31 (2023) 200184

Contents lists available at ScienceDirect

Human Nutrition & Metabolism

journal homepage: www.sciencedirect.com/journal/human-nutrition-and-metabolism

The prevalence of obesity among school-aged children in Vietnam: A

systematic review and meta-analysis
Thi Van Anh Tran a, 1, Thi Quynh Chi Vu b, 1, *, Quang Duc Tran c, Duc Tam Nguyen d,
Ngọc Quang Phan e
a
Faculty of Clinical Medicine, Nam Dinh University of Nursing, Nam Dinh, 420000, Viet Nam
b
Nutrition Department, Dong A University, 33 Xo Viet Nghe Tinh Road, Hai Chau District, Danang, 550000, Viet Nam
c
Independent Scholar, Tokushima, Japan
d
Department of Pediatrics, Thai Binh University of Medicine and Pharmacy, Thai Bình, Viet Nam
e
The Center Service for Technology Science of Medi-Phar., Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam

A R T I C L E I N F O A B S T R A C T

Keywords: Aim: The global incidence of obesity is rising, posing a substantial public health threat. This meta-analysis aim to
Obesity estimate of the prevalence of obesity among school-aged children in Vietnam and to analyze the risk variables
Vietnam that have been linked to this problem.
Meta-analysis
Method: MEDLINE, PubMed, and Scopus were used to identify articles published up to May 2022. According to
School-age
Children
peer-reviewed literature, studies reported the proportion of obesity among Vietnamese school-aged children. The
Scales of Newcastle-Ottawa Quality Assessment was used to evaluate the study quality for all qualifying research.
The data was analyzed using R-Studio software, and the combined effects were estimated using a random-effects
model. Cochran’s Q-test and the I2 test were employed to examine heterogeneity. Egger’s test was used to
determine publication bias.
Results: Eleven studies with 27,363 participants were suitable for inclusion in the final model after meeting the
prerequisites. The proportion of obesity among Vietnamese school-aged children was 13.08% (95% CI, 7.04%–
23.01%) with higher heterogeneity through the observed prevalence estimates (Q = 1,0339, p < 0.01, I2 =
99%). A higher prevalence was observed in boys (17.5%) than in girls (8.07%). Male gender of the children: 2.42
(95%CI: 1.43–4.09), mothers have less education: 2.63 (95% CI 1.52–4.55) have shown a positive association
with the development of obesity among children.
Conclusions: The recent pooled analysis of studies demonstrates that school-aged children in Vietnam have a high
prevalence of obesity. The male gender and the low education status of the mother were found to be significantly
associated with obesity. The findings provide evidence for prevention intervention strategies to reduce obesity in
school-age children.

1. Introduction reducing their quality of life. They also have lower self-esteem when it
comes to their looks.
Obesity is a significant public health problem in many developed and The World Health Organization (WHO) defines obesity as an
developing countries. It is also linked to developing diseases, including abnormal or excessive fat buildup that may negatively affect health. The
type II diabetes, cardiovascular diseases, stroke, and other metabolic prevalence of overweight and obesity in children has rocketed from 4%
disorders [1]. Obesity in children is also a cause for concern since excess (1975) to 18% (2016), and around 340 million kids were overweight or
fat mass may damage many of the body’s systems from a young age [2]. obese worldwide in 2016 [1]. From 1999 to 2016, the percentage of
Obese children have a higher chance of becoming obese adults; obese American children who were overweight or classified as having class III
children may find moving and breathing difficult and unpleasant, obesity rose dramatically [3]. In 2030, it is predicted that around 33% of

* Corresponding author.
E-mail address: [email protected] (T.Q.C. Vu).
1
Co-first author with equal contribution.

https://doi.org/10.1016/j.hnm.2023.200184
Received 26 July 2022; Received in revised form 20 December 2022; Accepted 10 January 2023
Available online 27 January 2023
2666-1497/© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

