Nutr Res Pract.  2022 Oct;16(5):658-672. 10.4162/nrp.2022.16.5.658.

Double burden of malnutrition in ethnic minority school-aged children living in mountainous areas of Vietnam and its association with nutritional behavior

Affiliations
  • 1Department of Nutrition and Food Safety, University of Medicine and Pharmacy - Thai Nguyen University, Thai Nguyen 24000, Vietnam

Abstract

BACKGROUND/OBJECTIVES
Although children of ethnic minority groups are experiencing a transition from a predominance of undernutrition to overnutrition, there is little evidence of a dual-malnutrition burden. Therefore, this study examined the double burden of malnutrition among school-aged ethnic minority children living in mountainous areas and its association with their diets.
SUBJECTS/METHODS
A cross-sectional study was conducted from September 2019 to March 2020 in 3 mountainous areas of Northern Vietnam among 1,556 ethnic minority schoolaged children. The prevalence of under-nutrition (stunting and thinness) and over-nutrition (overweight and obesity) were measured using the WHO 2006 child growth standards (height-for-age and BMI-for-age Z-score). Nutritional practices were evaluated by the frequency of food consumption based on a 4-level scale.
RESULTS
The percentage of children with stunting and thinness were 14.0% and 5.4%, respectively, while the figure for overweight/obesity was 9.4%. The factors positively associated with stunting were living in a family with more than 2 children or being Muong/ other ethnicities compared to the Tay ethnicity. Children who consumed fish/shrimps/crabs or milk weekly/daily were less likely to be undernourished compared to those who never consumed these foods. By contrast, children who never consumed foods rich in vitamin A precursors and vitamin A and fruit or consumed daily snacks/junk food were more likely to be overweight/obese.
CONCLUSIONS
Undernutrition remains a common issue among school-aged children and adolescents of ethnic minority groups, while over-nutrition exists simultaneously. Public health nutrition programs promoting adequate diets and positive lifestyle changes related to nutrition are essential to tackle the double burden of malnutrition among ethnic minority children.

Keyword

Malnutrition; adolescent; ethnic and racial minorities; Vietnam

Figure

  • Fig. 1 Frequency of consuming different food types of ethnic minority school-aged children in mountainous areas.


