The double burden of malnutrition in Vietnamese school-aged children and adolescents: A rapid shift over a decade in Ho Chi Minh City. Eur. J. Clin. Nutr. 2020, 74, 1448–1456. [Google Scholar] [CrossRef]
  26. Tan, X.; Tan, P.Y.; Som, V.; Nguyen, S.; Tran, D.T.; Tran, T.N.; Tran, V.K.; Gong, Y.Y.; Moore, J.B. Prevalence and associations between micronutrient deficiencies and growth indicators of 10–18-year-old female adolescents living in Vietnam. In Proceedings of the Nutrition Society—Winter Conference 2023, Diet and Lifestyle Strategies for Prevention and Management of Multimorbidity, London, UK, 5–6 December 2023. [Google Scholar]
  27. Stewart, C.; Iannotti, L.; Dewey, K.G.; MK, O.A. Childhood Stunting: Context, Causes, and Consequences. Matern. Child Nutr. 2013, 9, 27–45. [Google Scholar] [CrossRef] [PubMed]
  28. Suri, S.; Sidiq, F.F. 50 Years of Research on Stunting: A Bibliometric Analysis. Indones. J. Librariansh. 2024, 5, 1–14. [Google Scholar] [CrossRef]
  29. Kassaw, A.; Kassie, Y.T.; Kefale, D.; Azmeraw, M.; Arage, G.; Asferi, W.N.; Munye, T.; Demis, S.; Simegn, A.; Chanie, M.; et al. Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis. PLoS ONE 2023, 18, e0294689. [Google Scholar] [CrossRef]
  30. Jonah, C.M.; Sambu, W.C.; May, J.D. A comparative analysis of socioeconomic inequities in stunting: A case of three middle-income African countries. Arch. Public Health 2018, 76, 1–15. [Google Scholar] [CrossRef]
  31. Sheehy-Skeffington, J.; Rea, J. How Poverty Affects People’s Decision-Making Processes. 2017. Available online: https://discovery.ucl.ac.uk/id/eprint/10186609/ (accessed on 31 January 2025).
  32. Ngan, T.D.H.; Tuyen, D.L.; Phu, V.P.; Smita, N. Childhood overweight and obesity amongst primary school children in Hai Phong city, Vietnam. Asia Pac. J. Clin. Nutr. 2018, 27, 399–405. [Google Scholar]
  33. Carrillo-Larco, R.M.; Miranda, J.J.; Bernabe-Ortiz, A. Wealth index and risk of childhood overweight and obesity: Evidence from four prospective cohorts in Peru and Vietnam. Int. J. Public Health 2016, 61, 475–485. [Google Scholar] [CrossRef]
  34. Mathieu-Bolh, N. The elusive link between income and obesity. J. Econ. Surv. 2022, 36, 935–968. [Google Scholar] [CrossRef]
  35. Nguyen, T.; Trat, T.; Tieu, N.T.; Vu, L.; Sokal-Gutierrez, K. Key Informants’ Perspectives on Childhood Obesity in Vietnam: A Qualitative Study. Matern. Child Health J. 2022, 26, 1811–1819. [Google Scholar] [CrossRef] [PubMed]
  36. Pham, D.H. Risk attitude and economic welfare: A panel analysis on a multiethnic population in rural Viet Nam. J. Asian Econ. 2023, 88, 101645. [Google Scholar] [CrossRef]
  37. Vietnam GSO. Thông cáo báo chí kết quả sơ bộ tổng điều tra dân số và nhà ở năm 2019. Available online: https://www.gso.gov.vn/du-lieu-va-so-lieu-thong-ke/2019/10/thong-cao-bao-chi-ket-qua-so-bo-tong-dieu-tra-dan-so-va-nha-o-nam-2019/#:~:text=To%C3%A0n%20qu%E1%BB%91c%20c%C3%B3%2082.085.729,B%E1%BA%AFc%20v%C3%A0%20v%C3%B9ng%20T%C3%A2y%20Nguy%C3%AAn (accessed on 2 January 2025).
  38. Alanazi, A.M.L.; Alanazi, S.M.L.; Alanazi, S.S.M. Impact of Social Media on Fast Food Consumption and Increased Bad Nutritional Habits: Systematic Review. Saudi J. Med. Pharm. Sci. 2023, 9, 839–844. [Google Scholar] [CrossRef]
  39. Shinde, N.; Garg, V. Social media usage, eating habits and nutritional status of school-going adolescents: A descriptive study. Int. J. Sci. Res. Biol. Sci. 2020, 7, 19–25. [Google Scholar]
  40. Kansra, A.R.; Lakkunarajah, S.; Jay, M.S. Childhood and adolescent obesity: A review. Front. Pediatr. 2021, 8, 581461. [Google Scholar] [CrossRef]
  41. Carsley, S.; Pope, E.I.; Anderson, L.N.; Tremblay, M.S.; Tu, K.; Birken, C.S. Temporal trends in severe obesity prevalence in children and youth from primary care electronic medical records in Ontario: A repeated cross-sectional study. CMAJ Open 2019, 7, E351–E359. [Google Scholar] [CrossRef]
  42. Hong, Y.; Ullah, R.; Wang, J.B.; Fu, J.F. Trends of obesity and overweight among children and adolescents in China. World J. Pediatr. 2023, 19, 1115–1126. [Google Scholar] [CrossRef]
  43. Pawloski, L.R.; Harnirattisai, T.; Vuthiarpa, S.; Curtin, K.; Nguyen, J.T. Gender-Based Determinants of Obesity among Thai Adolescent Boys and Girls. Adolescents 2023, 3, 457–466. [Google Scholar] [CrossRef]
  44. Shah, B.; Cost, K.T.; Fuller, A.; Birken, C.S.; Anderson, L.N. Sex and gender differences in childhood obesity: Contributing to the research agenda. BMJ Nutr. Prev. Health 2020, 3, 387. [Google Scholar] [CrossRef]
  45. Belanger, D. Son preference in a rural village in North Vietnam. Stud. Fam. Plan. 2002, 33, 321–334. [Google Scholar] [CrossRef] [PubMed]
  46. WHO. The Double Burden of Malnutrition: Priority Actions on Ending Childhood Obesity; WHO Regional Office for South-East Asia: New Delhi, India, 2020. [Google Scholar]
  47. Haddad, L.; Cameron, L.; Barnett, I. The double burden of malnutrition in SE Asia and the Pacific: Priorities, policies and politics. Health Policy Plan. 2015, 30, 1193–1206. [Google Scholar] [CrossRef] [PubMed]