children ages 6 to 11 will be overweight or obese [4]. From 1999 to b) Participants were abroad Vietnamese people living in countries other
2016, most European nations had high rates of overweight/obesity in than Vietnam.
children aged 2–13, notably in Mediterranean countries 25% of fat c) The studies journal on self-reported obesity
children were seriously obese [5,6]. High rates of childhood overweight
and obesity have also been documented in other nations’ data (including 2.5. Quality assessment
Spain [7], China [8], Greece [8], and Poland [8]). Obesity has been an
increasing issue in Asia countries for over a decade [9]. One of the For the cross-sectional investigation, TQD, NDT, and PNQ separately
reasons for rapid rises in the incidence of obesity may be influenced by assessed the methodological quality of the eligible articles using the
changing eating habits, food availability, Western dietary influences, Newcastle-Ottawa Scale. The scale evaluates three domains, including
and lack of physical activity. It is generally agreed that kid obesity is a the representativeness of investigated subjects, the comparability, and
global problem that calls for immediate efforts and realistic remedies. the outcome. The cross-sectional study received a maximum score of 8
In Vietnam, obesity has increasingly become a major public health points. The eligible studies were then divided into three categories: high
issue. The prevalence of overweight and obesity in children aged 5–19 (more than 7 points), moderate (4 points to 6 points), and poor (0 point
years increased from 8.5% (2010) to 19.0% (2020) [10]. Hence, to 3 points) in terms of overall quality scores [14]. VTQC and TTVA
assessing the prevalence is important to explore the diversity of factors determined any disagreements between the two reviewers concerning
that contribute to the onset of childhood obesity and necessary. To date, the methodology and evidence score of the eligible articles.
no systematic research has been done in Vietnam to consider the prev­ Obesity among Vietnamese children has been assessed following the
alence of the obesity problem among school-aged children. Performing diagnostic criteria of the World Health Organization (WHO) and Obesity
analysis and evaluating the proportion of obesity among school-age Task Force (IOTF) [11,12]. The WHO classifications for overweight and
children is essential to provide data that could influence decisions obesity: Children above 1 standard deviation (SD) are described as being
about suitable interventions. Therefore, the objective of this review was “at risk of overweight”, above 2SD as overweight, and above 3SD as
to conduct a systematic review and meta-analysis to estimate the prev­ obese. For the IOTF model, the definitions for overweight and obesity
alence of obesity among Vietnamese school-aged children according to were taken as BMI 25 and BMI 30, respectively.
two diagnostics criteria: World Health Organization (WHO) [11] and The main finding of this study was the prevalence of obesity among
Obesity Task Force (IOTF) [12]. school-aged children. R-studio Desktop version 2021.09.21 was used for
all analyses, together with the meta and meta-for packages. Cochran’s Q
2. Materials and methods statistic and the I2 test were used to determine heterogeneity; if there
was no significant heterogeneity (I2 50%, P > 0.1), a fixed-effects model
2.1. Protocol was employed; otherwise, a random-effects model was utilized.

To guarantee that the review process was transparent and thorough, 3. Results
the approach for this systematic review was created based on the prin­
ciples and proposals given out in the Preferred Reporting Items for 3.1. Results of the search
Systematic Reviews and Meta-Analyses guidelines (PRISMA) [13].
All of the databases examined in this investigation yielded a total of
2.2. Search strategy 124 possibly relevant articles. After removing duplicates, 93 results
were examined extensively. Research titles and abstracts were examined
A rigorous systematic literature search of the PubMed, Scopus, for research methodology, research site, and the outcome of interest.
Medline, and WHO databases were conducted for the paper published in Following the screening of titles and abstracts, 40 studies remained to be
English up to and including May 2022, combining the keywords and assessed in their full-text, of which 16 studies did not report prevalence
medical subject headings: Vietnam, Vietnamese, children, pediatric, for outcomes of interest, 4 studies had pathology, and 9 studies were
childhood, school-age children obesity, overweight, obese. The excluded because they did not meet the selection criteria (participants
approach of Boolean operators and truncation is used to boost sensitivity under 6 years old). Finally, we explore eleven original articles for the
to the most relevant article possible (Supplementary material describes conclusion of this review. The results of the systemic searches and the
the whole search strategy). details of the selection process are shown in Fig. 1 and Supplementary,
respectively.
2.3. Eligibility standard
3.2. Data extraction and study selection
Titles and abstracts were used to identify potentially relevant
research; if an informed conclusion could not be reached based on this The selection technique was carried out in a step-by-step manner, as
information, entire articles were examined. Any observational study shown in the PRISMA flow diagram (see Fig. 1). The screening process
(cohort, case-control, or cross-sectional) that satisfied all of the was completed on two separate reviewers’ original collections of articles
following criteria was considered: (TQD, NDT, TTVA, and PNQ).
The third reviewer discussed and resolved any disagreements be­
a) The original research publications were published in peer-reviewed tween authors on whether research should be included (VTQC).
journals reporting outcomes on the proportion of obesity among Microsoft Excel 2019 was utilized to keep track of all the resources
school-aged Vietnamese children who reside in the country. chosen for database extraction. The information acquired from the data
b) The prevalence of obesity was determined by assessing height and collection is shown in Table 1. This includes study data (the first author,
weight in studies that qualified. study design, year, research location), characteristics of the population
(age, sex, the number of children), and childhood obesity data for the
2.4. Exclusion criteria prevalence as a whole and in each group, based on World Health Or­
ganization (WHO) and Obesity Task Force (IOFT) criteria for obesity in
Articles were excluded if they met one or more of the following children between 6 and 14 years old.
requirements:

