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

IntroductionThe 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. MethodsData 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)]. ResultsOverall, 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 [&ge;]3 MNDs had almost double the odds of stunting and underweight, whereas those with [&le;]3 MNDs had reduced odds of overweight (adjusted OR=0.38-0.60). ConclusionsSignificant 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. What is already known on this topic? summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be done O_LIThe triple burden of malnutrition (TBM) refers to the co-existence of undernutrition, overnutrition and micronutrient deficiencies (MNDs). Although TBM is a major public health issue that affects every country in the world, it is particularly pervasive in low- and middle-income countries. C_LIO_LIThere is no recent data investigating the magnitude of the TBM in Vietnam and how prevalence of TBM differs across different demographic and socioeconomic groups, especially amongst infants and young children. C_LI What this study adds? summarise what we now know as a result of this study that we did not know before O_LIOur analysis of the Vietnamese national representative General Nutrition Survey (GNS) 2020 data demonstrated the extent of the co-existence of each aspect of the TBM among children in Vietnam, and demographic variation and socioeconomic inequalities in child malnutrition were identified. C_LIO_LIAlthough child stunting reduction is on track towards the target of 40% reduction by 2025 set by the Global Nutrition Targets, prevalence is still high at10%-15% in 2020. Meanwhile overweight and obesity in school aged children is off track the target with the prevalence in urban areas increasing from 8.5% in 2010 to 31% in 2020. C_LIO_LIStunting, underweight and MNDs were more prevalent in infants and young children, particularly in ethnic minorities, living in the rural and mountainous areas and poorer families. Childhood overweight and obesity were evident, especially among school-aged children, males, living in the urban areas and richer families. C_LIO_LILow serum zinc (53%), anaemia (15%) and iron deficiency (14%) were the most common MNDs, and prevalence of low serum retinol was relatively low (<7%) in this population. C_LI How this study might affect research, practice or policy? summarise the implications of this study O_LIThese findings emphasise the need for double-duty actions to simultaneously address all forms of child malnutrition in Vietnam. C_LIO_LINational food and nutrition policies and programmes in Vietnam should address age-specific, sex-specific, geographical and socioeconomic disparities to ensure equitable access and opportunities for all, to accelerate progress in reducing child malnutrition. C_LI