Reference

1. World Health Organization. The World Health Report: 2002: Reducing the Risks, Promoting Healthy Life. Geneva: World Health Organization;2002.
2. World Health Organization. Double Burden of Malnutrition Policy Brief. Geneva: World Health Organization;2017.
3. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013; 382:427–451. PMID: 23746772.
Article
4. Song Y, Agardh A, Ma J, Li L, Lei Y, Stafford RS, Prochaska JJ. National trends in stunting, thinness and overweight among Chinese school-aged children, 1985-2014. Int J Obes. 2019; 43:402–411.
Article
5. Van Minh H, Mai VQ, Anh TT, Duyen NT, Tuyen LD, Mai TT, Phuong HN, Mustafa TS, Nwaigwe F, Phuong DH. The cost of implementing Vietnam’s national plan of action for nutrition for 2017-2020. AIMS Public Health. 2019; 6:276–290. PMID: 31637277.
Article
6. Zhou S, Ye B, Fu P, Li S, Yuan P, Yang L, Zhan X, Chao F, Zhang S, Wang MQ, et al. Double burden of malnutrition: examining the growth profile and coexistence of undernutrition, overweight, and obesity among school-aged children and adolescents in urban and rural counties in Henan Province, China. J Obes. 2020; 2020:2962138. PMID: 32148952.
Article
7. El-Kassas G, Ziade F. The dual burden of malnutrition and associated dietary and lifestyle habits among lebanese school age children living in orphanages in North Lebanon. J Nutr Metab. 2017; 2017:4863431. PMID: 28421143.
Article
8. United Nations Population Fund. Ethnic Groups in Viet Nam: An Analysis of Key Indicators from the 2009 Viet Nam Population and Housing Census. Hanoi: United Nations Population Fund;2011.
9. Mai TM, Pham NO, Tran TM, Baker P, Gallegos D, Do TN, van der Pols JC, Jordan SJ. The double burden of malnutrition in Vietnamese school-aged children and adolescents: a rapid shift over a decade in Ho Chi Minh City. Eur J Clin Nutr. 2020; 74:1448–1456. PMID: 32071399.
Article
10. Bundy DA, da Silva N, Horton S, Patton GC, Schultz L, Jamison DT. Child and Adolescent Health and Development: Realizing Neglected Potential. Washington, D.C.: World Bank;2017.
11. World Health Organization. Adolescent Nutrition: A Review of the Situation in Selected South-East Asian Countries. Geneva: World Health Organization;2006.
12. Moreno LA, Gottrand F, Huybrechts I, Ruiz JR, González-Gross M, DeHenauw S. HELENA Study Group. Nutrition and lifestyle in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Adv Nutr. 2014; 5:615S–23S. PMID: 25469407.
Article
13. Vicente-Rodriguez G, Libersa C, Mesana MI, Béghin L, Iliescu C, Moreno Aznar LA, Dallongeville J, Gottrand F. HELENA Study Group. Healthy lifestyle by nutrition in adolescence (HELENA). A new EU funded project. Therapie. 2007; 62:259–270. PMID: 17803895.
Article
14. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007; 85:660–667. PMID: 18026621.
Article
15. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization;2011.
16. Carreiro AL, Dhillon J, Gordon S, Higgins KA, Jacobs AG, McArthur BM, Redan BW, Rivera RL, Schmidt LR, Mattes RD. The macronutrients, appetite, and energy intake. Annu Rev Nutr. 2016; 36:73–103. PMID: 27431364.
Article
17. StataCorp LLC. Stata Statistical Software: Release 17. College Station (TX): StataCorp LLC;2021.
18. National Institute of Nutrition (VN). National Nutrition Survey of Vietnam 2019–2020. Hanoi: National Institute of Nutrition;2020.
19. National Institute of Nutrition (VN). National Nutrition Survey of Vietnam 2010. Hanoi: National Institute of Nutrition;2010.
20. Le TT, Le TT, Do NK, Nadezhda VS, Andrej MG, Nguyen TT, Nguyen TT, Vu TT, Le TH, Nguyen TT, et al. Ethnic variations in nutritional status among preschool children in Northern Vietnam: a cross-sectional study. Int J Environ Res Public Health. 2019; 16:4060.
Article
21. Mbuya NVN, Atwood SJ, Huynh PN. Persistent Malnutrition in Ethnic Minority Communities of Vietnam: Issues and Options for Policy and Interventions. Washington, D.C.: World Bank;2019.
22. Wamani H, Astrøm AN, Peterson S, Tumwine JK, Tylleskär T. Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatr. 2007; 7:17. PMID: 17425787.
Article
23. Thurstans S, Opondo C, Seal A, Wells J, Khara T, Dolan C, Briend A, Myatt M, Garenne M, Sear R, et al. Boys are more likely to be undernourished than girls: a systematic review and meta-analysis of sex differences in undernutrition. BMJ Glob Health. 2020; 5:e004030.
Article
