Bundred et al described a significant increase in weight and body
mass index in children in the Wirral Health Authority of North West
England.(1) Their article led to a number of media headlines bemoaning
the extent of childhood obesity in the UK.
Whilst Bundred et al’s article is interesting, their findings should
not distract attention from the high prevalence of both acute and chronic
protein-energy malnutrition in many communities. In 1990, Moy et al
reported that 16% of hospitalised children in Birmingham were severely
stunted, and 14% were severely wasted.(2) A further 20% were at risk of
severe malnutrition. Hendrickse et al also reported a high prevalence of
malnutrition in children seen in a Glasgow hospital in 1997.(3) Sixteen
percent of children were underweight-for age (<_5th centile="centile" _15="_15" were="were" stunted="stunted" _5th="_5th" height-for-age="height-for-age" and="and" _8="_8" wasted="wasted" _80="_80" weight-for="weight-for" height.="height." a="a" further="further" _16="_16" at="at" risk="risk" of="of" becoming="becoming" undernourished.="undernourished." p="p"/> In a recent study, we prospectively investigated the nutritional
status of 204 children attending the Booth Hall Children’s Hospital in
Manchester. Using the Waterlow criteria,(4,5) 23 children (11%) were
wasted (<_80 weight-for-height="weight-for-height" and="and" a="a" further="further" _43="_43" children="children" _21="_21" had="had" evidence="evidence" of="of" mild="mild" malnutrition="malnutrition" _80-90="_80-90" weight-for-height.="weight-for-height." thirty="thirty" nine="nine" _19="_19" were="were" chronically="chronically" malnourished="malnourished" with="with" _14="_14" them="them" _7="_7" severely="severely" stunted="stunted" _85="_85" height-for-age.="height-for-age." six="six" _3="_3" both="both" acute="acute" chronic="chronic" malnutrition.="malnutrition." _76="_76" _72="_72" respectively="respectively" the="the" no="no" pre-existing="pre-existing" disease="disease" that="that" would="would" explain="explain" their="their" p="p"/> The high incidence of both acute and chronic malnutrition in children
attending hospitals reflects the prevalence of undernutrition in the
community. The effects of this on health, growth, and development could
be serious. The interpretation of Bundred et al’ findings should
therefore be put into perspective.
Competing interests: None
References
1.Bundred P, Kitchiner D, Buchan I. Prevalence of overweight and obese
children between 1989 and 1998: population based series of cross sectional
studies. BMJ 2001;322:326–8
2.Moy RJD, Smallman S, Booth IW. Malnutrition in a UK children’s
hospital. J Hum Nutr Diet 1990;3:93-100
3.Hendrikse WH, Reilly JJ, Weaver LT. Malnutrition in a children’s
hospital. Clin Nutr 1997;16:13-8
4.Waterlow JC. Classification and definition of protein calorie
malnutrition. BMJ 1972;3:566-9
5.Waterlow JC. Note on the assessment and classification of protein
energy malnutrition in children. Lancet 1973;2:87-9
Competing interests:
No competing interests
07 March 2001
Sarah Liptrot
(a)Medical Student and (b)Consultant Paediatric Gastroenterologist
Anthony K Akobeng
Booth Hall Children's Hospital, Charlestown Road, Manchester. M9 7AA
Rapid Response:
Malnutrition in children
Bundred et al described a significant increase in weight and body
mass index in children in the Wirral Health Authority of North West
England.(1) Their article led to a number of media headlines bemoaning
the extent of childhood obesity in the UK.
Whilst Bundred et al’s article is interesting, their findings should
not distract attention from the high prevalence of both acute and chronic
protein-energy malnutrition in many communities. In 1990, Moy et al
reported that 16% of hospitalised children in Birmingham were severely
stunted, and 14% were severely wasted.(2) A further 20% were at risk of
severe malnutrition. Hendrickse et al also reported a high prevalence of
malnutrition in children seen in a Glasgow hospital in 1997.(3) Sixteen
percent of children were underweight-for age (<_5th centile="centile" _15="_15" were="were" stunted="stunted" _5th="_5th" height-for-age="height-for-age" and="and" _8="_8" wasted="wasted" _80="_80" weight-for="weight-for" height.="height." a="a" further="further" _16="_16" at="at" risk="risk" of="of" becoming="becoming" undernourished.="undernourished." p="p"/> In a recent study, we prospectively investigated the nutritional
status of 204 children attending the Booth Hall Children’s Hospital in
Manchester. Using the Waterlow criteria,(4,5) 23 children (11%) were
wasted (<_80 weight-for-height="weight-for-height" and="and" a="a" further="further" _43="_43" children="children" _21="_21" had="had" evidence="evidence" of="of" mild="mild" malnutrition="malnutrition" _80-90="_80-90" weight-for-height.="weight-for-height." thirty="thirty" nine="nine" _19="_19" were="were" chronically="chronically" malnourished="malnourished" with="with" _14="_14" them="them" _7="_7" severely="severely" stunted="stunted" _85="_85" height-for-age.="height-for-age." six="six" _3="_3" both="both" acute="acute" chronic="chronic" malnutrition.="malnutrition." _76="_76" _72="_72" respectively="respectively" the="the" no="no" pre-existing="pre-existing" disease="disease" that="that" would="would" explain="explain" their="their" p="p"/> The high incidence of both acute and chronic malnutrition in children
attending hospitals reflects the prevalence of undernutrition in the
community. The effects of this on health, growth, and development could
be serious. The interpretation of Bundred et al’ findings should
therefore be put into perspective.
Competing interests: None
References
1.Bundred P, Kitchiner D, Buchan I. Prevalence of overweight and obese
children between 1989 and 1998: population based series of cross sectional
studies. BMJ 2001;322:326–8
2.Moy RJD, Smallman S, Booth IW. Malnutrition in a UK children’s
hospital. J Hum Nutr Diet 1990;3:93-100
3.Hendrikse WH, Reilly JJ, Weaver LT. Malnutrition in a children’s
hospital. Clin Nutr 1997;16:13-8
4.Waterlow JC. Classification and definition of protein calorie
malnutrition. BMJ 1972;3:566-9
5.Waterlow JC. Note on the assessment and classification of protein
energy malnutrition in children. Lancet 1973;2:87-9
Competing interests: No competing interests