definition for malnutrition?

[Matthias.Merzenich at DWNHHSE.HEALTH.nt.gov.au]

     Hi everybody,
     being new to this list I thought it is time to introduce myself with a
     little question.

     I am a German Nutritionist working for Territory Health Service in
     Darwin, Australia. We are working on a Nutrition Information System to
     monitor the nutritional status of the 0-5 year olds in the NT. For now
     only in remote communities but in the long run for all children and
     eventually adults, too.

     We are having this discussion about malnutrition, with several
     definitions and misunderstandings, so I thought why not ask the
     experts on nutnet!

     By measuring weight and height and subsequently calculating Z-scores
     for Weight-for-Height, Weight-for-Age and Height-for-Age, we have
     several possibilities to report on the status of the kids in the
     communities.

     Some for you to criticise or praise:

     -using the WHO recommended cutoff point of <-2 Z-scores we can define
     malnutrition as being below that cutoff for either of the 3 mentioned
     indices

     -taking into account that weight-for-age is the least accurate
     indicator we could use only weight-for-height and height-for-age and
     define malnutrition as being below -2 for these two indices

     -we could not report at all on 'malnutrition' because WHO does not
     recommend the use of this term but just report on all three indices
     with the corresponding percentage of prevalence. Using the WHO terms
     stunted for low height-for-age, wasted for low weight-for-height and
     underweight for low weight-for-age (low being below -2)

     -an additional problem in using the term 'malnutrition' is that when
     we start to report on the nutritional status of adults and urban
     children we will have not only to low indices but also obese people.
     And that is a form of malnutrition, too.


     -any other suggestions or questions to clarify the subject?


     Please bear in mind that the reports will go to the Aboriginal
     Communities and have to be understood by different people, Health
     Workers, Nurses, DMOs and many more, including non-medical trained
     people who speak English as a second language. Does this make things
     easier???


     We would very much appreciate your comments, when you are so immersed
     in a project sometimes an outsiders view gives you a different angle!

     Matthias Merzenich
     Project Officer
     Food and Nutrition Unit, THS Darwin
     email matthias.merzenich at nt.gov.au