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Updated: Aug 13, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Nutritional Risk and Malnutrition in Paediatrics: From Anthropometric Assessment to Strongkids® Screening Tool
Luís Vieira Gonçalves1, Ana Gisela Oliveira2, Mariana Barracosa3
1Serviço de Anestesiologia. Centro Hospitalar de Leiria. Leiria. Portugal.
Insights
Hospitalized children face high malnutrition risks. The STRONGkids® tool effectively identifies at-risk children, enabling early nutritional intervention to improve health outcomes.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment
- Public Health
Background:
- Malnutrition is prevalent in hospitalized children, leading to adverse health consequences.
- Early identification and intervention are crucial for managing nutritional status in pediatric hospital settings.
Purpose of the Study:
- To characterize the nutritional status of hospitalized children.
- To compare nutritional risk stratification using the STRONGkids® tool versus anthropometric assessment.
Main Methods:
- Prospective study of children aged 1 month to 17 years.
- Utilized STRONGkids® screening and anthropometric measurements (z-scores).
- Assessed correlation with hospitalization details and chronic conditions.
Main Results:
- 25% of children were malnourished; 6% acute, 14% chronic malnutrition.
- STRONGkids® identified 54% at moderate risk and 2% at high risk.
- STRONGkids® scores correlated with admission nutritional status and disease severity.
Conclusions:
- STRONGkids® is a simple, rapid tool for nutritional screening in hospitalized children.
- High rates of malnutrition risk necessitate early detection and intervention.
- Implementing STRONGkids® can improve nutritional care during pediatric hospitalizations.
Introduction:
The prevalence of malnutrition in hospitalized children is high and is associated with negative health impact. The aim of this study was to characterize the nutritional status of hospitalized children as well as comparing nutritional risk stratification using the STRONGkids® tool and anthropometric assessment.
Material And Methods:
A prospective study was conducted between March and June 2019 in a paediatric unit of a district hospital. Children with ages between one month and 17 years were included. Nutritional screening (STRONGkids®) was performed, and demographic and anthropometric variables were assessed by trained doctors and nurses (z-scores for height-for-age, weight-for-age, weight-for-height and body mass index were compared to the World Health Organization reference values) and related to the underlying condition (cause of hospitalization; hospital stay; the presence of chronic disease).
Results:
A total of 209 children were evaluated, 188 of whom were included. Median age was 4.6 years and median hospital length of stay was four days. Fifty-four per cent were classified with "moderate risk" and 2% with "high risk" of developing malnutrition; 25% were effectively malnourished. Of the 105 children for which it was possible to calculate the z-scores, 6% presented acute malnutrition and nearly 14% presented chronic malnutrition. The STRONGkids® score correlated positively with nutritional status on admission, disease type on admission, and presence of previous underlying disease (p < 0.05).
Conclusion:
STRONGkids® is a simple, quick nutritional screening tool for hospitalized children that is related to nutritional status on admission. Given that a considerably high percentage of children were identified as being at risk for malnutrition, it is essential to identify this early and provide nutritional intervention during hospitalization.
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