  48. UNICEF. Nutrition, for Every Child: UNICEF. Nutrition Strategy 2020–2030; UNICEF: New York, NY, USA, 2020. [Google Scholar]
Table 1. Characteristics of the participants.
Table 1. Characteristics of the participants.
N%MeanSE
Age (year)5 to <974124.3
9 to <1288929.1
12 to <1476325.0
14–1966221.6
SexMale179358.7
Female126241.3
EthnicityKinh202066.1
Others103533.9
Household size≤3 people2138.3
4 people111743.2
5–6 people103640.1
>6 people2178.4
Number of siblings of the child≤2 children157379.9
>2 children39620.1
Number of household possessions≤6176657.8
>6128942.2
BAZ3052 −0.340.1
HAZ3053 −0.850.1
Table 2. Prevalence of malnutrition among children aged 5–19 years old.
Table 2. Prevalence of malnutrition among children aged 5–19 years old.
Nn (%)95% CI
Stunting *3050394 (12.8)9.8; 16.4
Thinness/underweight **3052267 (8.7)6.2; 12.2
Overweight and obesity ***3052460 (14.5)10.6; 19.6
Stunted-overweight a305516 (0.5)0.2; 0.9
Stunted-underweight b305572 (2.2)1.5; 3.4
At least one type of undernutrition c3055594 (19.7)15.0; 25.4
At least one type of malnutrition d30551039 (36.5)31.4; 41.9
* Height for Age Z-score (HAZ) < −2 [15]; ** BMI for Age Z-score (BAZ) < −2 [15]; *** BAZ > +1 [15]; a HAZ < −2 and BAZ > +1 [15]; b HAZ < −2 and BAZ < −2 [15]; c HAZ < −2 or BAZ < −2 [15]; and d HAZ < −2 or BAZ < −2 or BAZ > +1 [15].
Table 3. Association of stunting and socio-demographic factors.
Table 3. Association of stunting and socio-demographic factors.
VariableRaw EstimatesUnivariate Analysis *Multivariate Analysis **
TotalStunting N (%)OR (95%CI)p-ValueOverall p-Value ***OR (95%CI)p-ValueOverall p-Value ***
Age (year)5 to <9 (reference)73774 (10.0)1 <0.0011 0.007
9 to <12889136 (15.3)1.60 (1.16; 2.19)0.0041.80 (1.19; 2.71)0.005
12 to <1476288 (11.6)1.40 (0.98; 1.99)0.0631.30 (0.83; 2.05)0.252
14–1966296 (14.5)2.22 (1.55; 3.18)<0.0012.01 (1.25; 3.24)0.004
SexMale (reference)1792243 (13.6)1 1
Female1258151 (12.0)0.91 (0.72; 1.16)0.458 0.95 (0.71; 1.27)0.739
EthnicityKinh (reference)2018219 (10.9)1 1
Others1032175 (17.0)1.40 (1.01; 1.93)0.044 1.31 (0.87; 1.99)0.200
Household size≤3 people (reference)21331 (14.6)1 0.0641 0.339
4 people1115125 (11.2)0.71 (0.47; 1.11)0.1410.70 (0.42; 1.16)0.163
5–6 people1035149 (14.4)1.02 (0.67; 1.57)0.9190.91 (0.53; 1.58)0.743
>6 people21727 (12.4)0.83 (0.47; 1.48)0.5320.77 (0.37; 1.59)0.474
Number of siblings of the child≤2 children (reference)1570177 (11.3)1 1
>2 children39568 (17.2)1.39 (1.00; 1.91)0.047 1.11 (0.74; 1.67)0.605
Number of household possessions ≤6 (reference)1766281 (15.9)1 1
>61289113 (8.8)0.64 (0.49; 0.83)0.001 0.71 (0.50; 0.99)0.048
* Generalized linear mixed model including the covariate as a fixed effect and school as a random effect. ** Generalized linear mixed model including all socio-demographic factors as fixed effects and school as a random effect. *** Overall p-value for the association between the outcome and the socio-demographic factor.
Table 4. Association of overweight and obesity and socio-demographic factors.
Table 4. Association of overweight and obesity and socio-demographic factors.
VariableRaw EstimatesUnivariate Analysis aMultivariate Analysis b
TotalOverweight or Obesity N (%)OR (95%CI)p-ValueOverall p-Value cOR (95%CI)p-ValueOverall p-Value c
Age5 to <9 (reference)738146 (19.8)1 <0.0011 <0.001
9 to <12889169 (19.0)1.00 (0.77; 1.31)0.9781.51 (1.02; 1.26)0.042
12 to <1476399 (13.0)0.68 (0.50; 0.92)0.0130.98 (0.63; 1.50)0.909
14–1966246 (7.0)0.26 (0.18; 0.38)<0.0010.46 (0.27; 0.80)0.005
SexMale (reference)1790334 (18.7)1 1
Female1262126 (10.0)0.51 (0.40; 0.64)<0.001 0.50 (0.36; 0.68)<0.001
EthnicityKinh (reference)2017376 (18.6)1 1
Others103584 (8.1)0.53 (0.38; 0.75)<0.001 0.56 (0.36; 0.86)0.009
Household size≤3 people (reference)21338 (17.8)1 0.2781 0.804
4 people1117153 (13.7)0.76 (0.51; 1.15)0.1940.84 (0.51; 1.39)0.509
5–6 people1034136 (13.2)0.73 (0.49; 1.11)0.1420.83 (0.48; 1.44)0.511
>6 people21737 (17.1)1.00 (0.59; 1.68)0.9851.02 (0.51; 2.06)0.952
Number of siblings of the child≤2 children (reference)1572213 (13.6)1 1
>2 children39636 (9.1)0.55 (0.37; 0.82)0.003 0.64 (0.40; 1.01)0.056
Number of household possessions≤6 (reference)1764216 (12.2)1 1
>61288244 (18.9)1.61 (1.28; 2.03)<0.001 1.51 (1.11; 2.05)0.008
a Generalized linear mixed model including the covariate as a fixed effect and school as a random effect. b Generalized linear mixed model including all socio-demographic factors as fixed effects and school as a random effect. c Overall p-value for the association between the outcome and the socio-demographic factor.
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Hoang, N.T.D.; Hoang, N.T.T.; Tran, D.T.; Le, H.A.; Le, T.D.; Szymlek-Gay, E.A.; Le, H.N.; Le, H.T.; Dang, D.T.D.; Phung, H. Prevalence of and Socio-Demographic Factors of Malnutrition Among Vietnamese Children and Adolescents: A Cross-Sectional Study. Healthcare 2025, 13, 612. https://doi.org/10.3390/healthcare13060612

