Child growth is internationally recognized as an important indicator of nutritional status in populations and underweight, wasting, and stunting are the three most common indicators used to measure nutritional imbalance resulting in undernutrition. The percentage stunting in an area reflects the cumulative effects of undernutrition and infections since and even before birth. The percentage of underweight can reflect the percentage of ‘wasting’ indicating acute weight loss, ‘stunting’, or both. Thus, 'underweight' is a composite indicator and may therefore be difficult to interpret. But, scholars argue that wasting is not a preferable indicator of undernutrition in areas with a high prevalence of stunting, because it may underestimate undernutrition. Can this proposition be acceptable?
Yes, it is acceptable. While stunting and wasting have related etiologies, the former (as you rightly state) better reflect an accumulation of health and nutrition insults starting in utero, and its prevalence (especially when disaggregated by wealth quintile) does show how well a society is coping with entrenched poverty, hunger and diseases. Wasting prevalence varies widely, since incidence is more important. The mortality risks are more acute in wasting, and many children face repeated episodes of wasting over time where conditions do not improve, but wasting is much more associated with health context and more extreme temporal conditions. Since the numbers of children who are wasted are far smaller than those stunted, the chronic underlying conditions are not well captured by only measuring weight for height. Ideally, both need to be measured. And if one is being measured, why not both?
Wasting is sometimes referred to as "acute malnutrition" because it is believed that episodes of wasting have a short duration, in contrast to stunting, which is regarded as chronic malnutrition. According to the latest UN estimates, an estimated 52 million children under 5 years of age, or 8%, were wasted in 2011. https://en.m.wikipedia.org/wiki/Wasting
Kindly check https://www.who.int/nutrition/topics/globaltargets_wasting_policybrief.pdf
Yes, right. Wasting is not a preferable indicator of undernutrition in areas with a high prevalence of stunting. Wasting is acute, so it is very sensitive to the addition of intake. while stunting is a long-term effect, growth in body length is greatly influenced by a variety of factors, particularly in the first 1000 days of life.
Kindly check the following article. You may find more. Link:
https://www.researchgate.net/publication/332410525_Adverse_Effect_of_Micronutrient_Deficiencies_on_Children's_Development_The_Wasting_Syndrome
It's too narrow of a focus. Growth stunting happens in children with adequate nutrition based on other factors. Wasting is a good indicator of undernutrition. Growth stunting can be causes by a number of factors.Then the issues of malnutrition itself is not always associated with wasting, as malnutrition (not low intake) is common in the obese in the US. We have type 2 diabetics who are in the 39 to 40 BMI percectile who are malnourished, but overfed. So, I suggest separating the two (poor growth and malnutrition) or the sake of indicators.
why are we needing to chose between the two at all? they mean different things and provide overlapping but not identical sets of information about children and populations. i really do not accept this 'single-focus' way of dealing with public health problems. stunting is stunting and wasting is wasting and both are important in their own right and need to be worked upon in different ways. we need to calmly stick to a comprehensive approach instead of getting into false dichotomies and debates. in my work, wasting is important for individual children and their outcomes, and stunting is important for keeping track of population/community level trends.
NFHS 5 data shows that stunting (in rural children) is 37.3% and underweight is 33.8% whereas wasting is 19.5%. So, some government officials may show wasting statistics, and say that it is not so high, and therefore not a big cause for concern.
There are reasons why you should stop quoting wasting as a statistic.
So stunting is when the child has less height that expected for her age. Undernutrition is less weight that expected for age.
So what bureaucrats and researchers have done is to presume that Indian children are ‘small made” and that they need not go by expected weight for age, but rather expected weight for height. So basically, they say that Indian children are anyway short so for that short height, they need less weight and something less than that expected weight should be called wasting. That makes the statistics look better than the actual problem.
But we know that given good diets, many Indian children can reach the heights of their western counterparts. This argument that Indians are small and therefore need less weight and that measurement should be on expected weight for height rather than expected weight for age, should be rejected.
Stunting is a sign of poor nutrition and healthcare. FULL STOP
It cannot be justified by bogus “Indian body structure” arguments.
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