This study examines public support—and its drivers—for comprehensive policy packages (i.e., bundles of coherent policy measures introduced together) aimed at improving food environments.

Participants completed an online survey with a choice-based conjoint experiment, where they evaluated pairs of policy packages comprising up to seven distinct food environment measures. After choosing a preferred package or opting for a single policy, participants designed their ideal policy package. Based on their choices, respondents were categorized as resistant, inclined, or supportive towards policy packaging according to their frequency of opting out for single measures and the number of policies they included in their ideal package.

The study was conducted in Germany via an online survey.

The sample included 1,200 eligible German voters, recruited based on age, gender, and income quotas.

Based on both opt-out frequency (44.7%) and ideal policy packaging (72.8%) outcomes, most respondents were inclined towards policy packages. The inclusion of fiscal incentives and school-based measures in packages enhanced support, while fiscal disincentives reduced it. Key drivers of support included beliefs about the importance of diet-related issues and the role of government in regulation, while socio-demographic factors, political leaning, and personal experience with diet-related disease had minimal impact.

The results reveal public appetite for policy packages to address unhealthy food environments, contingent on package design and beliefs about the issue’s severity and legitimacy of intervention. Public health advocates should design and promote policy packages aligned with public preferences, especially given anticipated opposition from commercial interests.

To investigate the co-existence of single and multiple anthropometric failures among children using an extended composite index of anthropometric failure (ECIAF). This study aims to elucidate the complex interplay between child-specific and maternal factors, highlighting the multifaceted nature of childhood malnutrition.

A multicentre cross-sectional study as part of the BESLEN project

Mother-Child Education Centre in the Pendik district of Istanbul, Türkiye

1283 children (preschool children, n 822, school-aged children, n 462) and 1044 mothers

Almost 1/3 of the children included in the study had an anthropometric failure as determined by ECIAF. Weight excess was the leading cause of the total anthropometric failures, most of which were observed to be slightly higher in boys, except for stunting only and co-occurrence of stunting and underweight. Among the mother-related factors, including higher BMI and WC, low maternal age at delivery, low number of children in the household, and being a single parent may be considered predisposing factors to any phenomenon of childhood malnutrition. Among child-related factors, birth weight being ≥ 3500 grams had a higher risk for ECIAF failure, and children aged ≥ 60 months were more likely to experience stunting and underweight, while those < 60 months had a higher prevalence of weight excess.

The co-existence of stunting and overweight, the occurrence of weight excess in one in three stunted children, and the high risk of central obesity are public health concerns. Also, ECIAF can better assess all aspects of childhood malnutrition than conventional measures.

Despite bold commitments to reduce anemia, little change in prevalence was observed over the past decade. We aimed to generate subnational maps of anemia among women of reproductive age (WRA), malaria transmission, and hemoglobinopathies to identify priority areas, but also explore their geographical overlap.

Using the most recent Demographic and Health Surveys (DHS), we first mapped anemia clusters across Sub-Sahara Africa (SSA) and identified the WCA as a major cluster. Geographic clusters with high anemia and related etiologic factors were identified using spatial statistics. Multilevel regression models were run to identify factors associated with any, moderate and severe anemia.

West and Central African countries (n=17).

WRA (n= 112,024) residing in 17 WCA countries.

There was a significant overlap in geographical clusters of anemia, malaria, and hemoglobinopathies, particularly in the coastal areas of the WCA region. Low birth interval (0.86 [0.77, 0.97]), number of childbirth (1.12 [1.02, 1.23]), being in the 15-19 age range (1.47 [1.09, 1.98])) were associated with increased odds of any anemia. Unimproved toilet facility and open defecation were associated with any anemia, whereas the use of unclean cooking fuel was associated with moderate/severe anemia (P<0.05). Access to health care facility, living in malaria prone areas, and hemoglobinopathies (HbC and HbS) were all associated with any, moderate or severe anemia.

Interlinkages between infection, hemoglobinopathies, and nutritional deficiencies complicate the etiology of anemia in the WCA region. Without renewed efforts to integrate activities and align various sectors in the prevention of anemia, progress is likely to remain elusive.

