FOOD SECURITY - Science for Agriculture and Rural Development in Low-income Countries - page 33

There is a clear difference between food insecurity or undernourishment, as
defined by FAO and in the MDGs, and malnutrition. FAO calculates the number of
undernourished or hungry people in a country on the basis of average energy
availability per person per day (dietary energy supply, DES), based on food balance
sheets, which often lack sufficient accuracy (Smil 2000). Malnutrition reflects the
clinical status of being malnourished or undernourished. In malnutrition, chronic and
acute malnutrition are distinguished, and expressed by different indicators. Usually,
malnutrition is measured in children (0-5 years of age), as their nutritional status is
assumed to be representative for the nutritional situation of the community. Nutritional
status in children is expressed in different combinations of the parameters age,
weight and height.
Acute food shortage is reflected in a lag in weight gain, or even in weight loss in
a child of a certain age, and is expressed in Weight for Age (WFA). Subcutaneous
fat tissue has disappeared and in severe cases muscles may have been affected.
Acute food shortage can be caused by natural or political situations, but also by
sudden changes in the health situation of a child. Acute food shortage, resulting in
'wasting' of the child, is reversible.
Chronic food shortage leads to reduced and delayed growth of a child, reflected
in a lag in growth in stature, and is expressed in Height for Age (HFA), and children
below certain cut off points are considered stunted. Stunting is irreversible, and not
only leads to a short stature for age, but is associated with higher prevalence of
diseases, higher mortality rates, shorter life expectancy, lower rates of cognitive
development, etc. Maybe most important is that stunted adolescent girls and women
in the reproductive ages have higher chances to deliver malnourished children, who
have little chance to overcome their burden of malnutrition, thus perpetuating the
Figure 3. Map on prevalence of undernourishment (% of population), 2000-2002 (based on data
from: FAO 2005)