Classification and History of Malnutrition

Malnutrition can be classified into different categories, respectively, malnutrition, overnutrition, micronutrient-related malnutrition, severe acute (SAM), moderate acute (MAM), and global acute malnutrition (GAM). Evaluating body mass index (BMI) is one of the most important ways to distinguish some of these categories.

Malnutrition consists of stunting, wasting, underweight, and micronutrient deficiencies. Stunting refers to a condition in which children are lower than normal for age. Underweight refers to a lower than normal weight, while underweight refers to a lower than normal weight for age. Micronutrient deficiency refers to insufficient intake of vitamins and minerals. In more technical terms, the World Health Organization defines these terms as follows. Low weight is defined as weight for age <2 standard deviations (SD) of the WHO Child Growth Standards median.

Stunting is defined as the height of the WHO Child Growth Standard median for age <2 SD. Attenuation is defined as <2 SD height weight of the WHO Child Growth Standards median. Factors are known to predispose to some of them. It is associated with low birth weight, intrauterine growth retardation or restriction, prematurity, or both. This situation is likely to ultimately predispose to poor health in vulnerable societies. These conditions predispose to increased growth in adulthood, cognitive and chronic disease development, as well as morbidity and mortality, especially in newborns. Low birth weight babies are 20 times more likely to die from them than healthy babies.

Excessive nutrition consists of obesity and overweight. These are important as lifestyle disorders are increasingly associated with diabetes mellitus and cardiovascular diseases, particularly cancer-causing morbidity and mortality from stroke and even noncommunicable diseases. In more technical terms, overweight is defined as weight according to the> +2 SD of the WHO Child Growth Standards median.

While malnutrition is common in societies with malnutrition and other predisposing factors previously described, overnutrition is inversely associated with wealthier societies that tend to live more sedentary lives and can afford more palatable and quickly prepared junk food. This type of food is relatively inexpensive and readily available to most of the world’s population. No wonder there is an increase in related nutritional disorders. Differences in nutritional status can also be seen in individual families in a particular community.

Historical Background of Malnutrition Classification

Part of the documented historical background of malnutrition classifications goes back to 1956, when Gómez and Galvan examined factors that they thought were associated with death among malnourished children in Mexico City. Originally, this classification was based on the first, second, and third degrees, respectively. Ratings are based on weight below a certain median weight percentage for age. According to this classification, the risk of death increases with increasing degree of malnutrition.

An adaptation of Gomez’s original classification is still in use today. Although this change provides a way of comparing malnutrition within and between populations, this classification has been criticized for being too arbitrary and, apart from the fact that the neck alone may not be the best indicator of malnutrition, it does not view overweight as a classification of malnutrition. Premature children can be considered short for their age, even if they are well nourished. However, criticism has led to a new malnutrition classification by John Conrad Waterlow. The Waterlow classification therefore combines weight for height (indicating acute malnutrition episodes) with height to indicate stunting caused by chronic malnutrition. One advantage of the Waterlow classification over the Gomez classification is that the height can be examined even if their age is not known. The World Health Organization has since changed some of these classifications.


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