Malnutrition is “the syndrome that results from the interaction between poor diets and disease and leads to most of the anthropometric deficits observed among children in the world’s less developed countries” . A large percentage of the world’s children grow and develop while experiencing malnutrition. The consequences of children becoming and remaining malnourished are increased risk of morbidity and mortality, delays in motor and mental development, and decreased work capacity [2, 3]. Malnutrition potentiates the effects of infection and contributes to more than half of all deaths of children under five years old [4, 5]. Most of these deaths occur among children with mild to moderate malnutrition.
In developing countries, the prevalence of general and, in particular, protein-energy malnutrition (PEM) among children up to the age of 5 years is declining, but the rate of decline is slow relative to what is required to reach the year 2000 goal for reduction of malnutrition adopted by the WHO. An important contribution is the involvement of health professionals to improve child nutrition in the communities.
Protein-energy malnutrition (PEM) is a clinical syndrome that is characterized by multiple progressively worsening nutrient deficiencies. Paramount to the clinical recognition and classification of PEM is weight loss. This is followed by either small or no increases in length over time if the syndrome becomes chronic. Weight-for-age and height-for-age deficits are used successfully to assess the health and nutritional risk of individuals and communities.
Undernutrition, or protein-energy malnutrition as it is often called, may occur at any stage in life. Most often, however, it is a symptom of developmental impairment that results from causes primarily operating during intrauterine life and the first three years. It kills nearly half of all children in developing countries and leaves those who sur-vive functionally disadvantaged for life. In this paper, the focus is on studies from developing countries that assess effects of childhood undernutrition on physical and cognitive development at school age, adolescence and adulthood. This is not because effects during early childhood are unimportant or unknown. Rather, it is because less is known and written about long-term consequences.
From time immemorial, crisis states such as famine, emergencies, war and other forms of political strife have victimized the nutritional well being of large segments of populations, children being particularly vulnerable. Historical evidence based on hospital data has pointed to the ill effects of severe proteinenergy malnutrition (PEM) on child growth, survival and development. Presently, it is well recognized that the multi-dimensional nature of PEM also encompasses many micronutrient deficiencies and milder forms of malnutrition. PEM also is classified by the degree of wasting and stunting. Each indicates current or recent nutritional conditions and/or nutritional experiences respectively over time. Though stunting in poor populations is associated largely with poor mental development, the socio-cultural and economic disadvantages that co-exist with stunting make it difficult to determine whether the direct causes of stunting also result directly in other functional deficits.