Tan Pui Yee, Som Somphos Vicheth, Nguyen Son Duy, Tan Xiaomian, Tran Do Tranh, Tran Nga Thuy, Tran Van Khanh, Dye Louise, Moore J Bernadette, Caton Samantha, Ensaff Hannah, Lin Xiaodong, Smith Geoffry, Gong Yun Yun
School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK.
Section of International Health, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
BMJ Public Health. 2025 Feb 4;3(1):e001177. doi: 10.1136/bmjph-2024-001177. eCollection 2025.
INTRODUCTION: The double burden of malnutrition (DBM) is a global public health challenge. This study examined the prevalence of population-level DBM, its demographic and socioeconomic determinants as well as the associations between anthropometric indicators of undernutrition and overnutrition, and micronutrient deficiencies (MNDs), among Vietnamese children, using the data from the nationally representative General Nutrition Survey 2020. METHODS: Data on anthropometric parameters, micronutrient biomarkers, demographic and socioeconomic indicators for 7289 children aged 6 months to 9 years were analysed. Determinants of malnutrition were assessed using logistic regressions, reported as OR with 95% CIs. RESULTS: At national level, 12.7%, 10.5% and 4.7% of children were stunted, underweight and wasted/thin, while 7.3% and 7.1% were overweight and obese, respectively. Low serum zinc, anaemia and iron deficiency were the common MNDs observed, affecting 53.1%, 15.2% and 13.9% of the study participants. Older children aged 2-4 years (OR (95% CI) 1.43 (1.20, 1.72)), ethnic minorities (5.94 (3.78, 9.36)) and those 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 associated with underweight and MNDs. Males (1.43 (1.16, 1.76)), children aged 5-9 years (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 with 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.
引言：营养不良双重负担（DBM）是一项全球公共卫生挑战。本研究利用具有全国代表性的2020年综合营养调查数据，调查了越南儿童中人群层面DBM的患病率、其人口统计学和社会经济决定因素，以及营养不良和营养过剩的人体测量指标与微量营养素缺乏（MNDs）之间的关联。 方法：分析了7289名6个月至9岁儿童的人体测量参数、微量营养素生物标志物、人口统计学和社会经济指标数据。使用逻辑回归评估营养不良的决定因素，以比值比（OR）及95%置信区间（CIs）报告。 结果：在国家层面，12.7%、10.5%和4.7%的儿童发育迟缓、体重不足以及消瘦/瘦弱，而超重和肥胖儿童分别占7.3%和7.1%。血清锌水平低、贫血和缺铁是观察到的常见MNDs，分别影响了53.1%、15.2%和13.9%的研究参与者。2至4岁的大龄儿童（OR（95%CI）1.43（1.20，1.72））、少数民族儿童（5.94（3.78，9.36））以及生活在山区的儿童（5.06（1.18，14.42））发育迟缓的几率增加，而最富裕五分之一家庭的儿童发育迟缓几率降低（0.13（0.05，0.32））。类似的决定因素与体重不足和MNDs相关。男性（1.43（1.16，1.76））、5至9岁儿童（10.02（6.71，14.97））以及最富裕五分之一家庭的儿童（2.91（1.20，7.05））超重几率增加。与无MNDs的儿童相比，贫血、血清视黄醇水平低和血清锌水平低的儿童发育迟缓和体重不足的几率增加（调整后OR = 1.43 - 1.71）。与无MNDs的儿童相比，患有≥3种MNDs的儿童发育迟缓和体重不足的几率几乎翻倍，而患有≤3种MNDs的儿童超重几率降低（调整后OR = 0.38 - 0.60）。 结论：确定了儿童营养不良方面显著的人口统计学差异和社会经济不平等。越南的国家政策和计划应解决特定年龄、性别、地理和社会经济方面的差距，以加快在减少儿童营养不良方面取得进展。
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