Undernutrition in children: features of clinical manifestations and food intake

Undernutrition in children is an important problem of health care due to negative impact on the development of an organism and increase of global morbidity and mortality..

Objective. To assess the clinical manifestations and food intake of children with undernutrition.

Patients and methods. Four hundred and thirty-one children with undernutrition aged 1 month to 17 years and 11 months (the median of age is 7 [2.5; 13] years), boys – 238 (55.2 %), girls – 193 (44.8 %), were examined. All children underwent anthropometry using Z-Score values by WHO criteria (WHO Anthro and Anthro plus programs). Specialized centile tables were used with subsequent conversion of the obtained indicators into sigma deviations Z-Score in children with genetic syndromes. Undernutrition was registered in children with body mass index (BMI) by age Z-Score ≤ –1, the stunting was diagnosed with growth by age Z-Score ≤-2. Assessment of food intake at home was underwent in 199 children by recording and accounting for weighted food.

Results. Mild undernutrition was diagnosed in 175 (40.6 %) children, moderate – in 127 (29.5 %), severe – in 129 (29.9 %) children. Severe undernutrition (43.2 % and 38.9 %) was most often registered in the age groups of 11–14 years and 15–17 years. The stunting was observed in 116 (26.9 %) children. The onset of malnutrition was revealed in three-quarters of children before the age of 1 year. The analysis of food intake revealed hypocaloric diet in 153 (76.9 %) patients, normocaloric diet in 32 (16.1 %) and hypercaloric diet in 14 (7 %) patients. Deficiency of protein, fat and carbohydrate intake was registered in 38.7, 72.4, 78.4 % cases, respectively, by assessment of macronutrient composition of the diet in children with undernutrition.

Conclusion. Most children had mild undernutrition. Severe undernutrition was revealed significantly more often in patients of older age groups. Сhildren with undernutrition need early correction of the diet and appointment of nutritional support due to decrease in the energy intake in 76.9 % of children and the imbalance in macronutrients

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