Stunting, undernutrition and obesity: the triple threat of childhood malnutrition
This collection of BMI Medicine pulls together publications highlighting research into the mediating factors for, and potential solutions to, childhood undernutrition and obesity. They address a challenge that has faced public health and clinical nutritionists for decades: Can the rigorous application of research into causative pathways trigger a paradigm shift that will transform our currently limited
ability to stimulate better growth and development in stunted and wasted children and ameliorate the dangers of excess adiposity at the other end of the spectrum? And can nations combat undernutrition without the anthropometric pendulum swinging too far and causing a new health burden in the form of childhood obesity? The collection contains a number of articles focussing on different sides of the issue. One article reviews the potential mechanisms, consequences and management strategies of environmental enteric dysfunction, and its association relation with stunting. Another article sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of moderate-to-severe diarrhea (MSD). A last example of the articles aims to provide a comprehensive description of the worldwide epidemic of excess weight in children and present global, regional and national trends. The editorial of the collection conclude that successes of combating malnutrition generally occur without the aid of targeted interventions; many forms of undernutrition (stunting, wasting, anaemia, vitamin A deficiency) resolve as nations pass through the demographic and wealth transition. The bad news is that in almost all such circumstances the pendulum swings too far and the population races towards an obesity epidemic. Moreover, specific interventions to address stunting in countries that are not blessed by rapid economic progress are often stubbornly unsuccessful. The search for integrated and affordable solutions must go on.