Three new studies on early life malnutrition, authored by a team of UC Berkeley and UCSF researchers, were published in Nature last week.
According to Dr. Andrew Mertens, a study author and lecturer at the UC Berkeley Center for Targeted Machine Learning, these studies focus on poor child growth in low-resource settings. Mertens said there were more than 100 nutritionists and epidemiologists from around the world involved in the studies.
“(The studies) were truly a collaborative effort, and an example of team science and its best,” Mertens said in an email.
Mertens explained that each of the three papers focused on a different aspect of malnutrition, including patterns in low height-for-age, low weight-for-height and poor growth causes and consequences.
A main finding of Mertens’ research relates to wasting — a measure for acute malnutrition — being a “transient condition.” He explained that in the past, wasting was measured by the proportion of wasted children at a given time. However, Mertens said this method of measurement could “dramatically underestimate the true burden of wasting in the population.”
Mertens and the research team also found that while the wasting proportion across tens of thousands of children in a snapshot was 5.6%, the proportion of children who experienced wasting at least once was 30%. Even if children have recovered from early episodes of wasting, they are still at high risk for mortality and growth failure later in their lives, Mertens noted.
“This is a huge increase, and to our knowledge, it (is) the first time we’ve been able to quantify the full extent of the burden,” Mertens said in the email.
Mertens said a second significant finding was that the population of children who experienced stunting — a measure for chronic undernutrition or low height-for-age — between their birth and three months of age accounted for 23% of the total population of children stunted by the age of two years.
A third finding was the “seasonality of wasting.” Mertens explained that while “hunger seasons” are well-recognized in many countries, few single studies have numerically represented how seasons affect acute malnutrition. He added that this highlights how maternal nutrition at the time of pregnancy, along with food insecurity, can affect the status of a child at birth.
“It’s also a great example of just how powerful it can be to look across 17 separate populations and see the same pattern play out in each – it’s a much more convincing result than seeing it once or twice,” Mertens said in the email.
Mertens said the motivation for these research questions arose from the World Health Organization, or WHO, Sustainable Development Goal 2 to put an end to malnutrition by 2030.
Benjamin Arnold, a UCSF associate professor and former research scientist at campus’s Center for Targeted Machine Learning and Causal Inference, noted that the entire research process until publication took more than six years.
“Team science is not easy,” Arnold said in an email. “It was a lot of work to coordinate and find consensus across the consortium, but what an incredible intellectual opportunity it was for those of us to learn from some of the greats in the field.”
The findings of their research highlights the need for programs that address malnutrition in children between six to 24 months old, Arnold said in the email. He added that the findings also introduced an interest to improve the health of women of childbearing age and pregnant women.
Further research is needed to better understand seasonal wasting and how climate change can affect child malnutrition, Mertens noted. This could be done through the development of tailored “seasonally or individually targeted interventions,” he added.