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

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) +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.