a) Duplications in the assessment process were removed;

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T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

Frigure 1. PRISMA 2020 flow diagram showing the selection process of studies in the systematic review and meta-analysis.

Table 1
Characteristics of 11 studies reporting the prevalence of obesity among children in Vietnam included in the current systematic review and meta-analysis.
Author Publication year Region Sample size Prevalence (95%CI) Quality score The diagnostic criteria of obesity

Le GB et al., [15] 2022 Rural 782 14.32 (11.94–16.98) 6 WHO

HD Phan et al., [16] 2020 Rural and Urban 2788 8.61 (7.59–9.72) 7 WHO and IOTF
TMT Mai et al., [17] 2020 Rural and Urban 10,949 18.99 (18.26–19.74) 6 WHO and IOTF
NK Pham et al., [18] 2020 Rural and Urban 1806 36.99 (34.76–39.26) 5 IOTF
TTP Pham et al., [19] 2019 Urban 821 19.12 (16.49–21.98) 5 WHO
Ha NT et al., [20] 2018 Rural 264 33.33 (27.67–39.37) 6 WHO
Hoang NTD at el, [21] 2018 Rural 2327 22.09 (20.42–23.83) 6 WHO
HTD Ngan et al., [22] 2018 Rural and Urban 276 21.38 (16.69–26.69) 6 WHO
Do LM et al., [23] 2017 Urban 1989 3.27 (2.53–4.15) 6 WHO
PVN Nguyen et al., [24] 2013 Rural and Urban 2677 6.09 (5.21–7.06) 5 WHO
TK Hong et al., [25] 2007 Urban 2684 2.05 (1.55–2.66) 6 IOTF

Fig. 2. Forest plots for obesity among school-aged children in Vietnam.

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T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

3.3. Finding in children. It was determined that the sex of the children, the education
level of the mother, the region, and the frequency with which soft drinks
The research features of the studies included in the current meta- and sweet foods were consumed deserved study and meta-analysis. They
analysis are summarized in Table 1. A total of 27,363 participants were associated with obesity among children in Vietnam (Table 3). The
were included in the seven investigations, which were both cross- pooled effect size of eleven studies showed that female children were
sectional studies (11 articles). One study was performed in the whole 2.42 times more likely to be obese than their male counterparts, odds
of Vietnam; four studies were conducted in Southern Vietnam and five ratio 2.42 (95% CI 1.43–4.09). The pooled effect size of eleven studies
studies in Northern Vietnam. Children ranging in age from 6 to 19 years showed that female children were 2.42 times more likely to be obese
old were involved in all the studies Table 1. These standard diagnostic than their male counterparts, odds ratio 2.42 (95% CI 1.43–4.09).
criteria could be the World Health Organization (WHO) and the Inter­
national Obesity Taskforce (IOTF). 3.7. Quality assessment

