Prevalence thresholds for wasting, overweight and stunting in children under 5 years

Mercedes De Onis, Elaine Borghi, Mary Arimond, Patrick Webb, Trevor Croft, Kuntal Saha, Luz Maria De-Regil, Faith Thuita, Rebecca Heidkamp, Julia Krasevec, Chika Hayashi, Rafael Flores-Ayala

Research output: Contribution to journalArticle

Abstract

Objective Prevalence ranges to classify levels of wasting and stunting have been used since the 1990s for global monitoring of malnutrition. Recent developments prompted a re-examination of existing ranges and development of new ones for childhood overweight. The present paper reports from the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring.Design Thresholds were developed in relation to sd of the normative WHO Child Growth Standards. The international definition of 'normal' (2 sd below/above the WHO standards median) defines the first threshold, which includes 2·3 % of the area under the normalized distribution. Multipliers of this 'very low' level (rounded to 2·5 %) set the basis to establish subsequent thresholds. Country groupings using the thresholds were produced using the most recent set of national surveys.Setting One hundred and thirty-four countries.Subjects Children under 5 years.Results For wasting and overweight, thresholds are: 'very low' (<2·5 %), 'low' (≈1-2 times 2·5 %), 'medium' (≈2-4 times 2·5 %), 'high' (≈4-6 times 2·5 %) and 'very high' (>≈6 times 2·5 %). For stunting, thresholds are: 'very low' (<2·5 %), 'low' (≈1-4 times 2·5 %), 'medium' (≈4-8 times 2·5 %), 'high' (≈8-12 times 2·5 %) and 'very high' (>≈12 times 2·5 %).Conclusions The proposed thresholds minimize changes and keep coherence across anthropometric indicators. They can be used for descriptive purposes to map countries according to severity levels; by donors and global actors to identify priority countries for action; and by governments to trigger action and target programmes aimed at achieving 'low' or 'very low' levels. Harmonized terminology will help avoid confusion and promote appropriate interventions.

Original languageEnglish (US)
Pages (from-to)175-179
Number of pages5
JournalPublic health nutrition
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Children
  • Malnutrition
  • Overweight
  • Stunting
  • Wasting

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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    De Onis, M., Borghi, E., Arimond, M., Webb, P., Croft, T., Saha, K., De-Regil, L. M., Thuita, F., Heidkamp, R., Krasevec, J., Hayashi, C., & Flores-Ayala, R. (2019). Prevalence thresholds for wasting, overweight and stunting in children under 5 years. Public health nutrition, 22(1), 175-179. https://doi.org/10.1017/S1368980018002434