To characterize the nature of digital food and beverage advertising in Singapore

Food and beverage advertisements within 20 clicks on top 12 non-food websites and all posts on Facebook and Instagram pages of 15 major food companies in Singapore were sampled from January 1 to June 30, 2018.

Advertised foods were classified as being core (healthier), non-core or mixed-dishes (example burger) using the WHO nutrient profile model and national guidelines. Marketing techniques were assessed using published coding frameworks.

Advertisements (n=117) on the 12 non-food websites were largely presented as editorial content. Food companies posted twice weekly on average on social media sites (n=1261), with eatery-chains posting most frequently and generating largest amount of likes and shares. Key marketing techniques emphasized non-health attributes for example hedonic or convenience attributes (85% of advertisements). Only a minority of foods and beverages advertised were core foods (non-food website:16.2%; social media: 13.5%).

Top food and beverage companies in Singapore actively use social media as a platform for promotion with a complex array of marketing techniques. A vast majority of these posts were unhealthy highlighting an urgent need to consider regulating digital food and beverage advertising in Singapore.

Recent studies have shown that inclusion of eggs in young children’s diet can help meet nutritional requirements associated with cognitive development. This study aims to investigate the effect of egg consumption on Early Childhood Development (ECD) using Ages and Stages Questionnaire-3(ASQ-3) in Burkina Faso.

The study presented here uses data collected during a follow-up of the Un Oeuf-a 3 arm clustered randomized controlled trial (RCT), conducted roughly four months after the end of the RCT.

This research was conducted in 18 rural villages within the Kaya Department of the Sanmatenga Province in Burkina Faso.

Participants of this study include a total of 244 children aged between 18-33 months, with 78 children in the full intervention group, 83 in the partial group, and 83 in the control group.

Results show that children with consistent egg consumption (in all months) had a lower odd of falling below the cut-off scores in gross motor (OR = 0.13, p = 0.02) and personal social skills (OR = 0.34, p = 0.05). And a dose response was established; for each additional egg/week, a 1.9% increase in scores for problem-solving skills was observed.

Findings from this study contribute to a growing body of evidence that increasing egg consumption among children in LMICs can improve growth and development. The study highlights the need for additional research in LMICs to better understand the multifactorial relationship between diet and childhood development.

To assess associations between dietary fat quality indices (FQI) and risk of pre-diabetes and type 2 diabetes mellitus (T2DM) among Iranian adults.

Daily intakes of fatty acids were estimated using a validated food frequency questionnaire with 168 food item. Adjusted hazard Ratios (HRs) and 95% confidence intervals (CIs) of pre-diabetes and T2DM were calculated in tertile categories of dietary FQI including atherogenic index (AI), thrombogenic index (TI), health promoting index (HPI), ratio of poly-unsaturated fatty acids to saturated fatty acids (PUFA/SFA) and ratio of hypo and hypercholesterolemia (h/H).

Tehran Lipid and Glucose Study.

Iranian men and women.

Mean (±SD) age of the 2042 pre-diabetes-free participants in pre-diabetes analysis was 38.84 (12.97), and 55.2% were women. In T2DM analysis, mean (±SD) age of the 2295 T2DM-free participants was 40.06 (13.42), and 54.6% of them were women. In the crude model, PUFA/SFA ratio was positively associated with T2DM incidence (HR=1.43, 95% CI: 1.04-1.98). However, after adjustment for confounding variables, there were no significant associations between dietary FQI and risk of pre-diabetes and T2DM.

We found no significant association between FQI and risk of pre-diabetes and T2DM. Further prospective and clinical trial studies are needed to clarify the issue.

To co-design support strategies to enable sustainable, healthy, affordable food provision, including waste mitigation practices, in Australian Early Childhood Education and Care (ECEC) settings.

Based upon the co-design IDEAS framework (Ideate, DEsign, Assess & Share), this co-design process involved iterative interviews and focus groups with ECEC centre staff, and workshops with Nutrition Australia. Interview and workshop themes were coded to the Theoretical Domains Framework (TDF) to develop initial prototypes for support strategies that were further developed and refined in focus groups.

ECEC with onsite food provision, in Victoria, Australia.