AMA Style

Hoang NTD, Hoang NTT, Tran DT, Le HA, Le TD, Szymlek-Gay EA, Le HN, Le HT, Dang DTD, Phung H. Prevalence of and Socio-Demographic Factors of Malnutrition Among Vietnamese Children and Adolescents: A Cross-Sectional Study. Healthcare. 2025; 13(6):612. https://doi.org/10.3390/healthcare13060612

Chicago/Turabian Style

Hoang, Ngan Thi Duc, Nghien Thi Thao Hoang, Duong Thanh Tran, Hoa Anh Le, Tuyen Danh Le, Ewa A. Szymlek-Gay, Hiep N. Le, Hiep Thi Le, Du Thi Doan Dang, and Hai Phung. 2025. "Prevalence of and Socio-Demographic Factors of Malnutrition Among Vietnamese Children and Adolescents: A Cross-Sectional Study" Healthcare 13, no. 6: 612. https://doi.org/10.3390/healthcare13060612

APA Style

Hoang, N. T. D., Hoang, N. T. T., Tran, D. T., Le, H. A., Le, T. D., Szymlek-Gay, E. A., Le, H. N., Le, H. T., Dang, D. T. D., & Phung, H. (2025). Prevalence of and Socio-Demographic Factors of Malnutrition Among Vietnamese Children and Adolescents: A Cross-Sectional Study. Healthcare, 13(6), 612. https://doi.org/10.3390/healthcare13060612

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