3.4. Prevalence estimate and heterogeneity The study quality assessment of the selected studies is depicted in
Table 1 and Supplementary. The included studies had a moderate
The findings of the meta-analysis are depicted in Fig. 2. A random- overall quality, ranging from five to seven out of eight. The included
effects meta-analysis revealed that the pooled estimate of the preva­ studies’ significant faults were selection bias, and a lack of transparency
lence of obesity among school-age children in Vietnam was 13.08% and completeness since most of the studies were not randomized,
(95% CI, 7.04%–23.01%), and the heterogeneity among the studies was employed convenience and purposive sampling, and did not provide all
significant (I2 = 99.0%, Q = 1,0339, df = 10, p < 0.01). of the information required for statistical sample size computation.
The results of the meta-analysis are depicted in Fig. 3. A random-
effects meta-analysis revealed that the pooled estimate of obesity 3.8. Publication bias
among girls was 8.07% (95% CI, 3.81%–16.29%). There was significant
heterogeneity with Cochran Q (Q = 1,3683, df = 10, p < 0.01), and the The funnel plot, shown in Fig. 6, revealed that there was almost no
I2 statistic was 98.0%. publication bias, and the results of the Egger regression test (p = 0.1340)
The meta-analysis results are represented in Fig. 4. A random-effects strongly supported this conclusion.
meta-analysis revealed that the pooled estimate of obesity among boys
was 17.5% (95% CI, 9.30%–30.51%). There was significant heteroge­ 4. Discussion
neity with the Cochran Q (Q = 1,1570, df = 10, p < 0.01), and the I2
statistic was 99.0%. Obesity is primarily caused by a disparity in energy intake and
The prevalence of obesity among school-age Vietnamese children expenditure [26]. Obesity and being overweight have become more
was stratified by collecting period: Before 2015, from 2015 to 2020, and common in recent years, and it is now a major concern all over the world
after 2020 (Fig. 5). The percentage of obesity was 3.46 (0.1–11.27), 23.5 [27]. Obesity is on the rise among youngsters not only in rich nations but
(12.05–40.78), and 17.78 (8.89–32.39), respectively, according to the also in developing ones, according to available reports. As a result, we
times during which collections were made. performed this systematic review in order to synthesize available studies
and better understand the prevalence of obese school-aged children in
3.5. Meta-regression Vietnam.
As a result, for the first time in this meta-analysis, a total of 27,363
Univariate meta-regression models were used to investigate possible people from ten cross-sectional studies published after 2007 were
contributors to the prevalence variation; however, both publication year merged to investigate the prevalence of obesity among school-aged
and sample size were found to be statistically insignificant. (Table 2). children in Vietnam. According to the random effect size estimation,
the pooled prevalence (overall, boys and girls) of obesity in this meta-
3.6. The associated factor of obesity among school-age Vietnamese analysis was 13.08% in all included studies; it was 8.07% and 17.5%
children in girls and boys, respectively. The proportion of obesity was higher for
boys than girls.
By utilizing eleven relevant papers from the pool of eligible articles Our results are more significant than the prevalence of school chil­
that were included in this investigation, we were able to conduct a dren in European countries (4.9%), Western Asian regions (11.9%) [28],
complete review and meta-analysis of the related risk factors of obesity ASEAN countries (5.8%) [29], and Chinese (10.5%) [30]. The

Fig. 3. Forest plots for obesity among school-aged girls in Vietnam.

4
T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

Fig. 4. Forest plots for obesity among school-aged boy in Vietnam.

disparity are most likely due to the region’s disparate economies, life­
styles, and healthcare systems. Demography, as well as other significant
socioeconomic variables, appear to play an impact. As a result, several
factors appear to play a role in changes in obesity [31], and the impact of
some of these factors may be confusing. Rapid economic expansion, for
example, has made a big difference in reducing the number of under­
nourished individuals in Vietnam over the last few decades. However, it
may have come with changes in food systems and lifestyles, such as
changes in eating patterns, that make it harder for children to cope [32,
33].
Fig. 5. A boxplot prevalence of obesity among school-age Vietnamese children.
In our study, the prevalence of obesity differed by gender. Obesity
was found to be more prevalent in boys than in girls (17.5% and 8.07%,
Table 2 respectively). And male gender was a risk factor for the development of
Related factors with the heterogeneity of obesity prevalence among school-age obesity among children. Biological factors might be responsible for the
children in Vietnam in the meta-analysis. difference. The biological difference in body composition between
gender arises early in life, during prenatal and postnatal periods [34].
Variables Coefficient Std. Err. p-value
The fetal growth measures of female fetuses in the late second and third
Year of publication 0.1936 0.0511 0.053
trimesters are significantly smaller than those of male fetuses. The fetal
Sample size 0.0001 0.0004 0.7928
growth measures of female fetuses in the late second and third trimesters
are significantly smaller than those of male fetuses [35,36]. In children
prevalence estimates in this study differ from those in Chinese, Euro­ and adolescents, steroid hormone hormones are linked to changes in
pean, Western Asian, and Asian nations, which might be due to dis­ body composition [37,38]. In addition, females also have higher levels
parities in methodological quality. Furthermore, the causes for this of leptin in their blood, a hormone that inhibits cravings and promotes