ECEC staff and a Victorian Government funded program delivered through Nutrition Australia that provides nutrition support to ECEC services.

ECEC staff interviews (n=17) suggested a lack of knowledge on the topic of sustainable healthy food provision and a need for resources and support for all staff and children. Workshops with Nutrition Australia built on interviews and suggested a focus on lower intensity strategies, and a suggestion to embed knowledge-related activities into the children’s curriculum. Focus groups (n=8) further informed co-design of strategies, producing a visual representation of sustainable healthy food provision with supporting tips and a whole-of-centre approach that includes children through a classroom activity.

The co-designed resources could provide feasible strategies for the adoption of sustainable, healthy and affordable provision practices in the ECEC setting. Involvement of a local government-funded health promotion service provides valuable research-to-practice contribution as well opportunity for scalable dissemination of resources through existing infrastructure.

For the past three decades, India has implemented several nutrition programs to address malnutrition in the under-fives. To understand the program’s impact, this study assesses the prevalence of acute malnutrition, MAM, and SAM, using MUAC among tribal children.

The survey was conducted in two tribal blocks (Desaiganj and Bhamragad) of the Gadchiroli district in Maharashtra to identify children registered in the ‘Anganwadi’ program.

A community-based cross-sectional survey was carried out.

The total sample size was 1055 children (aged 0-59 months).

The overall prevalence of SAM and MAM was 1.4% (n=15) and 9.8% (n=103). A higher prevalence of MAM was found in males (38.5%, n= 40) and females (27.1%, n= 28) in below 6 months. Additionally, a higher prevalence of MAM was observed in females (10.7%, n=113) compared to males (9.0%, n=95). The prevalence of SAM was significantly (p<0.001) higher in females (1.7%, n=18) than in males (1.0%, n=11). Children aged between 12 and 17 months were sixteen times more likely (OR=16.9, p<0.001, CIs=4.8-59.6) to have MAM (MUAC<12.5cm) than children aged between 6 and 11 months. Children from the Desaiganj block were significantly less likely (OR=0.4, p<0.001, CIs= 0.2-0.7) to have MAM compared to children from Bhamragad. Approximately 4% (n=42) of children were classified as critically malnourished.

There is an urgent need for block-level monitoring of MAM and SAM, as well as evaluation of existing nutrition programs, to address the disparity in the sex-specific prevalence of MAM and SAM in tribal areas.

Online 24-hour dietary recall tools are commonly used in nationwide nutrition surveys to assess population diets. With a steep rise in the development of new and more advanced 24-hour recall tools, the decision of which tool to use for a national nutrition survey becomes increasingly challenging. Therefore, this short communication outlines the process of selecting a 24-hour dietary recall tool for a national nutrition survey in New Zealand.

To identify suitable 24-hour dietary recall tools, a review of peer-reviewed and grey literature was conducted (2019-2022). Data on functionalities, validation, usability, and adaptability were extracted for 18 pre-specified tools, which were used in the subsequent evaluation process.

Six of the 18 tools had new relevant publications since 2019. The 14 new publications described six validation studies and eight usability studies. Based on pre-selection criteria (e.g., availability, adaptability, previous use in national surveys), three tools were shortlisted: ASA24, Intake24, and MyFood24. These tools were further evaluated, and expert advice was sought to determine the most suitable tool for use in the New Zealand context.

A comprehensive yet time- and cost-efficient approach was undertaken to identify the potential use of online 24-hour dietary recall tools for a national nutrition survey. The selection process included key evaluation criteria to determine the tools’ suitability for adaptation within the New Zealand context and ultimately to select a preferred tool. A similar approach may be useful for other countries when having to select 24-hour dietary recall tools for use in national nutrition surveys.

To quantify and compare concurrent within-person trends in lifestyle risks, nutrition status, and drivers of food choice among urban migrants in Central Asia.

We collected panel data on household structure, drivers of food choice, nutrition knowledge, and diverse measures of nutrition status and lifestyle risk from urban migrants at 0, 3, 6, and 9 months using harmonized methodology in two cities. Trends were analyzed using mixed-effects models and qualitatively compared within and between cities.

