Nutrition morbidity interactions in pre-school children

Area of Science:

• Pediatric Nutrition
• Infectious Diseases Epidemiology
• Public Health Research

Background:

• Historical studies from the 1970s indicated a cyclical relationship between undernutrition and infections in preschool children.
• Over decades, improvements in healthcare access and reduced undernutrition prevalence have been observed.
• This study aimed to reassess the bidirectional impact of undernutrition and infection in contemporary preschool populations.

Purpose of the Study:

• To evaluate changes in the effect of pre-infection undernutrition on morbidity risk in preschool children.
• To assess the impact of morbidity on the nutritional status of preschool children over time.
• To compare current findings with historical data from the 1970s.

Main Methods:

• A mixed longitudinal study design was employed.
• 3888 preschool children (0-59 months) from urban low- and middle-income families were enrolled.
• Monthly weight and length/height measurements, alongside fortnightly morbidity data collection, were conducted.

Main Results:

• Underweight and wasting were associated with a modest increase in infection risk (OR 1.09 for underweight, 1.18 for wasting).
• A small but statistically significant deterioration in weight-for-age and BMI-for-age Z-scores was observed during and after illness (P<0.001).
• Increased infection risk in undernourished children in poor hygiene settings was not significant, likely due to high infection rates in well-nourished children.

Conclusions:

• The bidirectional relationship between undernutrition and infection persists, though its magnitude may have changed.
• Improved healthcare access and utilization significantly mitigate the negative impact of infections on nutritional status.
• While undernutrition slightly elevates infection risk, prompt medical and nutritional care is crucial for maintaining children's health.