# The Updated Dual Burden of Malnutrition Among Vietnamese School-Aged Children: A Nationwide Cross-Sectional Study

## TL;DR

This study finds that nearly 40% of Vietnamese children aged 6–17 have some form of malnutrition, with regional and gender differences in stunting, thinness, overweight, and obesity.

## Contribution

The study provides updated national data on the dual burden of malnutrition in Vietnamese children and identifies demographic and behavioral correlates.

## Key findings

- Stunting was more common in males, older children, and specific regions of Vietnam.
- Sports participation, vitamin K2 use, and puberty were associated with lower odds of stunting.
- Overweight and obesity were more prevalent in females and children from the Southeast and Mekong River Delta regions.

## Abstract

Objective: To assess the prevalence and associated factors of malnutrition—including stunting, thinness, overweight, and obesity—among Vietnamese children aged 6–17 years, and to identify demographic, geographic, and behavioral correlates to inform targeted nutrition interventions. Methods: A cross-sectional, nationally representative study was conducted from January 2024 to June 2025 using data from the MIDU Assessment Program. A multistage stratified random sampling approach recruited 43,505 children aged 6–17 years across all regions of Vietnam. Anthropometric measurements were obtained following WHO 2007 growth reference standards. Stunting was defined as height-for-age Z-score (HAZ) < −2 SD, and overweight/obesity as body mass index-for-age Z-score (BAZ) > +1 SD. Data on demographic characteristics, sleep patterns, sports participation, vitamin K2 use, and pubertal status were collected via structured questionnaires. Multivariable logistic regression was used to identify factors associated with stunting and overweight/obesity. Results: Overall, 3.9% were stunted, 5.1% were thin, 20.7% were overweight, and 11.4% were obese; 8.6% had any undernutrition and 39.5% had any form of malnutrition. Stunting was significantly associated with being male (OR = 1.37, 95% CI: 1.24–1.52), older age—particularly 14–17 years (OR = 6.56, 95% CI: 5.48–7.84)—and residing in the Northern midlands, North Central, South Central, and Central Highlands regions. In contrast, frequent sports participation (OR = 0.76, 95% CI: 0.68–0.84), daily vitamin K2–MK7 use (OR = 0.82, 95% CI: 0.72–0.93), and having reached puberty (OR = 0.26, 95% CI: 0.22–0.30) were associated with lower odds of stunting. For overweight and obesity, lower odds were found among females (OR = 0.48, 95% CI: 0.46–0.51) and older children, while higher odds occurred among those living in the Southeast (OR = 1.45, 95% CI: 1.36–1.53) and Mekong River Delta (OR = 1.35, 95% CI: 1.24–1.48) regions. Early sleep (OR = 0.91, 95% CI: 0.87–0.95) and sports participation (OR = 1.07, 95% CI: 1.02–1.11) showed modest associations, whereas vitamin K2 use and puberty were not significant predictors. Conclusions: Vietnamese school-aged children face a significant rate of malnutrition, with regional, gender, and age disparities.