Body composition of children with moderate and severe undernutrition and after treatment: a narrative review

Abstract Background Until recently, undernourished children were usually assessed using simple anthropometric measurements, which provide global assessments of nutritional status. There is increasing interest in obtaining more direct data on body composition to assess the effects of undernutrition o...

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Main Author: Jonathan C. K. Wells
Format: Article
Language:English
Published: BMC 2019-11-01
Series:BMC Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12916-019-1465-8
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author Jonathan C. K. Wells
author_facet Jonathan C. K. Wells
author_sort Jonathan C. K. Wells
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description Abstract Background Until recently, undernourished children were usually assessed using simple anthropometric measurements, which provide global assessments of nutritional status. There is increasing interest in obtaining more direct data on body composition to assess the effects of undernutrition on fat-free mass (FFM) and its constituents, such as muscle and organs, and on fat mass (FM) and its regional distribution. Main text Recent studies show that severe-acute undernutrition, categorised as ‘wasting’, is associated with major deficits in both FFM and FM that may persist in the long-term. Fat distribution appears more central, but this is more associated with the loss of peripheral fat than with the elevation of central fat. Chronic undernutrition, categorised as ‘stunting’, is associated with deficits in FFM and in specific components, such as organ size. However, the magnitude of these deficits is reduced, or – in some cases – disappears, after adjustment for height. This suggests that FFM is largely reduced in proportion to linear growth. Stunted children vary in their FM – in some cases remaining thin throughout childhood, but in other cases developing higher levels of FM. The causes of this heterogeneity remain unclear. Several different pathways may underlie longitudinal associations between early stunting and later body composition. Importantly, recent studies suggest that short children are not at risk of excess fat deposition in the short term when given nutritional supplementation. Conclusion The short- and long-term functional significance of FFM and FM for survival, physical capacity and non-communicable disease risk means that both tissues merit further attention in research on child undernutrition.
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spelling doaj.art-02a8415dfd0941659660dc82859561eb2022-12-21T18:22:14ZengBMCBMC Medicine1741-70152019-11-011711910.1186/s12916-019-1465-8Body composition of children with moderate and severe undernutrition and after treatment: a narrative reviewJonathan C. K. Wells0Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, University College London (UCL) Great Ormond Street Institute of Child HealthAbstract Background Until recently, undernourished children were usually assessed using simple anthropometric measurements, which provide global assessments of nutritional status. There is increasing interest in obtaining more direct data on body composition to assess the effects of undernutrition on fat-free mass (FFM) and its constituents, such as muscle and organs, and on fat mass (FM) and its regional distribution. Main text Recent studies show that severe-acute undernutrition, categorised as ‘wasting’, is associated with major deficits in both FFM and FM that may persist in the long-term. Fat distribution appears more central, but this is more associated with the loss of peripheral fat than with the elevation of central fat. Chronic undernutrition, categorised as ‘stunting’, is associated with deficits in FFM and in specific components, such as organ size. However, the magnitude of these deficits is reduced, or – in some cases – disappears, after adjustment for height. This suggests that FFM is largely reduced in proportion to linear growth. Stunted children vary in their FM – in some cases remaining thin throughout childhood, but in other cases developing higher levels of FM. The causes of this heterogeneity remain unclear. Several different pathways may underlie longitudinal associations between early stunting and later body composition. Importantly, recent studies suggest that short children are not at risk of excess fat deposition in the short term when given nutritional supplementation. Conclusion The short- and long-term functional significance of FFM and FM for survival, physical capacity and non-communicable disease risk means that both tissues merit further attention in research on child undernutrition.http://link.springer.com/article/10.1186/s12916-019-1465-8Child undernutritionUndernutritionBody compositionWastingStunting
spellingShingle Jonathan C. K. Wells
Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
BMC Medicine
Child undernutrition
Undernutrition
Body composition
Wasting
Stunting
title Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
title_full Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
title_fullStr Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
title_full_unstemmed Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
title_short Body composition of children with moderate and severe undernutrition and after treatment: a narrative review
title_sort body composition of children with moderate and severe undernutrition and after treatment a narrative review
topic Child undernutrition
Undernutrition
Body composition
Wasting
Stunting
url http://link.springer.com/article/10.1186/s12916-019-1465-8
work_keys_str_mv AT jonathanckwells bodycompositionofchildrenwithmoderateandsevereundernutritionandaftertreatmentanarrativereview