Table 3
The pool odds ratio of the association between obesity and its purported associated risk factors among school-age children in Vietnam.
Determinants Comparison No of studies Sample size OR (95%CI) p-value I2 (%) Heterogeneity Test (p-value)

Gender Male vs Female 11 27,363 2.42 (1.43–4.09) 0.0038 94.3 <0.001

Mother education Above vs Under high school 5 5388 2.63 (1.52–4.55) 0.0081 72.5 0.0058
Region Rural vs Urban 4 19,173 0.57 (0.29–1.12) 0.07 93.1 <0.001
Soft drink Yes vs No 2 1033 1.03 (0.61–1.76) 0.579 0 0.8088
Sweet food Yes vs No 2 1033 0.69 (0.29–1.59) 0.1108 0 0.7383

Fig. 6. Forest plots for meta-analysis of school-aged children in Vietnam.

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T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

energy use [39,40]. The difference in sex in leptin levels has also been Ethics approval
evaluated through the research revealing the substantial effect of sex
steroid hormones on leptin expression and release on the status of the Not required.
adipocyte has also looked into sex variations in leptin levels [41]. Other
study has discovered separate genes or subgroups of genes that Author contributions
contribute to body composition variations in boys and girls, implying
that sexually dimorphic presentations of juvenile obesity might be VTQC and TTVA involved in the general design, article selection,
explained by genetic differences as well [35]. Brown adipose tissue review, and manuscript preparation. TQD, NDT and the PNQ both
(BAT) is another biological component that must be investigated, as it is contributed to the study’s overall quality assessment. All of these au­
thought that a decrease in BAT is associated with the development of thors participated in reviewing, revising, and submitting the
obesity [42]. manuscript.
Differences in obesity rates between males and females may also be
due to sociocultural factors. According to researches, females, particu­ Funding
larly those in higher-income countries, prefer low-calorie, nutrient-
dense diets, such as fruits and vegetables, whereas boys prefer meat and Not applicable.
calorie-dense meals [43–46]. These discrepancies are most likely related
to gender stereotypes since a feminine identity is generally character­
Data availability statement
ized by eating smaller quantities and choosing healthier options to
maintain attractiveness, whereas a male eating identity is defined by
The datasets used and/or analyzed during the current study are
feeling full and focusing on physical ability [47]. According to studies,
published in the publication or posted as supplemental material.
parents are more concerned about their daughters’ weight than their
sons’, while sons are often encouraged to eat more. According to
Authorship statement
research, parents are more concerned about their daughters’ weight
than their sons’, although sons are frequently urged to eat more. Boys
Category 1.
are frequently given more priority in Vietnamese culture than girls [48],
Conception and design of study: Vu Thi Quynh Chi, Tran Thi Van
resulting in boys being sufficiently nourished and well cared after.
Anh;
Moreover, in cross-sectional studies conducted in Vietnam, a devel­
Acquisition of data: Tran Quang Duc, Nguyen Duc Tam, Phan Ngọc
oping county, obesity was significantly and strongly correlated with the
Quang;
mother’s degree of education. Children of moms with a high school
Analysis and/or interpretation of data: Vu Thi Quynh Chi, Tran
diploma or higher were more likely to be overweight than those of
Quang Duc, Tran Thi Van Anh;
mothers with a lower education level.
Category 2.
These findings can assist in identifying the most vulnerable com­
Drafting the manuscript: Vu Thi Quynh Chi, Tran Thi Van Anh;
munities to childhood obesity and informing the development and
Revising the manuscript critically for important intellectual content:
implementation of policies and initiatives to avoid further increases.
Vu Thi Quynh Chi.
Therefore, the new period’s policy must pay special attention to the
rising prevalence of childhood obesity and the double burden of
nutrition. Declaration of competing interest
There are certain limitations to this review:
The author declares that the publishing of this article does not
1) The cross-sectional research design was used in all of the papers involve any conflict of interest.
included in this meta-analysis, which is inadequate for making causal
conclusions because of its lack of evidence capacity. Acknowledgements
2) We identified a lot of heterogeneity between studies, which might be
attributable to methodological differences, such as different ways of All persons who have made substantial contributions to the work
measuring obesity in children. reported in the manuscript (e.g., technical help, writing and editing
3) We may have missed some essential studies because we only assistance, general support), but who do not meet the criteria for
included peer-reviewed English-language publications. authorship, are named in the Acknowledgements and have given us their
written permission to be named. If we have not included an Acknowl­
Given the limitations discussed above, the findings of this meta- edgements, then that indicates that we have not received substantial
analysis must be confirmed by further well-designed multi-center contributions from non-authors.
studies with a larger sample size before being declared definitive.
Appendix A. Supplementary data
5. Conclusion
Supplementary data to this article can be found online at https://doi.
The recent pooled analysis of studies demonstrates that school-aged org/10.1016/j.hnm.2023.200184.
children in Vietnam have a high prevalence of obesity. The male gender
and the low education status of the mother were found to be signifi­
References
cantly associated with obesity. The findings provide evidence for pre­
vention intervention strategies to reduce obesity in school-age children. [1] World Health Organization, Obesity and Overweight, 2021.
We have recommended that a coordinated effort between schools and [2] C.B. Ebbeling, D.B. Pawlak, D.S. Ludwig, Childhood obesity: public-health crisis,
community health extension programs be made to ensure the wide­ common sense cure, Lancet 360 (9331) (2002 Aug 10) 473–482.
[3] A.C. Skinner, S.N. Ravanbakht, J.A. Skelton, E.M. Perrin, S.C. Armstrong,
spread adoption of a comprehensive nutrition education curriculum. Prevalence of obesity and severe obesity in US children, Pediatrics 141 (3) (1999-
More focus should be given by healthcare providers and policymakers to 2016), 2018 Mar 1.
the development and implementation of preventative programs to [4] Y. Wang, M.A. Beydoun, J. Min, H. Xue, L.A. Kaminsky, L.J. Cheskin, Has the
prevalence of overweight, obesity and central obesity levelled off in the United
reduce the rising rate of pediatric obesity in Vietnam. States? Trends, patterns, disparities, and future projections for the obesity
epidemic, Int. J. Epidemiol. 49 (3) (2020) 810–823.

