Table 4.
Findings on the determinants associated with different forms of malnutrition in Vietnamese children aged 0–18 years old
| Authors and year | Study duration & design | Sample age | Sample size | Measurements | Key findings – risk factors / determinants | Risk of bias |
|---|---|---|---|---|---|---|
| Hanieh et al. 2015 [44] | Prospective longitudinal | 6 months | 1,046 | Length, weight, and LAZ |
Positive association between infant LAZ scores at 6 months and maternal BMI (coefficient 0.04 kg/m2, CI = 0.01–0.07), weight gain during pregnancy (0.04/kg, CI = 0.01–0.06) and maternal ferritin concentration (− 41.5 g/twofold increase in ferritin, CI = − 78 to − 5.0) Inverse association between maternal 25-(OH)D concentration and infant LAZ scores (coefficient − 0.06 per 20 nmol/L, CI = -0.11 to -0.01) No association between maternal iodine status & infant LAZ |
Low |
| Vaktskjold et al. 2010 [26] |
Prospective cohort 2005–2006 (1 year) |
0–1 year | 237 | Weight, height, LAZ, WHZ, and BMI-Z | Lower LAZ (β = -2.2, CI = -4.0 to -0.5) and WAZ (-0.5, CI = -1.0 to -0.1) were statistically associated with living rurally | Low |
| Hien and Hoa 2009 [11] | Cross-sectional | 0–3 years | 383 | Weight and height | Positive association between being underweight and rural living region (OR = 2.22), minority ethnicity (OR = 1.74), mother’s occupation-housewife (OR = 7.91), household size ≤ 4 (OR = 3.07), underweight mother (OR = 1.95), number of children in the family ≥ 3 (OR = 3.35), low birth weight < 2500 g (OR = 7.99), exclusive breastfeeding duration < 6 months (OR = 4.41) and initiation of breastfeeding after 1 hour (OR = 2.54) | Medium |
| Tran 2008 [45] | Cross-sectional | 0–3 years | 547 | Height, weight and questionnaire | Positive association between fathers not taking children to a medical facility for immunisation and being underweight or stunted (OR = 1.75, CI = 1.07–2.87) | Low |
| Khan et al. 2007 [23] |
Repeat cross-sectional 1990–2005 (14 years) |
0–5 years | 357,396 | Weight, height and BMI |
Higher prevalence of underweight, stunting and wasting in rural and mountainous areas than urban areas. Larger rates of reduction of underweight, stunting and wasting in urban areas, than rural and mountainous areas Household size and being a male are all both positively associated with being stunted (β = -0.1543, p = 0.0001) |
Low |
| Nguyen et al. 2014 [28] | Cross-sectional | 0–5 years | 4,029 |
Weight and height Maternal CMD |
Maternal CMD was positively associated with underweight children (OR = 1.27, CI = 1.01–1.61). Low birth weight was positively associated with stunting (OR = 3.71, p < 0.001), underweight (OR = 3.96, p < 0.001), and wasting (OR = 3.61, p < 0.001). Poor household wealth was positively associated with underweight (OR = 1.99, p < 0.01) | Low |
| Huong et al. 2014 [35] | Repeat cross–-sectional—seasons | 2–4.9 years | 853 | Weight, height and BMI | Summertime is positively associated with being underweight (p < 0.05) and stunted (p < 0.05) | Low |
| Chen 2021 [51] |
Young Lives Study Longitudinal 2002–2006 (4 years) |
1–6 years | 2,000 | Weight, height, WAZ, HAZ and WHZ | Negative association between malnutrition and family size; having one additional child is associated with declines of the first child’s HAZ (0.49 SD) and WAZ (0.57 SD) | Medium |
| Kim et al. 2022 [30] | Cross-sectional | 3–4 years | 103 | Weight, height, physical activity and sedentary behaviour | Children not meeting screen time guidelines were at a higher risk of being overweight/ obese but was not significant (OR = 0.94, p = 0.904) | Low |
| Lavin et al. 2017 [49] |
Longitudinal cohort study 8 years |
0–8.5 years | 1,812 | Weight, height and HAZ | Positive associations with moderate/severe stunting were found in low birth weight (OR = 0.114, p = 0.001), food shortages (OR = 0.048, p < 0.001), rural location (OR = 0.068, p < 0.001), decreasing wealth (OR = 0.080, p = 0.008) and ethnic minority (OR = 0.077, p < 0.001) | Low |
| Bennett et al. 2015 [46] | Young Lives Longitudinal Cohort study 2001–06 | 1–8 years | 1,961 | Weight, height, questionnaire and risk of maternal CMD | Maternal CMD is positively associated with stunting at age 1 (ARR = 1.24, CI = 1.03–1.62), age 8 (1.22, CI = 1.03–1.45) | Low |
