Agriculture Reference
In-Depth Information
Malnutrition and
Undernourishment: Some Terminology
This chapter focuses on the problems of malnutrition, as distinct from other terms such
as poverty, food insecurity, and food shortages. Of paramount concern is the widespread
undernutrition, primarily found in developing countries. Undernutrition is generally
assessed by examining anthropometric indicators, which are the most general indicators
of health and nutritional status, especially among young children (Beaton et al. 1990;
de Onis, Frogillo, and Blossner 2000). For infants and children, there are three widely
used anthropometric indicators. The first, stunting, or below normal height-for-age, is a
failure to reach an expected level of stature at a given age. It is generally associated with
long-term undernutrition that results from chronic episodes of illness and inadequate
nutrient intake, and feeding and care practices. The second is wasting, below normal
weight-for-height, which is a measure of acute malnutrition that usually results from
dramatic deficits in intake and/or serious illness. This is often associated with acute
inadequacies in nutrient intakes from events such as famines and severe economic
shocks, as well as ravages associated with diseases such as measles, HIV/AIDS, and diar-
rheal disease. The third is underweight or below normal weight-for-age. This is a com-
posite indicator of undernutrition that can be caused by any combination of stunting
and wasting. In all three cases, the individual's anthropometric outcomes are compared
with norms used to define a healthy population, where the norms are developed based
on readily available and widely adapted international reference standards (WHO 1983).
Among adults who have achieved their full stature, the primary anthropometric indi-
cator of general nutritional status is the body mass index (BMI), defined as weight in
kilograms (kg) divided by height in meters (m) squared (kg/m2). A BMI of less than 18.5
is considered an indicator of wasting or being too thin for good health. Low BMI can be
caused by deficits in any of a range of nutrients, but also by infection that contributes to
poor absorption of consumed nutrients. For example, undernutrition or wasting among
adults is widely observed among adults with AIDS or acute episodes of diarrheal disease
and respiratory infections in high-risk populations.
Beyond using anthropometric indicators to assess nutritional status, there is also a
wide range of more specific mineral and vitamin deficiencies that have various clinical
and functional consequences. Among these are vitamin A deficiency that contributes
to stunting, disease and death, and blindness, as well as reproductive health problems;
iodine deficiency that results in a range of deleterious outcomes that range from goiter
to impaired neurological and mental function to stillbirths and unwanted abortion; and
anemia, often caused by iron deficiency or related absorption problems that can con-
tribute to impaired cognitive development, reduced ability to work, and increased risk
of maternal and child mortality.
To make matters a bit more complicated, we must also consider that the broader
concept of malnutrition includes an abnormal physiological condition caused by
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