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Child overweight or obesity is increasing in most countries, including Vietnam. We sought to elucidate the drivers of child overweight or obesity in Vietnam and understand how they vary geographically. We compiled nationally representative cross-sectional data from the Vietnam Nutrition Surveillance Survey collected annually between 2012-2015 and household income data from the General Statistics Office. We used a quasi-Poisson log link function to calculate relative risks (RRs) of under-five child overweight or obesity for 13 variables and stratified analyses by child age (&lt;2 y and 2-5 y) and region. Additional analysis included log-log linear regression to assess the relationship between average provincial monthly per capita income and child overweight or obesity. The strongest associations with child overweight or obesity included birthweight &gt;4000 g (RR: 1.66; 95% confidence interval (CI): 1.48, 1.86), maternal body mass index (BMI) ≥27.5 compared with BMI &lt;23 (RR: 1.62; 95% CI: 1.47, 1.78), and living in the Southeast (RR: 2.06; 95% CI: 1.84, 2.30), Mekong River Delta (RR: 1.58; 95% CI: 1.41, 1.77), or Central South (RR: 1.54; 95% CI: 1.37, 1.74) compared with the Central Highland. A 20% higher provincial average monthly per capita income was associated with a 17.4% higher prevalence in child overweight or obesity ( P &lt; 0.0001, Adjusted R 2 = 0.36). High birthweight and maternal BMI were strongly associated with child overweight or obesity but are not likely primary drivers in Vietnam, given their low prevalence. C-section delivery, sedentary lifestyle, high maternal education, urbanicity, and high household income affect a large proportion of the population and are, therefore, important risk factors. Policies and programs should target these factors and regions at greatest risk of overweight or obesity, particularly the Southeast and Mekong River Delta.

Child Overweight or Obesity Is Associated with Modifiable and Geographic Factors in Vietnam: Implications for Program Design and Targeting