Defining Pediatric Malnutrition

Abstract

Lack of a uniform definition is responsible for underrecognition of the prevalence of malnutrition and its impact on outcomes in children. A pediatric malnutrition definitions workgroup reviewed existing pediatric age group English-language literature from 1955 to 2011, for relevant references related to 5 domains of the definition of malnutrition that were a priori identified: anthropometric parameters, growth, chronicity of malnutrition, etiology and pathogenesis, and developmental/ functional outcomes. Based on available evidence and an iterative process to arrive at multidisciplinary consensus in the group, these domains were included in the overall construct of a new definition. Pediatric malnutrition (undernutrition) is defined as an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. A summary of the literature is presented and a new classification scheme is proposed that incorporates chronicity, etiology, mechanisms of nutrient imbalance, severity of malnutrition, and its impact on outcomes. Based on its etiology, malnutrition is either illness related (secondary to 1 or more diseases/injury) or non-illness related, (caused by environmental/behavioral factors), or both. Future research must focus on the relationship between inflammation and illness-related malnutrition. We anticipate that the definition of malnutrition will continue to evolve with improved understanding of the processes that lead to and complicate the treatment of this condition. A uniform definition should permit future research to focus on the impact of pediatric malnutrition on functional outcomes and help solidify the scientific basis for evidence-based nutrition practices.

Social determinants of malnutrition among Serbian children aged <5 years: ethnic and regional disparities

“…Malnutrition is a global public health concern and has been correlated to both under-nutrition and the obesity (Mehta et al 2013). The association between poverty and malnutrition is well-established, as is poverty as a negative predictor of healthy child development and childrearing (Bornstein et al 2012 Cook et al (2013) described considerable evidence of poorer nutrition among Roma children and the results of our study indicated that ethnic affiliation was a significant predictor of stunted and severely stunted growth among Serbian children.…”

Independent and interactive effects of HIV infection, clinical stage and other comorbidities on survival of children treated for severely malnourished in rural South Africa: A retrospective multi-cohort study

“…[8,15] While it is usual to present with kwashiorkor in the southern African region, with the high prevalence of HIV infection, SAM patients become wasted owing to changes in physiological and metabolic functions associated with HIV infection. [16] This study also examined the independent effect of HIV infection on survival. The CFRs in this study were higher in the HIV-infected group (41%) compared with their HIV-uninfected counterparts (11%).…”

Risk factors associated with wasting among children aged 6 to 24 months old in Gaza strip

“…Pediatric malnutrition (undernutrition) is defined as an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes (Mehta et al 2013). Malnutrition continues to be a major health burden and contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections (Prendergast 2015).…”