Nutritional status, age and survival: the muscle mass hypothesis

The relevance of nutritional indices derived from comparison with growth standards to assess the risk of dying was evaluated in a 2-year prospective study in rural Senegal. An average of 3151 children aged 6-59 months were measured twice a year and followed up during the intervening 6-month periods. Children who survived and those who died during follow-up were found to differ more by anthropometric measures directly related to absolute muscle mass (viz. weight, height or arm circumference) than by nutritional indices obtained from comparison with growth standards (weight-for-age, weight-for-height and height-for-age). The findings could not be explained by a confounding effect of age. This brings into question the current approach used to identify high-risk children.