Micronutrient needs of malnourished children

PURPOSE OF REVIEW: In addition to overt manifestations of undernutrition such as stunting, wasting and underweight, micronutrient deficiencies are also recognized as important components of the spectrum of malnutrition. This review focuses on recent advances in our understanding of undernutrition and micronutrient deficiencies during childhood from a review of the literature over the last 18 months (August 2006-January 2008). RECENT FINDINGS: There is considerable advance in our understanding of the epidemiology and burden of childhood undernutrition and micronutrient deficiencies. Based on recent surveys, an estimated 32% (178 million) of children under 5 years of age were stunted. The corresponding global estimate of wasting is 10% (55 million children), of which 3.5% (19 million children) are severely wasted. It is estimated that nearly 11% of all children under 5 years of age, die due to four micronutrient deficiencies (vitamin A, zinc, iron and iodine). There is evidence from recent reviews of evidence-based interventions that administering single or multiple micronutrients can make a significant difference to health outcomes. However, delivery strategies may differ and recent data suggest that fortification may be a more efficient strategy to deliver multiple micronutrients. SUMMARY: These findings support the scaling up of evidence-based interventions to prevent and treat such deficiencies and to integrate these within health systems.