Ulaanbaatar, Mongolia and Almaty, Kazakhstan.

200 adults (22-55 years) who migrated to these cities within the past 2 years.

Adjusting for age and sex, each month since migration was positively associated with fasting triglycerides in Almaty (0.55 mg/dL; 95%CI: 0.13-0.94) and BMI (0.04 kg/m2; 95%CI: 0.01-0.07), body-fat (0.14%; 95%CI: 0.01-0.26), and fasting glucose (0.04 mmol/L; 95%CI: 0.02-0.05) and lipids in Ulaanbaatar (p<0.05). In Almaty, nutrition knowledge (measured using an objective 20-point scale) declined despite improvements in diet quality (measured by Prime Diet Quality Score). Influence of food availability, price, and taste on food choice increased in Almaty (p<0.05). Upon multivariable-adjustment, nutrition knowledge was positively associated with diet quality in Almaty and adherence to “Acculturated” diet patterns in both cities (p<0.05). Different trends in smoking, sleep quality, and generalized anxiety were observed between cities.

Findings indicate heterogenous shifts in nutrition, lifestyles, and drivers of food choice among urban migrants in Central Asia and provide an evidence base for focused research and advocacy to promote healthy diets and enable nutrition-sensitive food environments.

To understand the dietary patterns of adults and explore their association with iodine nutritional levels and thyroid function in adults.

We randomly collected 5 ml of adult urine samples and measured urinary iodine concentration by cerium arsenate-catalyzed spectrophotometry. A serum sample of 5 ml was collected for the determination of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH), and diet-related information was collected through a food frequency questionnaire. Dietary patterns were extracted by principal component analysis and the relationship between dietary patterns and iodine nutrition levels and thyroid function was explored.

A cross-sectional study involving adults in Xinjiang, China was conducted.

A total of 435 adults were enrolled in the study.

The overall median urinary iodine of the 435 respondents was 219.73 μg/L.The dietary patterns were PCA1 (staple food pattern), PCA2 (fruit, vegetable, and meat pattern), PCA3 (fish, shrimp, and legume pattern), and PCA4 (Dairy-based protein pattern). The correlation analyses showed that PCA1 and PCA3 were positively correlated with the urinary iodine concentration (UIC). The results of the multivariable analysis showed that PCA1, Q1, Q2, and Q3 were associated with an increased risk of iodine deficiency compared with Q4 [ (OR): 260.41 (95%CI: 20.16, 663.70)], 59.89 (5.64, 335.81), and 2.01 (0.15, 26.16), respectively]. In PCA2, Q3 was associated with an increased risk of iodine deficiency compared with Q4 [OR: 0.16 (0.05, 0.53)]. In PCA3, Q3 was associated with an increased risk of iodine deficiency compared with Q4 [OR: 0.23 (0.06, 0.90)]. In PCA4, Q1 was associated with an increased risk of iodine deficiency compared with Q4 [OR: 31.30 (4.88, 200.64)].

This study demonstrated that of the four dietary patterns, the least dependent staple food pattern (Q1) had a higher risk of iodine deficiency compared to the most dependent staple food pattern (Q4). However, the current evidence on the effect of dietary patterns on thyroid function needs to be validated by further longitudinal studies that include long-term follow-up, larger sample sizes, and repeated measures.

To understand the characteristics of food environments in the Pacific region, and the broader economic, policy, and sociocultural surroundings that influence food choices and interventions to improve food environments for Pacific communities.

Systematic searches were conducted for articles related to food environments or factors influencing food choices from 1993-2024 in five academic databases, Google, Google Scholar, and relevant organizations’ websites. Studies were included if they meet the eligibility criteria. Two authors independently reviewed the title and abstract of identified articles. Full-text screening was conducted before data was extracted from eligible studies. A narrative analysis was informed by an existing food environments framework.

Pacific Island countries or territories that are a member of the Pacific Community (SPC).

Not Applicable.

From the 66 included studies (of 2520 records screened), it was clear that food environments in the Pacific region are characterized by high availability and promotion of ultra-processed unhealthy foods. These foods were reported to be cheaper than healthier alternatives and have poor nutritional labelling. Food trade and investment, together with sociocultural and political factors, were found to contribute to unhealthy food choices. Policy interventions have been implemented to address food environments; however, the development and implementation of food environment policies could be strengthened through stronger leadership, effective multisectoral collaboration and clear lines of responsibility.