| Dearden et al. 2017 [48] | Longitudinal | 1–8 years | 1,905 | Height, weight and BMI-Z | Improved access to water at 1 year old was negatively associated with stunting at 1 (RR = 0.27–1.20), 5 (RR = 0.25–1.17) and 8 (RR = 0.25–1.42) years old | Low |
| Huynh et al. 2011 [63] |
Cohort study 2005–2006 |
4–5 years | 526 |
Weight, height, SSF: SSFT, TSFT and suprailia Questionnaire: physical activity level |
BMI and SSF were negatively associated with neighbourhood safety for boys (β = -0.80, CI = –1.53 to –0.08) and girls (β = -0.59, CI = -1.16 to -0.01) Boys increasing BMI was positively associated with both parents being overweight (β = 1.18, CI = 0.21–2.16) Availability of food at home was associated with increased BMI in girls (β = 1.23, CI = 1.91–0.55) but not boys |
Medium |
| Nguyen et al. 2013 [8] |
SEANUTS multi-stage cluster-randomised sampling |
0.2–11.9 years | 2,872 |
Weight, height, mid-upper arm circumference, waist and hip circumferences Blood: Hb, serum ferritin, vitamin A and D |
Positive association between undernutrition and rural habitation (p < 0.05) Positive association between overnutrition and urban habitation (p < 0.05) Ferritin: significantly higher levels in urban girls than urban boys (p < 0.05) and significantly higher levels in urban children than rural children (p < 0.05) aged 6–11.9 years |
Low |
| Nguyen et al. 2021 [52] | Cross-sectional, follow up | 6–7 years | 1,579 |
Weight, height and BMI Maternal weight, height and BMI |
Preconception maternal nutritional status is positively associated with child attained size at age 6–7. Child HAZ was positively associated with maternal height (+ 0.28 SD) and BMI (+ 0.13 SD), and faster linear growth at age 6–25 months (β = 0.39–0.42) | Low |
| Trinh et al. 2021 [53] | Longitudinal | 5 months – 13 years | 2,000 | Rainfall data (flooding, drought), weight, height, BMI, HAZ and WAZ |
Positive association between flooding and being stunted (RR = 0.122, p < 0.01) and underweight (RR = 0.067 p < 0.01). Positive association between droughts and stunting (RR = 0.127, p < 0.01) Rainfall shocks can impact parental mental health, increasing the probability of child being underweight by 0.976 (p < 0.001) |
Medium |
| Hoang et al. 2019 [67] | Cross-sectional | 6–9 years | 839 |
Weight and height Blood: Hb and mean corpuscular volume |
Underweight, stunting and wasting were all positively associated with anaemia (p < 0.004), specifically normocytic anaemia (p < 0.006) No significant association between anaemia and demographic indicators or socio-economic indicators |
Low |
| Nguyen 2022 [50] | Cross-sectional | 0–15 years | 158,019 | Height, weight, HAZ and WAZ | Preschool attendance is negatively associated with prevalence of underweight (p = 0.079) and stunting (p = 0.079) at 2–15 years | Medium |
| Krishna et al. 2015 [47] | Longitudinal– | 6 months—15 years | 2,489 | Weight, height and HAZ | Wealth index is positively associated with growth in children | Low |
| Mai et al. 2003 [33] | Cross-sectional 1999 | 7–9 years | 348 girls | Weight, height, WAZ, HAZ, WHZ and LMAC | Positive association between rural living and being underweight (OR = 4.5, p < 0.001), stunted (OR = 7.9, P < 0.001), wasted (OR = 2.4, p = 0.039) or undernourished (OR = 3.0, p = 0.045) | Low |
| Van Lierop et al. 2008 [62] | Cross-sectional | 6–10 years | 2,631 | Weight, height and waist circumference |
21.4% were stunted, and higher prevalence was found in rural regions (23.8% vs 17.3%, p < 0.001) Living in urban areas is positively associated with being overweight (4.6% vs 1.6%, p < 0.001) |
Low |
| Le and Dinh 2022 [39] | Cross-sectional, two-stage cluster random sampling | 6–11 years | 782 | Questionnaire, weight, height, and BMI-Z |
Significant positive association between male and childhood obesity (OR = 2.48, p < 0.0001) Positive association between overweight/ obesity and children who live with only their father (OR = 11.96, p = 0.0219), transport to school being inactive (motorbike/car/bus) (OR = 1.58, p = 0.0096) and mother’s occupation being white collar (OR = 1.56, p = 0.004) |
Low |
| Hung et al. 2005 [65] |
Longitudinal 1997–2000 (3 years) |
0–17 years | 2,767 |
Blood: Hb and ferritin Malaria and intestinal helminth infection (worms) |
Malaria is significantly positively associated with anaemia (OR = 2.408, p = 0.0006) No significant association between intestinal helminth & anaemia |
