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Related Experiment Video

Updated: Mar 21, 2026

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Published on: January 29, 2018

Forensic aspects of starvation.

Burkhard Madea¹, Jan Ortmann², Elke Doberentz²

¹Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany. b.madea@uni-bonn.de.

Forensic Science, Medicine, and Pathology

|May 6, 2016

Summary

Fatal starvation, though rare, has medicolegal importance, especially in infant deaths. The Waterlow classification aids forensic pathologists in assessing malnutrition severity and duration in legal cases.

Keywords:

Autopsy findings Protein–energy malnutrition Starvation Stunting Wasting Waterlow classification

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Area of Science:

Forensic Pathology
Pediatric Nutrition
Medical Law

Background:

Fatal starvation is a rare but medicolegally significant cause of death, particularly in infants due to deliberate food withholding.
Accurate assessment of malnutrition is crucial for forensic investigations to determine the cause, degree, and duration of starvation.
Existing classifications like Gomez may lack accuracy for infants due to weight variations.

Purpose of the Study:

To demonstrate the application of the Waterlow classification in assessing fatal starvation cases.
To highlight the utility of anthropometric data and the Waterlow classification in legal contexts involving malnutrition.
To evaluate the Waterlow classification's effectiveness in grading chronic malnutrition and its progression.

Main Methods:

Review and application of the Waterlow classification system to case material and published literature.
Calculation of stunting using the ratio of measured height to expected height for age.
Analysis of anthropometric data for grading malnutrition (stunting and wasting).

Main Results:

The Waterlow classification provides a method for grading stunting and wasting, aiding in the assessment of nutritional status in legal cases.
The classification is valuable for evaluating the final stage of fatal starvation.
Repeated anthropometric measurements allow for the chronological assessment of nutritional status development.

Conclusions:

The Waterlow classification is a valuable tool for forensic pathologists in cases of fatal starvation, especially in infants.
It assists in objectively grading the severity and duration of malnutrition in medicolegal investigations.
The classification's utility extends to understanding the progression of malnutrition over time when serial data is available.