Interventions focused on improving physical, economic, policy, and sociocultural influences on food choices should be prioritized in the Pacific region to improve the food environment and mitigate barriers to healthy eating.

To investigate the relationship between violence and the nutritional status of pregnant women, and whether mental health could be a mediator in this relationship.

Cross-sectional study. Violence and mental health status were investigated using the following questionnaires: World Health Organization Violence Against Women (WHO-VAW), Abuse Assessment Screen (AAS), Patient Health Questionnaire (PHQ-9), and General Health Questionnaire (GHQ). Demographic, socioeconomic, obstetric, and lifestyle factors (smoking/alcohol consumption) were also investigated. The nutritional status of the women was assessed by the body mass index.

Data were collected from February 2021 to August 2022 in Araraquara city, Brazil.

Four hundred pregnant women recruited at 34 health units and the municipal maternity hospital.

Experience of violence was reported by 52.2% of the women and psychological violence in the last 12 months was the most prevalent type of domestic violence (19.5%). Approximately 43% of the women showed mental health changes and 59.7% had a risk of major depression. Women with mental health changes had an increased risk (OR=2.34) of obesity. Psychological violence in the last 12 months was associated with obesity (p=0.01) when mediated by mental health changes. The mediation effect was significant (β=0.708; 95%BCa CI=0.004-1.460), with mental health changes mediating 46.1% of the relationship between psychological violence and obesity.

The relationship between psychological violence and obesity during pregnancy was mediated by changes in mental health. This original study shows that nutritional status is not limited to biological factors and highlights the importance of social, mental, and psychological factors.

Growth faltering is widespread in many low- and middle-income countries, but its effects on childhood bone mass accrual are unknown. The objective of this study was to estimate associations between length (conditional length-for-age z-scores, cLAZ) and weight (conditional weight-for-age z-scores, cWAZ) gain in 3 age intervals (ages 0-6, 6-12, 12-24 months) with dual-energy x-ray absorptiometry (DEXA)-derived measures of bone mass (total-body-less-head (TBLH) bone mineral content (BMC), areal bone mineral density (aBMD), and bone area) at 4 years of age.

Associations between interval-specific growth parameters (cLAZ and cWAZ) and bone outcomes were estimated using linear regression models, adjusted for maternal, child, and household characteristics.

Data collection occurred in Dhaka, Bangladesh.

599 healthy children enrolled in the BONe and mUScle Health in Kids Study.

cLAZ in each age interval was positively associated with TBLH BMC, aBMD, and bone area at 4 years; however, associations attenuated towards null upon adjustment for concurrent height-for-age z-scores (HAZ) at age 4 years and confounders. cWAZ from 0-6 and 6-12 months was not associated with bone mass, but every SD increase in cWAZ between 12-24 months was associated with greater BMC (7.6g; 95%CI:3.2, 12.0) and aBMD (0.008g/cm2; 95%CI:0.003, 0.014) after adjusting for concurrent WAZ, HAZ, and confounders.

Associations of linear growth (birth to 2 years) with bone mass at age 4 years were explained by concurrent HAZ. Weight gain in the second year of life may increase bone mass independently of linear growth in settings where growth faltering is common.

Child undernutrition among under 5 aged children is a prevalent global issue, especially in Bangladesh. This study aimed to explore relationships of household environmental conditions (HECs) with child under-nutrition in Bangladesh, with a specific focus on rural-urban differences.

We analysed children’s data from the 2017/18 Bangladesh Demographic Health Survey (BDHS). The outcome variable considered were measures of child under-nutrition, including stunting, wasting, and underweight. The major exposure variable considered was indicators of HECs. We used a hierarchical Poisson regression model to explore the association between outcomes and exposures adjusted for potential confounders.

Nationally representative cross-sectional survey.

8,057 under-5 aged children.

