Type of Paper: Review
Purpose: In 2008, the World Health Organization (WHO) organized a meeting on the nutrient needs and the dietary management of moderate malnutrition in children under 5 years of age. This paper was written as a background paper for the meeting and was included in the special issue on the Dietary Management of Moderate Malnutrition in the Food and Nutrition Bulletin. The purpose of this paper was to review the effectiveness of dietary counseling in treating moderate malnutrition in children.
- Moderate malnutrition is common in children living in low-income countries.
- Although moderate malnutrition increases the risk for disease and mortality, moderate malnutrition has rarely been identified as a public health priority.
- Data was obtained from United Nations organizations, international organizations, pediatric associations, and national programs about the dietary advice and counseling these organizations give to caregivers of children with moderate malnutrition.
Summary of Results:
- Dietary counseling is a vital part of treating malnutrition.
- Dietary recommendations given to mothers of moderately malnourished children are the same as those given to mothers of well-nourished children.
- General dietary recommendations for well-nourished children may be appropriate for moderately malnourished children but need to be made slightly more prescriptive (e.g., “give 2 cups of milk” instead of “give a dairy product”).
- Dietary counseling needs to emphasize the amounts of nutrient-dense and energy-dense foods needed for recovery.
- Successful dietary counseling emphasizes the usefulness of local foods.
- In food-secure populations, dietary counseling about family foods may be used to treat and prevent moderate malnutrition.
- Moderate malnutrition has been treated successfully (i.e., rapid weight gain) through family foods with the addition of a mineral and vitamin supplement.
- A set of dietary guidelines that aim to prevent and treat both severe and moderate malnutrition is needed.
There is evidence that dietary counseling can be effective in promoting gains in length and weight in moderately malnourished children. Frequent and regular exposure to a few simple and age-appropriate recommendations is most effective.
Ashworth A, Ferguson E. Dietary counseling in the management of moderate malnourishment in children. Food Nutr Bull. 2009;30: S405-433.