Diagnosing and misdiagnosing malnutrition

With the purpose of validating new tools as AKS and Energy/Protein Indices for a more precise diagnosis of malnutrition, specially in the case of constitutionally thin or constitutionally heavy subjects which could mistakenly be interpreted as undernourished or obese, two hundred healthy children, one hundred girls and one hundred boys 4.6 to 5.5 years of age, were studied. The limitations of weight for stature and the advantages of indicators which determine body composition as accurate measures of malnutrition were demonstrated. In a group of lean individuals with weight for stature under 90%, if E/P figures are under the 10th percentile and AKS is under 1.12, the subject is very likely to be undernourished. In contrast, if the subject, though underweight, shows an E/P Index above the 10th percentile and an AKS over 1.12, constitutional thinness should be considered. In overweight subjects, E/P figures above the 90th percentile point to obesity, while children with E/P between the 10th and 90th percentiles are probably stocky but not fatty subjects. The usefulness of the combination of the above mentioned criteria in cases suspected to be malnourished, and its introduction in daily practice, will prevent from iatrogenic practices due to erroneous diagnosis.