Association Between Picky Eating and Stunting Among Ethnic Minority Children Aged 12–35 Months in a Mountainous Area of Northern Vietnam: A Cross-Sectional Study

Background: Stunting remains a major public health problem among ethnic minority children in mountainous areas of Vietnam. Picky eating has been suggested as a potential behavioral risk factor for poor child growth, but evidence from vulnerable rural populations remains limited. This study examined the association between picky eating and stunting among ethnic minority children aged 12–35 months in Vietnam. Methods: This cross-sectional study was conducted from October to November 2025 in two communes of Phu Tho province, formerly part of Lac Son District, Hoa Binh Province, Vietnam. A total of 341 children aged 12–35 months and their caregivers were included. Data were collected using structured interviewer-administered questionnaires on feeding practices and child characteristics. Picky eating was assessed based on caregiver-reported behaviors. Anthropometric measurements were performed according to standard procedures, and height-for-age Z-scores were calculated using the WHO Child Growth Standards. Zinc status was assessed in a subsample of children. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with stunting. Adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) were reported. Results: The prevalence of picky eating was 39.6%, while 24.9% of children were stunted. Zinc deficiency was identified in 41.9% of children with available blood samples. In multivariable analysis, picky eating was significantly associated with increased odds of stunting (AOR = 3.63; 95% CI: 1.71–7.70). Snacking before main meals was also independently associated with stunting (AOR = 1.81; 95% CI: 1.01–3.24). In contrast, zinc deficiency was associated with stunting in crude analysis but was not statistically significant after adjustment. Other factors, including child age, sex, caregiver identity, and timing of complementary feeding, were not independently associated with stunting. Conclusions: Picky eating was common and was independently associated with stunting among ethnic minority children in this mountainous setting. These findings suggest that behavioral feeding practices, particularly picky eating and pre-meal snacking, warrant attention in nutritional programs targeting this population; however, longitudinal studies are needed to confirm the direction of this relationship.