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: 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...
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: 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: 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...
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...
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: The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976 to 2016
View this article as a pdf Summary of research1 Location: Gambia What we know: There are gaps in understanding the relationship between wasting and stunting that often...
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: Children concurrently wasted and stunted: A meta- analysis of prevalence data of children 6-59 months from 84 countries
Research summary1 Location: Global What we know: Wasting and stunting are often present in the same geographical populations and can exist concurrently in the same children,...
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: Summary of Lancet Series on Maternal and Child Undernutrition
Below are short summaries of the recently launched Lancet series of papers on Maternal and Child Undernutrition1. This high profile series focuses on the disease burden...
The Wasting and Stunting (WaSt) project – investigating the relationship between wasting and stunting and exploring the implications for policy programmes and research
Donor: Irish Aid, USAID, OFDA Collaborators: Technical Interest Group ENN project lead: Carmel Dolan & Tanya Khara Timeframe: 2014 - ongoing Background While wasting and...
FEX: Double Burden of obesity and malnutrition in Western Sahara refugees
Summary of published research1 There is growing recognition of a ‘double burden’ of malnutrition among populations in both affluent and less-affluent countries, i.e. the...
FEX: Editorial perspective on the continuum of care for children with acute malnutrition
View this article as a pdf Lisez cet article en français ici By Jeremy Shoham and Marie McGrath, Field Exchange Co-Editors Rationale for FEX special edition We are...
FEX: Nutrition sensitive multi-sectoral planning: experiences on Link Nutrition Causal Analysis Kenya
By Kevin Mutegi and Jacob Korir Kevin Mutegi is currently working with Action Against Hunger (ACF-USA) Kenya mission as Food Security and Nutrition Surveillance Programme...
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)