Not to be taken lightly

AT In the previous article in this two-part series, I talked about the many negative health effects of childhood obesity. In the second part, we will turn our attention to the opposite end of the spectrum – underweight children.

The term “stunted growth” is used to describe children who do not grow at the expected rate for children of the same age and gender. The World Health Organization (WHO) has standardized the definition of stunted growth as two standard deviations (z-score from -2 to -3) below the mean for age and sex.

While we know that Malaysia is the most obese country in Southeast Asia, the 2018 Global Nutrition Report also ranks us among the worst in ASEAN in terms of nutrition. The criteria of interest were a certain percentage of the population with stunting, anemia in women of reproductive age, and obesity. In ASEAN, Malaysia is the only country reported to fulfill all three “burdens” listed above.

According to local statistics, in 2018 approximately 20% of our Malaysian children, or about 500,000 children, have stunted growth.

It has long been established that poor growth is closely associated with long-term cognitive deficits and academic performance. The child’s development is retarded and the child is unable to realize the expected learning potential in school. Often the psychosocial problems that contribute to growth retardation, including poverty and single-parent families, play a role in further limiting a child’s abilities.

Paradoxically, in low-income populations, stunting at an early age also poses a risk of subsequent obesity due to malnutrition, resulting in a double burden of undernourishment and then obesity. A possible explanation is that a dysfunctional family may prefer a diet that is mostly high in carbohydrates that lacks other essential nutrients due to the high cost of living.

80% of stunted growth is due to insufficient intake. This can be environmental (due to poverty), social (poor nutritional knowledge, improper milk dilution, neglect of children, etc.) or feeding difficulties (medical conditions such as cerebral palsy, cleft palate). etc.).

The remaining 20% ​​is associated with increased calorie intake (eg, in children after major surgery or with chronic diseases) and inefficient use of calories (eg, due to chronic diarrhea/vomiting, children with diabetes, etc.). This list is not exhaustive and in fact there are many possible medical causes of stunt growth.

When spotted growth is detected, it is best to recognize it at an early stage. During the first 2 years of life, all children visit medical facilities for vaccination, and it is at this time that routine measurements of weight, height and head circumference are taken. It is necessary to take into account not only the absolute number of measurements, but also the trend of the parameters. After 2 years of age, it is recommended to visit the clinic for height measurement every year until at least 5 years of age.

Early recognition and the first steps in managing interrupted growth work wonders in allowing a child to grow up healthy and reach their maximum potential.

Dr. Yip is a pediatrician working for KPJ Sentosa KL. Through his articles, he aims to help raise public awareness of common health issues in children.