Beyond wasted and stunted—a major shift to fight child undernutrition
Author: Jonathan C KWells, André Briend, Erin M Boyd, James A Berkely, Andrew Hall, Sheila Isanaka, Patrick Webb, Tanya Khara, Carmel Dolan
Year: 2019
Resource type: Article
This is the word version of the Viewpoint article as published in the Lancet Journal of Child and Adolescent Heath.
Abstract
Child undernutrition refers broadly to the condition in which food intake is inadequate to meet a child’s needs for physiological function, growth, and the capacity to respond to illness. Since the 1970s, nutritionists have categorised undernutrition in two major ways, either as wasted (i.e., low weight for height, or small mid-upper arm circumference) or stunted (i.e., low height for age). This approach, although useful for identifying populations at risk of undernutrition, creates several problems: the focus is on children who have already become undernourished, and this approach draws an artificial distinction between two idealised types of undernourished children that are widely interpreted as indicative of either acute or chronic undernutrition. This distinction in turn has led to the separation of programmatic approaches to prevent and treat child undernutrition. In the past 3 years, research has shown that individual children are at risk of both conditions, might be born with both, pass from one state to the other over time, and accumulate risks to their health and life through their combined effects. The current emphasis on identifying children who are already wasted or stunted detracts attention from the larger number of children undergoing the process of becoming undernourished. We call for a major shift in thinking regarding how we assess child undernutrition, and how prevention and treatment programmes can best address the diverse causes and dynamic biological processes that underlie undernutrition.
Download
Beyond-WaSt.pdf (PDF, 337kb)
More like this
FEX: Response to malnutrition treatment in low weight-for-age children: secondary analyses of ComPAS trial data
View this article as a pdf Research summary1 Location: Kenya and South Sudan What we know: Children who are concurrently wasted and stunted (WaSt) have a very high mortality...
FEX: Predicting coexistence of wasting and stunting in Guinea-Bissau: A secondary data analysis
Summary of MSc thesis1 By Abbi Sage Abbi Sage is a recent MSc graduate in Nutrition for Global Health from the London School of Hygiene and Tropical Medicine. She is now part...
Wasting and Stunting: Overcoming the divide
Wasting-Stunting (WaSt) Technical Interest Group (TIG) Donor: Irish Aid, USAID, OFDA Collaborators: Technical Interest Group ENN project lead: Tanya Khara Timeframe: 2014 -...
Blog post: Child wasting and stunting - are we where we need to be?
We've been on a high this week with the publication of the Viewpoint from the ENN coordinated Wasting-Stunting Technical Interest Group (WaSt TIG). 'Beyond wasted and...
en-net: Is stunted children less prone to be wasted than normal children during emergency context?
Dear experts, In the country where I recide, we have high prevalence of stunting and low prevalence of wasting and in emergency context same is seen- high prevalence of...
FEX: Link NCA offers a new opportunity to study drivers of concurrent wasting and stunting (WaSt)
View this article as a pdf By Lenka Blanárová and Grace Heymsfield Lenka Blanárová is Senior Nutrition Assessment Coordinator at Action Against...
FEX: Wasting and Stunting Technical Interest Group (WaSt TIG) meeting
On the 15th of January 2018 the Wasting and Stunting (WaSt) Technical Interest Group (TIG) held their third face-to-face meeting at Trinity College, Oxford. This group of 30...
en-net: Growth monitoring Vs stunting/wasting
If a child is growing normally following the growth trajectory based on a growth chart, can we say that the child is not wasted/stunted? I know that if a child is low...
en-net: Assessing levels of maternal malnutrition
In Niger the 2006 MICS estimated 19.2% of women of reproductive age to be malnourished (with a BMI-18.5) and 1.9% severely malnourished (BMI-16). In Zinder the rate was 29.6%...
FEX: Multi-sector nutrition programming: ‘Nutrition Smart Villages’ in Bangladesh and India
View this article as a pdf By Sweta Banerjee Sweta Banerjee is the Nutrition Specialist for Welthungerhilfe's India country programme. She provides support to the food and...
FEX: Wasting prevention and treatment - central to stunting reduction in Pakistan
View this article as a pdf Lisez cet article en français ici Click here to listen to more information on the work being done in Pakistan on the ENN podcast channel By...
FEX: Child wasting and stunting: Time to overcome the separation
A briefing note for policy-makers and programme implementers was released in June 2018 by the ENN-coordinated Wasting-Stunting Technical Interest Group (WaSt TIG). The brief,...
FEX: Action Against Hunger Research for Nutrition conference, 2017
By Miriam Ait-Aissa and Stephanie Stern Myriam Ait-Aissa is currently Head of Research and Analyses at Action Against Hunger - France (Action contre la Faim). She has been...
FEX: The relationship between wasting and stunting: policy, programming and research implications
Summary of review1 This summary was prepared by Tanya Khara, an independent consultant engaged by the ENN on this review. The review was made possible by the generous support...
en-net: Nutritional status and vulnerability of older adults/older people (aged 50 +)
Happy New Year to En-net colleagues, I have recently been contracted by HelpAge International (in partnership with NutritionWorks) to write a module on nutrition in older...
FEX: Deterioration of children with MAM who have no access to supplementary feeding programmes
James P, Sadler K, Wondafrash M, Argaw A, Luo H, Geleta B, et al. (2016) Children with Moderate Acute Malnutrition with No Access to Supplementary Feeding Programmes Experience...
FEX: Child wasting and concurrent stunting in low- and middle-income countries
View this article as a pdf Click here to listen to an interview with one of the authors on the ENN podcast channel Summary of research1 What we know: Cross-sectional,...
en-net: Variance in number of children admitted to OTP using MUAC < 11.cm and WHZ <-3SD
Since 2008, we have been screening and admitting children to outpatient therapeutic program using MUAC 11.0; in June 2009 we adopted MUAC- 11.5 as per the new WHO guidelines....
FEX: Relationships between wasting and stunting and their concurrent occurrence in Ghanaian pre-school children
Summary of research* Location: Ghana. What we know: Wasting is a short-term health issue, but repeated episodes may lead to stunting (long-term or chronic malnutrition). This...
Resource: Best Practice in Preventing Child Wasting within the Wider Context of Undernutrition
Introduction UNICEF estimated that in 2020 nearly 150 million children under five years of age were stunted and approximately 50 million were wasted, numbers that are expected...
Reference this page
Jonathan C KWells, André Briend, Erin M Boyd, James A Berkely, Andrew Hall, Sheila Isanaka, Patrick Webb, Tanya Khara, Carmel Dolan (2019). Beyond wasted and stunted—a major shift to fight child undernutrition. www.ennonline.net/resource/beyondwast
(ENN_6434)