Defining Paediatric Malnutrition



"an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein or micronutrients that may negatively affect growth, development and other relevant outcomes"1

Includes consideration of:

  • anthropometry
  • aetiology
  • mechanism
  • nutritional imbalance
  • outcomes

WHY IS THIS AN ISSUE?

Prevalence

  • 6-22% across Europe2-5, 7%-19.5% North America6,7, 7%-36% Turkey8,9, up to 38% China10,11
    • Varying figures reflect
      • How malnutrition/ malnutrition risk is quantified
      • Population sampled
  • Over the past 30 years paediatric malnutrition in the UK has stayed about the same:
    • 16% stunted, 14% wasted, 20% at risk (1990) 12
    • 13% stunted, 11% wasted (2011) 13

Consequences

  • Growth retardation
  • Delayed puberty
  • Impaired neurological development
  • Altered behaviour e.g. apathy, tiredness
  • Specific nutrient deficiencies
  • Effects on long-term health
  • Increased morbidity
  • Prolonged length of stay in hospital
  • Additional costs to the healthcare system
  • Family stress
References:
1.
Mehta et al, Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions 2013; 37:460-481.

2.
Chourdakis M, et al. Am. J. Clin. Nutr. 2016;103:1301-1310;

3.
Pawellek I, et al. Clin. Nutr.2008;27:72-76;

4.
Huysentruyt K, et al. Acta Paediatr. 2013;102:e460-e466;

5.
Lezo A, et al. Clin. Nutr. ESPEN 2017;21:72-78;

6.
Belanger V, et al. J. Pediatr. 2018.

7.
Hendricks KM, et al. Arch. Pediatr. Adolesc. Med. 1995;149:1118-1122;

8.
Dogan Y, et al. Turk. J. Gastroenterol. 2005;16:212-216;

9.
Pars H, et al. Clin Nutr. 2020;39:96-103;

10.
Song T, et al. Asia Pacific Journal of Clinical Nutrition 2017;26(6):1107-1112;

11.
Wang Y, et al. Spinal Cord 2017;55:247-254;

12.
Moy et al, Malnutrition in a UK children's hospital 1990; 3(2):93-100.

13.
Carey et al, Children's Nutrition Survey 2011: early key findings from the UK and Ireland 2011.