24. Boulom S, Essink DR, Kang MH, Kounnavong S, Broerse JE. Factors associated with child malnutrition in mountainous ethnic minority communities in Lao PDR. Glob Health Action. 2020; 13:1785736. PMID: 32741342.
Article
25. Wang A, Scherpbier RW, Huang X, Guo S, Yang Y, Josephs-Spaulding J, Ma C, Zhou H, Wang Y. The dietary diversity and stunting prevalence in minority children under 3 years old: a cross-sectional study in forty-two counties of Western China. Br J Nutr. 2017; 118:840–848. PMID: 29189194.
Article
26. Kien VD, Lee HY, Nam YS, Oh J, Giang KB, Van Minh H. Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000-2011. Glob Health Action. 2016; 9:29263. PMID: 26950558.
Article
27. Le TT, Luu NH, Rheinländer T, Dalsgaard A, Konradsen F. Sanitation behavior among schoolchildren in a multi-ethnic area of Northern rural Vietnam. BMC Public Health. 2012; 12:140. PMID: 22353490.
Article
28. Rheinländer T, Samuelsen H, Dalsgaard A, Konradsen F. Hygiene and sanitation among ethnic minorities in Northern Vietnam: does government promotion match community priorities? Soc Sci Med. 2010; 71:994–1001. PMID: 20619522.
Article
29. Huong LT, Tuyet-Hanh TT, Minh HV, Ha BT, Anh NQ, Huong NT, Trang PT, Long KQ, Ha NT, Trang NT, et al. Access to improved water sources and sanitation in minority ethnic people in Vietnam and some sociodemographic associations: a 2019 national survey. Environ Health Insights. 2020; 14:1178630220946342. PMID: 32821114.
Article
30. Målqvist M, Hoa DT, Liem NT, Thorson A, Thomsen S. Ethnic minority health in Vietnam: a review exposing horizontal inequity. Glob Health Action. 2013; 6:1–19.
Article
31. National Institute of Nutrition (VN). Action Plan of Children Feeding from 2006–2010. Hanoi: National Institute of Nutrition;2006.
32. Minot N, Epprecht M, Anh T, Trung L. Income Diversification and Poverty in the Northern Uplands of Vietnam. Research Report of the International Food Policy Research Institute. Washington, D.C.: International Food Policy Research Institute;2006.
33. Huong T, Xuan TT, Phuong H, Huyen DT, Rocklöv J. Diet and nutritional status among children 24-59 months by seasons in a mountainous area of Northern Vietnam in 2012. Glob Health Action. 2014; 7:23121. PMID: 25511885.
Article
34. Huong L, Nga VT. Nutritional practices among ethnic minorities and child malnutrition in mountainous areas of Central Vietnam. Food Nutr Sci. 2013; 04:82–89.
Article
35. Prime Minister of Vietnam. Decision on approval of the school milk program to improve nutritional status contributes to improving the stature of preschool and primary school children until 2020. Number: 1340/QĐ-TTg. Hanoi: Vietnamese Government;2016.
36. Moore LL, Bradlee ML, Gao D, Singer MR. Effects of average childhood dairy intake on adolescent bone health. J Pediatr. 2008; 153:667–673. PMID: 18701115.
Article
37. Feskanich D, Bischoff-Ferrari HA, Frazier AL, Willett WC. Milk consumption during teenage years and risk of hip fractures in older adults. JAMA Pediatr. 2014; 168:54–60. PMID: 24247817.
Article
38. Berkey CS, Colditz GA, Rockett HR, Frazier AL, Willett WC. Dairy consumption and female height growth: prospective cohort study. Cancer Epidemiol Biomarkers Prev. 2009; 18:1881–1887. PMID: 19505921.
Article
39. Wiley AS. Does milk make children grow? Relationships between milk consumption and height in NHANES 1999-2002. Am J Hum Biol. 2005; 17:425–441. PMID: 15981182.
Article
40. Wikipedia. Tay People in Vietnam [Internet]. San Francisco (CA): Wikimedia Foundation, Inc.;2021. cited 2021 May 1. Available from: https://vi.wikipedia.org/wiki/Ng%C6%B0%E1%BB%9Di_T%C3%A0y.
41. Pham TT, Matsushita Y, Dinh LT, Do TV, Nguyen TT, Bui AT, Nguyen AQ, Kajio H. Prevalence and associated factors of overweight and obesity among schoolchildren in Hanoi, Vietnam. BMC Public Health. 2019; 19:1478. PMID: 31703653.
Article
42. Ha SA, Lee SY, Kim KA, Seo JS, Sohn CM, Park HR, Kim KW. Eating habits, physical activity, nutrition knowledge, and self-efficacy by obesity status in upper-grade elementary school students. Nutr Res Pract. 2016; 10:597–605. PMID: 27909557.
Article
43. Steele MM, Daratha KB, Bindler RC, Power TG. The relationship between self-efficacy for behaviors that promote healthy weight and clinical indicators of adiposity in a sample of early adolescents. Health Educ Behav. 2011; 38:596–602. PMID: 21474635.
Article
Full Text Links
  • NRP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr