GCRF - Addressing micronutrient deficiencies associated with the double burden of childhood malnutrition in China, a combined food system framework

Researchers standing in line smiling at the camera

The double burden of malnutrition (DBM) is increasing in low- and middle-income countries (LMICs) along with rapid economic development. People living in rural poor communities lack food diversity and are frequently nutrient deficient, whilst urban populations show a rapid rise of obesity owing to unhealthy diets and imbalanced energy intake. Such micronutrient deficiencies (MND) associated with DBM are particularly problematic in children. Food system based intervention from biofortification, nutrient supplementation, to nutritional education and nudging for diet behaviour change in school and home food environment have been shown effectiveness. The focus of this research is to determine the barriers to uptake of these effective interventions of double burden of malnutrition in children in Asian countries (China, Vietnam, Malaysia), and to explore novel approaches to promoting their uptake, with the overall aim of improving child nutrition and health.


The outcome of the project will lead directly to improved child health and development, benefitting both poor rural communities and more affluent communities where childhood obesity is linked to MNDs. This will result in more productive adults in the future, bringing wider societal and economic benefits. The nurseries and schools as well as parents will gain knowledge in promoting healthful diet to children and students, positively impacting child health, cognitive function and student performance. Furthermore, integrating sustainable and culturally sensitive nutritional intervention guidance into policy to protect against DBM in children will have significant impact on public health and well-being in local communities. These benefits will be extended beyond China, the lessons learned will be disseminated to policy makers and scientists in Southeast Asian countries, with Vietnam and Malaysia as the first steps in spreading the impact of improved uptake of successful nutrition interventions. 

Publications and outputs

X Tan, PY Tan, YY Gong & JB Moore (2024) Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis. BMJ Glob Health 9(4):e015135. https://doi.org/10.1136/bmjgh-2024-015135

C Mondon, PY Tan, CL Chan, TN Tran & YY Gong (2024) Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: a systematic review. BMC Public Health 24 (1), 960. https://doi.org/10.1186/s12889-024-18419-8

X Tan, PY Tan, SV Som, SD Nguyen, DT Tran, NT Tran, et al. (2024) Micronutrient deficiencies and the double burden of malnutrition in Vietnamese female adolescents: a national cross-sectional study in 2020. medRxiv 2024.04. 11.24305546. https://doi.org/10.1101/2024.04.11.24305546 

PY Tan, SV Som, SD Nguyen, X Tan, DT Tran, NT Tran, et al. (2024) Demographic variation and socioeconomic inequalities associated with the triple burden of malnutrition in Vietnamese children aged 6 months to 9 years old: Findings from the Vietnamese General Nutrition Survey 2020. medRxiv 2024.03. 18.24304456. https://doi.org/10.1101/2024.03.18.24304456 

PY Tan, JB Moore, L Bai, GY Tang & YY Gong (2022) In the context of the triple burden of malnutrition: A systematic review of gene-diet interactions and nutritional status. Crit Rev Food Sci Nutr 64(11):3235-3263 https://doi.org/10.1080/10408398.2022.2131727

CL Chan, PY Tan & YY Gong (2022) Evaluating the impacts of school garden-based programmes on diet and nutrition-related knowledge, attitudes and practices among the school children: a systematic review. BMC Public Health 22(1):1251. https://doi.org/10.1186/s12889-022-13587-x 

PY Tan, F Amini & SR Mitra (2022) Dietary protein interacts with polygenic risk scores and modulates serum concentrations of C-reactive protein in overweight and obese Malaysian adults. Nutr Res 107:75-85. https://doi.org/10.1016/j.nutres.2022.09.002 

JM Njunge, K Tickell, AH Diallo, ASM Sayeem Bin Shahid, MA Gazi, A Saleem, et al. (2022) The Childhood Acute Illness and Nutrition (CHAIN) network nested case-cohort study protocol: a multi-omics approach to understanding mortality among children in sub-Saharan Africa and South Asia. Gates Open Res 3:6:77. https://doi.org/10.12688/gatesopenres.13635.2 

PY Tan & SR Mitra (2021) Dietary copper and selenium are associated with insulin resistance in overweight and obese Malaysian adults. Nutr Res 93:38-47. https://doi.org/10.1016/j.nutres.2021.06.008 

H Rasheed, Y Xu, ME Kimanya, X Pan, Z Li, X Zou, et al. (2021) Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa. Sci Rep 11, 1619. https://doi.org/10.1038/s41598-020-80356-4 

GY Tang, PY Tan, Q Zhang, JS Huo & YY Gong (2021) Physical activity, transportation mode and sedentary time on the development of overweight and obesity in school-age children in China: China Health and Nutrition Survey (CHNS) 2010–2012. P Nutr Soc 80(OCE3):E145. https://doi.org/10.1017/S0029665121002688 


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