The prevalence of stunting, wasting and underweight in Bangladesh was 31%, 8% and 22%, respectively, with significant urban-rural variations. Under-5 children who lived in houses constructed with unimproved materials (aRR: 1.17), exposed to household air pollution (HAP) (aPR: 1.37), had unimproved drinking water sources (aPR: 1.28), or had poor handwashing facilities (aPR: 1.24) had a greater likelihood of stunting compared to their counterparts. Similar associations were observed for underweight. The likelihood of stunting and underweight increased with increasing scores of poor HECs, varying significantly across urban-rural areas.

The high prevalence of stunting and underweight in Bangladesh is linked to poor HECs. Therefore, policies and programs aimed at reducing child undernutrition need to account for household environmental conditions, with a particular focus on children in poor household environments.

School-based interventions encouraging children to replace sugar-sweetened beverages (SSBs) with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure.

The Water First cluster randomized trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-hour recalls).

Eighteen elementary schools (serving ≤ 50% children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area.

Students in fourth-grade classes (n=1056).

Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (-0.04, confidence interval [CI] -0.08 to 0.01) compared to no CFI controls (0.01, CI -0.01 to 0.04) (p=0.04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86.2%, CI 21.7 to 185.0%) compared to high CFI controls (-13.6%, CI -45.3 to 36.6%) (p=0.02).

Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity.

To determine the associations among iron status, depressive/anxiety symptoms, and quality of life (QoL) throughout pregnancy.

This longitudinal study recruited participants in their 1st trimester (< 13 weeks; n=116) and followed in their 2nd (n=71) and 3rd (n=71) trimesters. Sociodemographic, food security, anxiety, depressive symptoms, and QoL questions were collected. Hemoglobin (Hb), ferritin (Ft), and transferrin saturation (TSAT) were determined. Women were categorized as iron improvers or non-improvers based on changes in iron status. Associations were assessed using difference-in-difference analyses.

Cape Coast, Ghana between October 2017 to September 2018.

Pregnant women, 18-38 years.

Improvement in Ft levels from the 1st to 2nd trimester were associated with reduced depressive symptoms (-2.96 vs -0.58, p=0.028), and higher overall QoL (13.99 vs 1.92, p=0.006) particularly role physical (23.32 vs -2.55, p=0.025) and role emotional (27.50 vs 10.06, p=0.025) subscales. Improvement in Hb levels during the same period were linked to less anxiety, particularly fear factor (-2.62 vs -0.51, p=0.020); and worsened physical health aspect of QoL (-21.80 vs -3.75, p=0.005). Improvement in TSAT levels from 2nd to 3rd trimester were associated with increased total anxiety (1.56 vs -0.64, p=0.030) and panic factor (0.45 vs -0.26, p=0.004) and decreased total QoL (-1.08 vs 7.94, p=0.017), specifically role physical (-10.98 vs 11.93, p=0.018).

Increases in iron status from first to second trimester were related to improvements in psychosocial wellbeing, implying potential benefit of iron supplementation on affect in early pregnancy. Larger studies are needed to confirm these findings.

To develop a web-based food frequency questionnaire (FFQ) measuring intake of plant-based protein foods (PBPs) among older adults from the province of Quebec, Canada.

The questionnaire was adapted from an existing self-administered FFQ and first underwent expert panel evaluation for face and content validity. Then, three phases of cognitive testing were conducted in French, using the probe and think aloud approaches. Between each phase, the questionnaire was modified based on participants’ feedback to improve the clarity and comprehension of the questions.

Quebec City, Quebec, Canada.

Twenty adults aged 65 years and older. Purposive sampling was used to maximize variation in sociodemographic characteristics, including gender, age, education level, and PBP consumption.

The expert panel found the 28-item questionnaire to be a comprehensive measure of PBP intake and suggested minor changes to improve its clarity. The cognitive interviews showed that our PBP-FFQ was generally well understood and identified issues requiring modifications to improve comprehension and accuracy.

Our FFQ provides a comprehensive measure of PBP intake, is well understood by older adults in Québec, and will support rigorous assessment of PBP intake in this population, but requires further validation to confirm validity and reproducibility.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old

Cross-sectional survey

A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta.

4001 children between 6 months and 11.9 years of age

Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI.

SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.