# Nutritional status and determinants among primary school students in the challenging terrain of northern mountainous Vietnam

## TL;DR

This study examines malnutrition among primary school students in northern Vietnam's mountainous region, finding high thinness rates and low obesity, linked to household income and unhealthy eating habits.

## Contribution

The study identifies household income and dietary habits as key factors in the dual burden of malnutrition among ethnic minority children in rural Vietnam.

## Key findings

- Thinness prevalence was 18.1% among primary school students in the study area.
- Lower household income was associated with higher odds of thinness in children.
- Consumption of sugary drinks and snacks correlated with BMI status in students.

## Abstract

Malnutrition remains a significant public health challenge among primary school students in the northern mountainous region of Vietnam. We conducted a cross-sectional survey in two primary schools in Trung Khanh District, Cao Bang Province (Trung Khanh Town: n = 476; Dam Thuy: n = 296). Anthropometry followed WHO protocols, and nutritional status was classified using the WHO 2007 growth reference (5–19 years) based on BMI-for-age Z-scores. A parent/guardian questionnaire captured household sociodemographics, parental nutrition knowledge, children’s dietary habits, and physical activity. In total, 772 students participated. Thinness prevalence was 18.1% (95% CI: 15.4–21.0), and overweight/obesity was 1.2% (95% CI: 0.5–2.3). In multivariable models, lower household income was associated with higher odds of thinness (aOR 0.57, 95% CI 0.36–0.88), while sugary-drink and snack consumption were key correlates of BMI status. Findings highlight the double burden of malnutrition in ethnic-minority settings and point to school- and household-level targets for intervention.

The online version contains supplementary material available at 10.1038/s41598-025-28827-4.