Demographic variation and socioeconomic inequalities associated with the triple burden of malnutrition in Vietnamese children aged 6 months to 9 years old: Findings from the Vietnamese General Nutrition Survey 2020

Abstract

Introduction: The triple burden of malnutrition (TBM) is a growing public health issue worldwide. This study examined the prevalence and association between undernutrition, overnutrition and micronutrient deficiencies (MNDs), and the associated demographic and socioeconomic determinants, among Vietnamese children, using the nationally representative General Nutrition Survey 2020. Methods: Data on anthropometric parameters, micronutrients biomarkers, demographic and socioeconomic indicators for 7,289 children aged 6 months to 9 years old were analysed. Determinants of malnutrition were assessed using logistic regressions and reported as odds ratio (OR) [95% confidence intervals (CI)]. Results: Overall, 12.7%, 10.5% and 4.7% of children were stunted, underweight and wasted/thin; while 7.3% and 7.1% were living with overweight and obesity, respectively. Low serum zinc, anaemia and iron deficiency (ID) were the common MNDs observed, affecting 53.1%, 15.2% and 13.9% of the study participants. Older children aged 2-4 years old [OR (95% CI): 1.43 (1.20, 1.72)], ethnic minorities [5.94 (3.78, 9.36)] and living in mountainous areas [5.06 (1.18, 14.42)] had increased odds of stunting, whereas reduced odds were found in children from the richest quintile [0.13 (0.05, 0.32)]. Similar determinants were found to be associated with underweight and MNDs. Males [1.43 (1.16, 1.76)], children aged 5-9 years old [10.02 (6.71, 14.97) and children from the richest quintile [2.91 (1.20, 7.05)] had increased odds of overweight. Children with anaemia, low serum retinol and low serum zinc had increased odds of stunting and underweight than non-micronutrient deficient children (adjusted OR=1.43-1.71). Compared to children without MNDs, those with ≥3 MNDs had almost double the odds of stunting and underweight, whereas those with ≤3 MNDs had reduced odds of overweight (adjusted OR=0.38-0.60). Conclusions: Significant demographic variation and socioeconomic inequalities in child malnutrition were identified. National policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to accelerate progress in reducing child malnutrition.

Micronutrient deficiencies and the double burden of malnutrition in Vietnamese female adolescents: a national cross-sectional study in 2020

“…In order to prevent selection bias, participants were recruited using a multi-stage cluster sampling design based on geographical areas, as detailed (currently in Preprint). 12 Of the 20,864 participants completing the GNS 2020, a total of 1,471 participants met our inclusion criteria of being aged 10-to 18-years-old and female, were included in this study for analysis.…”

“…Procedures for taking participant’s height and weight meaurements in the GNS 2020 have been described in detail in our Preprint. 12 Body mass index (BMI) was calculated as weight (kg) divided by square of height (m 2 ). The World Health Organization (WHO) growth reference was used to define stunting, thinness, and overweight.…”

“…Blood samples were taken as part of the Vietnam GNS 2020 as detailed (Preprint) 12 . Biomarkers measured included: haemoglobin by point-of-care assay (HemoCue Diagnostics), serum ferritin and serum transferrin receptor by electrochemiluminescence immunoassay (Roche Cobas e 601; Roche Diagnostics), serum zinc by atomic emission spectrometry (MP-AES 4200, Agilent Technologies), serum retinol and retinol binding protein by high performance liquid chromatography (Agilent 1200, Agilent Technologies), serum c-reactive protein (CRP) and serum alpha-1-acid glycoprotein (AGP) using an automated protein analyzer (BN ProSpec Siemens® System, Siemens Healthineers).…”