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Evidence-based prevention of childhood malnutrition

Imdad, Aamera; Sadiq, Kamranb; Bhutta, Zulfiqar Aa

Current Opinion in Clinical Nutrition and Metabolic Care: May 2011 - Volume 14 - Issue 3 - p 276–285
doi: 10.1097/MCO.0b013e328345364a
Paediatrics: Edited by Berthold V. Koletzko and Raanan Shamir

Purpose of review Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field.

Recent findings Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease.

Summary There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions.

aDivision of Women and Child Health, Pakistan

bDepartment of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan

Correspondence to Dr Zulfiqar A. Bhutta, Chair Women and Child Health Division, Faculty Office Building, Aga Khan University, Stadium Road, Karachi 74800, Pakistan Tel: +92 21 486 4782; fax: +92 21 493 4294; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.