Clinical and biochemical characteristics associated with anthropometric nutritional categories

Clinical nutrition status as well as selected biochemical characteristics, levels of parasitic infection and aspects of family and health history were assessed in rural EI Salvadoran children categorized as severely malnourished by anthropometric measurements. The anthropometric categories used were based on weight-for-age, weight-for-height, height-for-age, and simple mid-upper-arm circumference. Results indicated that 16 of 17 children with less than 80% of expected weight-for-height ("wasted") and all 17 children with arm circumference below 12.5 cm had clinically evident malnutrition. Children with less than 82.5% of expected height-for-age ("stunted") were more frequently anemic than controls and had a higher intestinal parasite burden, but only 3 of 23 were malnourished clinically. Sixteen of 22 children with severe weight-for-age deficit (Gomez grade III) were judged clinically malnourished, but the remaining six were underweight primarily because of short stature and did not appear malnourished clinically. The results illustrated the inability of weight-for-age classification to distinguish between acute and chronic malnutrition. The interrelationships between weight-for-height, height-for-age, and weight-for-age classification are illustrated graphically as a guide to the interpretation of these results.