Medium |
| Hall et al. 2001 [32] | Cross-sectional | 7–11 years | 588 | Blood: Hb levels |
Anaemia is positively associated with boys: Aged 7–11 years (RR = 1:07, CI = 1.10–1.13) Aged 12–14 years (1.18, CI = 1.12–1.24) Aged ≥ 15 years (1.30, CI = 1.16–1.46) |
Medium |
| Mai et al. 2020 [21] |
Cross-sectional 2014–2015 |
6–18 years | 10,949 | Weight and height |
Positive association between overweight status, urban living (p < 0.001), and male (p < 0.001) Positive association between underweight status and rural living (p < 0.001) |
Low |
| Trang et al. 2012 [56] |
Longitudinal study 2004–2009 (5 years) |
11–14 years | 759 | Weight, height, BMI, questionnaire: level of physical activity and socio-economic status | Levels of ‘moderate-to-vigorous physical activity’ are negatively associated with overweight/ obesity (RR = 0.60, CI = 0.53–0.67) | Low |
| Tang and Dibley 2022 [59] | Longitudinal | 10–15 years | 482 |
Weight, height and BMI SSF: SSFT and TSFT |
Male at higher risk for higher BMI than girls (p = 0.006) Inactive adolescents at higher risk of gaining weight than active adolescents; TSFT (RR = 1.43, CI = 1.22–1.67), SSFT (1.09, CI = 1.00–1.18) and BMI (1.06, CI = 1.02–1.10) |
Low |
| Tang et al. 2020 [57] | Cross-sectional | 10–15 years | 2,660 |
Weight, height and BMI SSF: SSFT and TSFT |
Overweight status was positively associated with boys (p < 0.0001) TSFT & SSSF significantly higher in girls than boys (p < 0.0001) |
Low |
| Nguyen et al. 2022 [58] | Cross-sectional | 11–15 years | 2,660 | Weight, height and consumption of sugar-sweetened beverages (SSBs) | Negative association between overweight/ obese status and consumption of milk based SSBs. Every kcal more of fresh milk with sugar & condensed milk, can reduce the obesity odds of 0.005 (CI = 0.002–0.008) | Low |
| Hong et al. 2007 [40] |
Repeated cross-sectional 2002–2004 |
11–16 years | 3,687 | Weight, height and BMI |
Positive association between increase in overweight/ obesity and male: 113% increase (p < 0.001) Significant difference in the increase in prevalence by gender: obesity and overweight in males increased by 113%, with only a 39% increase in girls Poorer households showed smaller increase in obesity/overweight at 33%, compared to wealthier households at 77–124% |
Low |
| Tang et al. 2007 [61] | Cross-sectional | 11–16 years | 1,504 | Weight, height and BMI-Z |
Being male is positively associated with being underweight (p = 0.001) Non-significant association between being male and being overweight or obese (p = 0.074) Positive association between living in wealthy urban districts and being overweight/ obese (p < 0.001) |
Low |
| Trang et al. 2009 [55] | Cross-sectional | 11–16 years | 2,684 | Weight, height, questionnaire: physical activity levels, and family characteristics | Being overweight is positively associated with physical inactivity (OR = 2.5, CI = 1.9–3.2), passive transport to school (OR = 4.2, CI = 3.3–5.2), no recess exercise (OR = 1.3, CI = 1.1–5.6), time spent playing video games (OR = 2.3, CI = 1.7–3.1), or watching television (OR = 1.5, CI = 1.2–1.9) | Low |
| Van Nhien et al. 2009 [41] | Cross-sectional | 11–17 years | 245 girls |
Weight and height Blood: serum Hb and selenium |
Anaemia is positively associated with selenium deficiency (OR = 5.36, CI = 2.57–11.18), being underweight (2.72, CI = 1.37–5.37) and years of age (1.35, CI = 1.14–1.59) in girls | Low |
| Tran et al. 2017 [64] | Cross-sectional | 12–17 years | 1,851 | Weight, height and memory tests |
No significant association between child maltreatment and overweight or underweight status Underweight status is negatively correlated with working memory (r = -0.07, p < 0.01) and academic performance (r = -0.08, p < 0.01) Overweight status is positively associated with male (OR = 1.39, p = 0.00) and negatively associated with rurality OR = 0.66, p = 0.04) |
Low |
BMI body mass index, BMI-Z body mass index for-age-Z score, CI confidence interval, CMD common mental disorder, HAZ height-for-age-Z score, Hb haemoglobin, MUAC mid upper arm circumference, LAZ length-for-age-Z score, LMAC left mid arm circumference, OR odds ratio, RR relative risk, SSF skinfold thickness, SSSF subscapular skinfold thickness, TSFT tricep skinfold thickness, WAZ weight-for-age-Z score, WHZ weight-for-height-Z score