Using a standardized set of measurements will help health professionals more accurately diagnose malnutrition among children ages 1 month to 18 years, as well as improve their treatment, according to a new joint statement from the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition.
In the consensus statement endorsed by the American Academy of Pediatrics and published in the December Journal of the Academy of Nutrition and Dietetics, and Nutrition in Clinical Practice, the two organizations say: "The universal use of a single set of diagnostic parameters will expedite the recognition of pediatric undernutrition, lead to the development of more accurate estimates of its prevalence and incidence, direct interventions and promote improved outcomes." (Read the complete text of "Indicators Recommended for the Identification and Documentation of Pediatric Malnutrition (Undernutrition)" on the Journal website.)
Pediatric malnutrition - or undernutrition - contributes to an estimated 45 percent of all children's deaths around the world, according to the Academy's and ASPEN's statement. "Approximately 20 million children younger than 5 years of age worldwide are severely undernourished, leaving them extremely vulnerable to illness and premature death. Many older children in developing countries enter adolescence undernourished, which increases their vulnerability to disease and premature death. Poverty, famine and war are primary contributors to global malnutrition and limit food distribution and access, even when food is available for consumption."
The number of American children who experience undernutrition is unknown, according to the Academy and ASPEN. "Children and adolescents who live in homeless shelters, are victims of abuse or neglect or live in urban or rural areas where access to high-quality food is difficult, are thought to be at increased risk for undernutrition." Also at risk are children hospitalized with acute and/or chronic illness and children with special health care needs.
The Academy and ASPEN recommend that "a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice." These indicators include "z scores for weight for height/length, body mass index for age, mid-upper arm circumference, rate of weight gain or loss and inadequate nutrient intake," among other measures. The indicators should become part of routine practice by clinicians caring for pediatric patients in all health care settings.
"Clinicians should use as many data points as available to identify and document the presence of malnutrition…A standardized diagnostic approach will also inform the prediction of the human and financial responsibilities and costs associated with the prevention and treatment of undernutrition in this vulnerable population, and help to further ensure the provision of high-quality, cost-effective nutrition care," the statement reads.
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