nutritional status of children measures, estimates and explanations
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Nutritional Status of Children 2
Malnutrition Indicators
• Malnutrition indicators: Differ with respect to the stage in one’s life cycle.
Nutritional Status of Children 3
Intra-uterine Undernutrition: Low Birth Weight (LBW)
• Cause: Maternal malnutrition:
• Effect: Malnutrition during intra-uterine life.
Retards the growth and development of the foetus during pregnancy.
The foetus is born with birth weight lower than normal.
The cut-off value for birth weight is 2.5 kg(WHO).
Babies born with birth weight <2.5 kg are LBW babies.
Nutritional Status of Children 4
Childhood Malnutrition
• Severe consequences if it occurs early in life.
– Adverse impact on subsequent growth, morbidity, cognitive development, educational attainment and productivity in adulthood.
Nutritional Status of Children 5
Nutrition status: Children U5
• Anthropometric Indicators:Height-for-age (HFA),Weight-for-age (WFA), Weight-for-height (WFH), andMUAC-for-age. Most sensitive indicators of food security, vulnerability
and overall socio-economic development of a country. Stunting, Wasting and Underweight. Z-score classification.
Nutritional Status of Children 6
Malnutrition IndicatorsMeasure the clinical phenomena of malnutrition.Standard cutoff points are used internationally to
define under nutrition in children 6-59 months.The cutoff points for nutrition indicators are derived
from the WHO child growth standard population (WHO standards) or NCHS reference population (NCHS population).
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Stunting (low height-for-age)
• Cause: Chronic under nutrition retards growth of a child by height.
• Stunting: child is shorter for its age.
• Information requirement: Estimates of height and age.
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Stunting (low height-for-age)
• Low HFA identifies past or chronic under nutrition (stunting)
• Stunting indicates reduced linear growth Cannot measure short-term changes in malnutrition For children <2 yrs of age, the term is
length-for-age/LA For children > 2 yrs age, the index is referred to as
height-for-age/HA
Nutritional Status of Children 9
Stunting: Classification
• Height-for-age up to -2SD = Normal
• Height-for-age <-2SD to -3SD = Moderate
• Height-for-age <-3SD = Severe
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Wasting (low weight–for-height)
• Cause: Acute, short-run malnutrition Affects only body weight.
“Wasting” of the body, i.e. loss of body mass compared to the body size.
Indicator: Weight-for-height.
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Wasting (low weight–for-height)
Weight for-height:Low WFH identifies current or acute under
nutrition (wasting)Useful when exact age is difficult to determine• - Weight for-length (< 2 yrs) or weight for-
height (in > 2 yrs)- Appropriate for examining short-term effects
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Wasting: Classification
• Normal weight-for-height: If its weight-for-height is within 2 standard deviations (-2SD) of the median weight-for-height of a reference population.
• Moderately wasted: If the weight-for-height falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD).
• Severely wasted: If the weight-for-height falls below 3SD of the reference median (<-3SD).
Nutritional Status of Children 13
Wasting: Classification
• Weight-for-height up to –2SD = Normal
• Weight-for-height <-2SD to –3SD = Moderate
• Weight-for-height <-3SD = Severe
Nutritional Status of Children 14
Underweight (low weight-for-age)
Composite indicator of long-term and acute short-term malnutrition.
The body weight may be lost from malnutrition for a long time => low weight-for-age.
Weight may also be lost from acute, short-term malnutrition => low weight-for-age.
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Underweight: Classification
• Normal weight-for-age: If weight-for-age is within 2 standard deviations (-2SD) of the median weight-for-age of a reference population.
• Moderately underweight: If the weight-for-age falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD).
• Severely underweight: If the weight-for-age falls below 3SD of the reference median (<-3SD).
Nutritional Status of Children 16
Underweight: Classification
• Weight-for-age up to -2SD = Normal
• Weight-for-age <-2SD to -3SD = Moderate
• Weight-for-age <-3SD = Severe
Nutritional Status of Children 18
Mid- Upper Arm Circumference (MUAC)
Low MUAC (<12.5 cm) indicates acute malnutrition among children 6-59 months.
Is relatively easy to measure and a good predictor of immediate risk of death.
Is used for rapid screening of acute malnutrition.
Nutritional Status of Children 21
Undernutrition trends among <5 children in Bangladesh
47.8
1713
44.6
57.4
68.3
41
51
65.8
43
43.1
51.4
64.264.6
48.3
42.4
14.416.7 16.6
12 12.7
10
20
30
40
50
60
70
80
1989/90 1992 1995 2000 2005 2007 2009
Source: 1990-2005 CMNS; 2007 BDHS; 2009 HFSNA
Per
cent
Underweight <5 Stunting <5Wasting <5 MDG target for underweight
22
Food consumption, energy and nutrient intake and nutritional status in rural
Bangladesh: Changes from 1981 – 1982 to 1995 – 96
Source: Hels et al. (2003)