Undernutrition in children, occurs when children do not consume enough calories, protein, or micronutrients to maintain good health. It is common globally and may result in both short and long term irreversible adverse health outcomes. Undernutrition is sometimes used synonymously with malnutrition; however, malnutrition could mean both undernutrition and overnutrition (causing childhood obesity). The World Health Organization (WHO) estimates that malnutrition accounts for 54 percent of child mortality worldwide, which is about 1 million children. Another estimate, also by WHO, states that childhood underweight is the cause for about 35% of all deaths of children under the age of five worldwide. The main causes of malnutrition are often related to poverty: unsafe water, inadequate sanitation or insufficient hygiene, factors related to society, diseases, maternal factors, gender issues as well as other factors. Linked to ¹⁄₃ of all child deaths, malnutrition is especially dangerous for women and children. Malnourished women will usually have malnourished fetuses while they are pregnant, which can lead to physically and mentally stunted children, creating a cycle of malnutrition and underdevelopment. One of the most severe at risk populations are children under 5. Malnutrition during the early stages of development can have negative and severe effects on growth and intellectual development. This effect on a child's intellectual quotient makes it harder for them later in life to achieve their true potential abilities. Breaking the cycle of malnutrition during early childhood development can break the cycle of intergenerational poverty among poor communities. There are a variety of ways in which malnutrition can affect the body. Globally, 162 million children show symptoms of malnutrition such as stunting, which is an indicator of malnourishment. The WHO reported that two out of five children that are stunted live in Southern Asia, however Africa is the only region where there is an increasing number of stunted children. Common micronutrient deficiencies are iron, zinc, iodine, and vitamin A. Micronutrient deficiencies can cause an increase of illness due to a compromised immune systems or abnormal physiology and development. Protein-Energy Malnutrition (PEM) is another form of malnutrition that affects children. PEM can appear as conditions called marasmus, kwashiorkor, and an intermediate state of marasmus-kwashiorkor. Although malnutrition can have severe and lasting health effects on women and children, they are still susceptible to other water-related dangers.

There are three commonly used measures for detecting malnutrition in children:

• stunting (extremely low height for age),
• underweight (extremely low weight for age), and
• wasting (extremely low weight for height).

These measures of malnutrition are interrelated, but studies for the World Bank found that only 9 percent of children exhibit stunting, underweight, and wasting. Children with severe acute malnutrition are very thin, but they often also have swollen hands and feet, making the internal problems more evident to health workers.

Children with severe malnutrition are very susceptible to infection. Undernutrition in children causes direct structural damage to the brain and impairs infant motor development and exploratory behavior. Children who are undernourished before age two and gain weight quickly later in childhood and in adolescence are at high risk of chronic diseases related to nutrition. Studies have found a strong association between undernutrition and child mortality. Once malnutrition is treated, adequate growth is an indication of health and recovery. Even after recovering from severe malnutrition, children often remain stunted for the rest of their lives. Even mild degrees of malnutrition double the risk of mortality for respiratory and diarrheal disease mortality and malaria. This risk is greatly increased in more severe cases of malnutrition. Undernourished girls tend to grow into short adults and are more likely to have small children. Prenatal malnutrition and early life growth patterns can alter metabolism and physiological patterns and have lifelong effects on the risk of cardiovascular disease. Children who are undernourished are more likely to be short in adulthood, have lower educational achievement and economic status, and give birth to smaller infants. Children often face malnutrition during the age of rapid development, which can have long-lasting impacts on health.

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Regards,
Catherine
Journal Co-Ordinator
Journal of Obesity and Eating Disorders