‘Severe malnutrition’: thinking deeply, communicating simply
Marko Kerac, Marie McGrath, Nichola Connell, Chytanya Kompala, William H. Moore, Jeanette Bailey, Robert Bandsma, James A. Berkley, André Briend, Steve Collins, Tsinuel Girma, Jonathan C. K. Wells
Abstract
### Summary box Malnutrition affects millions worldwide and underlies almost half of deaths in children aged <5 years.1 Progress towards Sustainable Development Goal 2 (End hunger) was already slow but coronavirus-related secondary impacts now threaten nutritional crises described as: Biblical, on steroids, across generations .2 Towards effective actions, effective communication matters. Malnutrition involves a plethora of complex technical terminology. Sometimes it helps to go beyond details and consider problems at broader scale, especially when engaging with non-specialist stakeholders like policymakers, funders and the public. These may not wish to know full technical nuances, but they should: Focusing on undernutrition, we argue that a simple umbrella term, ‘Severe Malnutrition’ would benefit future communication and advocacy efforts. Defining a problem is vital for effective action/evaluation. Assessing both individual and population nutritional status typically involves anthropometry.3 Measurements (eg, weight) are interpreted through indices (eg, weight-for-age) in comparison with reference populations (eg, WHO Growth Standards, a ‘gold standard’ describing how healthy children should grow). Current terminology is summarised below.1 Often neglected is the full definition of malnutrition: ‘Any condition in which deficiency, excess or imbalance of energy, protein or other nutrients…adversely affects body function and/or clinical outcome’.4 Problems consequently arise. ### Undue focus on body size Being severely small (short or thin) alone …