Malnutrition

Editor(s): H. Szajewska Annales Nestlé Vol.67 / 2,  2009

Summary

While there is no generally accepted definition of malnutrition, one definition, also cited in this issue of Annales Nestlé, is ‘A state of nutrition in which a deficiency or excess (or imbalance) of energy, protein, and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function, and clinical outcomes’ [1] . Given the magnitude of the problem, as well as its consequences on growth, morbidity and mortality, this issue of Annales Nestlé was developed in an attempt to summarize recent developments related to pediatric malnutrition.

ARTICLES
  • Basic Clinical Assessment of Pediatric Malnutrition

    Author(s): C. Hartman, R. Shamir

    Screening and assessment for nutritional risk should be a routine part of clinical evaluation. Goals of nutritional assessment are to determine the risk or presence of malnutrition and to provide guidelines for short- and long-term therapy. Nutritional status is assessed through a simple, mainly clinical approach based on medical history, physical examination, anthropometric measurements, dietary intake, body composition and biological parameters. Nutritional status assessment should start by history and physical examination combined with dietary record. When a child is assumed to be at risk of malnutrition, evaluation for inadequate intake, reduced absorption, excessive losses, impaired utilization or increased requirements is needed. Growth is the best indicator of nutritional status. Analysis of growth (weight gain and growth velocity) using growth curves remains the simplest tool for assessing changes in nutritional status. Other anthropometric indices used for the assessment of nutritional status are body mass index, skinfold thickness and mid-arm circumference (MAC). Several classifications are used to define malnutrition, but none has been properly validated for diagnosing malnutrition in children. To date, routine nutritional screening is rarely carried out in pediatric patients due to the lack of a simple and valid nutritional screening tool. An easy-to-use screening tool that has been validated in a variety of pediatric conditions is yet to be developed.

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