6
T.V.A. Tran et al. Human Nutrition & Metabolism 31 (2023) 200184

[5] M. Garrido-Miguel, I. Cavero-Redondo, C. Álvarez-Bueno, F. Rodríguez-Artalejo, L. [26] O. Colombo, S. Villani, G. Pinelli, C. Trentani, M. Baldi, O. Tomarchio, et al., To
A. Moreno, J.R. Ruiz, et al., Prevalence and trends of overweight and obesity in treat or not to treat: comparison of different criteria used to determine whether
European children from 1999 to 2016: a systematic review and meta-analysis, weight loss is to be recommended, Nutr. J. 7 (1) (2008) 5.
JAMA Pediatr. (10) (2019 Oct 1) 173. [27] T. Lobstein, L. Baur, R. Uauy, Obesity in children and young people: a crisis in
[6] A. Spinelli, M. Buoncristiano, V.A. Kovacs, A. Yngve, I. Spiroski, G. Obreja, et al., public health, Obes. Rev. 5 (1) (2004 May) 4–104, 1.
Prevalence of severe obesity among primary school children in 21 European [28] B. Olaya, M.V. Moneta, O. Pez, A. Bitfoi, M.G. Carta, C. Eke, et al., Country-level
countries, Obesity facts 12 (2) (2019) 244–258. and individual correlates of overweight and obesity among primary school
[7] J. De Bont, Y. Diáz, M. Casas, M. Garciá-Gil, M. Vrijheid, T. Duarte-Salles, Time children: a cross-sectional study in seven European countries, BMC Publ. Health 15
trends and sociodemographic factors associated with overweight and obesity in (1) (2015 Dec 1) 1–12.
children and adolescents in Spain, JAMA Netw. Open 3 (3) (2020 Mar 18). [29] M. Mazidi, M. Banach, A.P. Kengne, Prevalence of childhood and adolescent
[8] W. Qin, L. Wang, L. Xu, L. Sun, J. Li, J. Zhang, et al., An exploratory spatial analysis overweight and obesity in Asian countries: a systematic review and meta-analysis,
of overweight and obesity among children and adolescents in Shandong, China, Arch. Med. Sci. 14 (6) (2018) 1185.
BMJ Open 9 (8) (2019 Aug 1), e028152. [30] J. Zhang, H. Wang, Z. Wang, W. Du, C. Su, H. Jiang, et al., Prevalence and
[9] E.S. Tee, Obesity in Asia: prevalence and issues in assessment methodologies, Asia stabilizing trends in overweight and obesity among children and adolescents in
Pac. J. Clin. Nutr. 11 (2002 Dec) S694–S701. China, 2011-2015, BMC Publ. Health 18 (1) (2018 May 2).
[10] Vietnam Ministry of Health, The Ministry of Health Announced the Results of the [31] Y.N. Ang, B.S. Wee, B.K. Poh, M.N. Ismail, Multifactorial influences of childhood
Nutrition Census during 2019-2020, 2022. obesity, Curr Obes Rep 2 (1) (2013 Dec 30) 10–22.
[11] M. de Onis, A. Onyango, E. Borghi, A. Siyam, C. Nishida, J. Siekmann, [32] H. Trinh Thi, M. Simioni, C. Thomas-Agnan, Assessing the nonlinearity of the
Development of a WHO Growth Reference for School-Aged Children and calorie-income relationship: an estimation strategy – with new insights on
Adolescents, World Health Organ, 2007. nutritional transition in Vietnam, World Dev. 110 (2018 Oct 1) 192–204.
[12] T.J. Cole, M.C. Bellizzi, K.M. Flegal, W.H. Dietz, Establishing a standard definition [33] T.T. Nguyen, M.V. Hoang, Non-communicable diseases, food and nutrition in
