Severe Malnutrition

Severe malnutrition includes growth stunting among impoverished populations that begins in childhood and continues into adulthood. Acute malnutrition can occur at any age and often complicates the care of patients with acute illnesses worldwide. All forms of severe malnutrition lead to an array of pathophysiologic changes in multiple organ systems that may not recover fully, even when the patient’s nutritional status appears be clinically restored. Effective interventions to reverse growth stunting are relatively lacking, and preventive approaches focus on improved sanitation, attention to acute and chronic infections, and increased intake of complete dietary protein. Uncomplicated cases of acute malnutrition can generally be treated as outpatients using ready-to-use therapeutic food; cases complicated by severe infection or anorexia require inpatient treatment. Patients with malnutrition concomitant with an acute illness will benefit from nutritional rehabilitation in addition to therapies directed at their primary underlying disease(s). The consequences of stunting and acute malnutrition in childhood persist for life and place survivors at increased risk for the metabolic syndrome and obesity.