The quantitative effect of infection on the use of food by young children in poor countries

A framework based on consistent and explicit set of assumptions is developed for evaluating the effect of infection on the intake and efficiency of use of food by children under 5 years old in poor countries. A variety of data is used to obtain quantitative estimates of catabolic losses, clinical and subclinical absorbtive losses, changes in food intake patterns, and losses due to high infant and childhood mortality. Although additional data are required before these estimates can be considered reliable, it appears that about 9% of the food available to a cohort of children under 5 years old in Bangladesh is not used for maintenance, growth, or activity of those children who survive to their 5th birthday. The amount of food that is not used effectively may be reduced to about 3% in a (hypothetical) situation where all sources of infection are eliminated but other conditions remain unchanged. The estimates suggest that the most important factors contributing to this inefficiency are reduced intake through food withdrawal and anorexia, and high mortality in young childhood. The potential nutritional effects of various public health programs are tentatively assessed.