for child overweight and obesity worldwide: international survey, BMJ 320 (7244) Vietnam from 1975 to 2015: the burden and national response, Asia Pac. J. Clin.
(2000 May 6) 1240–1243. Nutr. 27 (1) (2018 Jan 1) 19–28.
[13] L. Zorzela, Y.K. Loke, J.P. Ioannidis, S. Golder, P. Santaguida, D.G. Altman, et al., [34] Z.A. Broere-Brown, E. Baan, S. Schalekamp-Timmermans, B.O. Verburg, V.W.
PRISMA harms checklist: improving harms reporting in systematic reviews, BMJ V. Jaddoe, E.A.P. Steegers, Sex-specific differences in fetal and infant growth
(2016 Feb 1) 352. patterns: a prospective population-based cohort study, Biol. Sex Differ. 7 (1) (2016
[14] Modesti P, al et. PA Modesti et al. Panethnic Differences in Blood Pressure in Dec 3) 1–9.
Europe: a Systematic Review and Meta-Analysis. S1 Text S1 Text NEWCASTLE- [35] A.B. Wisniewski, S.D. Chernausek, Gender in childhood obesity: family
OTTAWA QUALITY ASSESSMENT SCALE (Adapted for Cross Sectional Studies). environment, hormones, and genes, Gend. Med. 6 (SUPPL. 1) (2009) 76–85. Suppl
[15] G.B. Le, D.X. Dinh, Prevalence and Associated Factors of Overweight and Obesity 1.
Among Primary School Children: a Cross-Sectional Study in Thanhhoa City, 12, [36] M.K. Campbell, Biological, environmental, and social influences on childhood
BMJ open, Vietnam, 2022 Apr 22, 4. obesity, Pediatr. Res. 79 (1–2) (2016 Jan 1) 205–211.
[16] H.D. Phan, T.N. Phuong Nguyen, P.L. Bui, T.T. Pham, T.V. Doan, D.T. Nguyen, et [37] J.C.K. Wells, Sexual dimorphism of body composition, Best Pract. Res. Clin.
al., Overweight and obesity among Vietnamese school-aged children: national Endocrinol. Metabol. 21 (3) (2007 Sep) 415–430.
prevalence estimates based on the world health organization and international [38] J.D. Veldhuis, J.N. Roemmich, E.J. Richmond, A.D. Rogol, J.C. Lovejoy,
obesity Task Force definition, PLoS One 15 (10) (2020 Oct 1). M. Sheffield-Moore, et al., Endocrine control of body composition in infancy,
[17] T.M.T. Mai, N.O. Pham, T.M.H. Tran, P. Baker, D. Gallegos, T.N.D. Do, et al., The childhood, and puberty, Endocr. Rev. 26 (1) (2005 Feb) 114–146.
double burden of malnutrition in Vietnamese school-aged children and [39] W.F. Blum, P. Englaro, S. Hanitsch, A. Juul, N.T. Hertel, J. Müller, et al., Plasma
adolescents: a rapid shift over a decade in Ho Chi Minh City, Eur. J. Clin. Nutr. 74 leptin levels in healthy children and adolescents: dependence on body mass index,
(10) (2020 Oct 1) 1448–1456. body fat mass, gender, pubertal stage, and testosterone, J. Clin. Endocrinol. Metab.
[18] N.K. Pham, A. Sepehri, T.M. Le, V.T. Tran, Correlates of body mass index among 82 (9) (1997 Sep 1) 2904–2910.
primary school children in Ho Chi Minh City, Vietnam. Public Health 181 (2020 [40] S.P. Garnett, W. Högler, B. Blades, L.A. Baur, J. Peat, J. Lee, et al., Relation
Apr 1) 65–72. between hormones and body composition, including bone, in prepubertal children,
