Acute Undernutrition and Child Development in Low- and Middle-Income Countries: A Meta-analysis
Nazia Binte Ali1,2, Mathilda Regan1, Nandita Perumal1,3
1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
Nutrition Reviews
|October 7, 2025
Summary
Acute undernutrition in children, including severe acute malnutrition (SAM) and wasting, is linked to poorer cognitive and motor development. These findings highlight the critical impact of early nutrition on long-term child development outcomes.
Area of Science:
- Child Development
- Global Health
- Nutritional Science
Background:
- While linear growth faltering's impact on child development is known, less attention has been given to acute undernutrition metrics.
- Acute undernutrition significantly affects child development, particularly in low- and middle-income countries (LMICs).
Purpose of the Study:
- To quantify the association between acute undernutrition metrics in childhood and subsequent development outcomes.
- Focus on children under five years old in LMICs.
Main Methods:
- Systematic literature review of observational studies.
- Included metrics: BMI-for-age z score (BMIZ), mid-upper arm circumference (MUAC), weight-for-height/-length z score (WHZ/WLZ), wasting, and severe acute malnutrition (SAM).
- Assessed cognitive, motor, language, and socioemotional development up to 19 years of age; pooled correlation and standardized mean difference (SMD) were estimated.
Main Results:
- 113 studies from 40 LMICs were analyzed.
- Acute undernutrition metrics were associated with lower cognitive and motor development scores.
- Severe acute malnutrition (SAM) was linked to significantly lower cognitive (-1.06 SD) and motor (-0.42 SMD) scores; wasting was associated with lower motor scores (-0.30 SMD).
Conclusions:
- Childhood acute undernutrition consistently correlates with diminished development scores.
- The negative impact on development appears more pronounced in children with severe acute malnutrition (SAM) or wasting.
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