Prevalence of protein-energy malnutrition.

The data presented in this paper update the Bengoa-Donoso data (1974) presenting a more recent picture of the global nutrition situation with regard to the prevalence of protein-energy malnutrition (PEM) in children under 5 years of age. Since more specific indicators have been chosen for the tables in this paper a clearer picture can be drawn of the malnutrition problem. The data have been broken down into specific age groups and the indicators reference population and cut-offs are specified so that there can be better inter-country comparison than was possible with the Bengoa-Donoso data. In addition to updating the global nutrition picture another purpose of this paper is to introduce a process of evaluating progress toward health for all by utilizing nutritional indicators. The major nutritional indicators studied are: stunting (low height-for-age); underweight (low weight-for-age); and wasting (low weight-for-height). Of the 3 wasting is the most dangerous and signifies acute malnutrition. Comparing the prevalences among the 3 indicators it is evident that wasting is by far the lowest in prevalence with the prevalence of stunting and underweight being approximately the same. Since it has been shown that low weight-for-age reflects low weight-for-height and low height-for-age and since stunting is much more prevalent than wasting the report concludes that a great number of the underweight children are stunted and not suffering from acute malnutrition. Separating stunted from wasted children does present a more optimistic picture of the situation of global malnutrition than classifying them all together as underweight especially because we know that most of the underweight children are stunted but of normal weight-for-height and therefore do not necessarily require immediate intervention. The number of childern in need of immediate intervention is smaller than suggested by the number of low-weight-for-age children. Where high prevalence of wasting does occur--among 1-2 year olds it is not a result of general lack of food availability but rather a problem in which nutrition education and general health measures might have an impact. The world wide prevalence of stunting draws attention to the need for more information on the etiology and prevention of nutritional stunting.