[19] T.T.P. Pham, Y. Matsushita, L.T.K. Dinh, T Van Do, T.T.T. Nguyen, A.T. Bui, et al., Am. J. Clin. Nutr. 80 (4) (2004) 966–972.
Prevalence and associated factors of overweight and obesity among schoolchildren [41] M. Wabitsch, W.F. Blum, R. Muche, M. Braun, F. Hube, W. Rascher, et al.,
in Hanoi, Vietnam, BMC Publ. Health 19 (1) (2019 Nov 8). Contribution of androgens to the gender difference in leptin production in obese
[20] N. Thanh Ha, D. Thi Hanh Trang, L. Thi Thu Ha, Is obesity associated with children and adolescents, J. Clin. Invest. 100 (4) (1997 Aug 8) 808.
decreased health-related quality of life in school-age children?-Results from a [42] K. Karastergiou, S.R. Smith, A.S. Greenberg, S.K. Fried, Sex differences in human
survey in Vietnam, AIMS public health 5 (4) (2018) 338–351. adipose tissues - the biology of pear shape, Biol. Sex Differ. 3 (1) (2012).
[21] H.T.D. Ngan, L.D. Tuyen, P. Van Phu, S. Nambiar, Childhood overweight and [43] K.W. Bauer, N.I. Larson, M.C. Nelson, M. Story, D. Neumark-Sztainer, Socio-
obesity amongst primary school children in Hai Phong City, Vietnam. Asia, Pac J environmental, personal and behavioural predictors of fast-food intake among
Clin Nutr 27 (2) (2018) 399–405. adolescents, Publ. Health Nutr. 12 (10) (2009 Oct) 1767–1774.
[22] N.T.D. Hoang, L. Orellana, T.D. Le, R.S. Gibson, A.F. Worsley, A.J. Sinclair, et al., [44] E.J. Wouters, J.K. Larsen, S.P. Kremers, P.C. Dagnelie, R. Geenen, Peer influence on
Anthropometric status among 6− 9-year-old school children in rural areas in hai snacking behavior in adolescence, Appetite 55 (1) (2010) 11–17.
phong City, Vietnam, Nutrients 10 (10) (2018 Oct 4). [45] N.L. Caine-Bish, B. Scheule, Gender differences in food preferences of school-aged
[23] L.M. Do, T.K. Tran, B. Eriksson, M. Petzold, H. Ascher, Prevalence and incidence of children and adolescents, J. Sch. Health 79 (11) (2009 Nov) 532–540.
overweight and obesity among Vietnamese preschool children: a longitudinal [46] V.H. Wang, J. Min, H. Xue, S. Du, F. Xu, H. Wang, et al., Factors contributing to sex
cohort study, BMC Pediatr [Internet] 17 (1) (2017). differences in childhood obesity prevalence in China, Publ. Health Nutr. 21 (11)
[24] P.V.N. Nguyen, T.K. Hong, T. Hoang, D.T. Nguyen, A.R. Robert, High prevalence of (2018 Aug 1) 2056.
overweight among adolescents in Ho Chi Minh City, Vietnam, BMC Publ. Health 13 [47] K.L. Keller, S.M.R. Kling, B. Fuchs, A.L. Pearce, N.A. Reigh, T. Masterson, et al.,
(1) (2013). A biopsychosocial model of sex differences in children’s eating behaviors,
[25] T.K. Hong, M.J. Dibley, D. Sibbritt, P.N.T. Binh, N.H.H.D. Trang, T.T.M. Hanh, Nutrients 11 (3) (2019 Mar 1).
Overweight and obesity are rapidly emerging among adolescents in Ho Chi Minh [48] D. Belanger, Son preference in a rural village in North, Vietnam. Stud Fam Plann.
City, Vietnam, 2002-2004, Int. J. Pediatr. Obes. 2 (4) (2007) 194–201. (2002).