The association between wasting and stunting: an international perspective

Wasting and stunting are widely used indices for describing the prevalence of malnutrition in childhood. Studies from Latin America, however, consistently show low prevalences of wasting in the presence of other indicators of poor health. A data base assembled by the World Health Organization, including 175 studies with information on wasting and stunting among 1-y-old children from four regions (Africa, Americas, Asia and Eastern Mediterranean), was used for examining the prevalences of the two indices and their associations. Whereas there was little variation in the median prevalences of stunting among the four regions, those of wasting showed a sevenfold differential. In Africa and Latin America, the correlations between the two prevalences were low; nevertheless, wasting was about three times higher in Africa, for any given level of stunting, than in Latin America. In Asia and the Eastern Mediterranean, there were strong positive correlations between stunting and wasting, but wasting was about twice as common in Asia for any given level of stunting. To interpret low prevalences of wasting as being indicative of a low intensity of malnutrition may be misleading; weight-for-height standards and cut-offs may have to be re-examined for use in different populations.