title: Evidence-based prevention of childhood malnutrition.
abstract: OBJECTIVE
  Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field.
  
  
  RESULTS
  Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease.
  
  
  CONCLUSIONS
  There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions.
authors.affiliation: Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Aamer
authors.initials: A
authors.lastname: Imdad
authors.forename: Kamran
authors.initials: K
authors.lastname: Sadiq
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
mesh_terms: D000740:Anemia / Q000517:prevention & control; D002648:Child; D003967:Diarrhea / Q000517:prevention & control; D004044:Dietary Proteins / Q000627:therapeutic use*; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D006128:Growth; D015658:HIV Infections; D006801:Humans; D007223:Infant; D007225:Infant Food; D044342:Malnutrition / Q000517:prevention & control*; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000627:therapeutic use*; D011247:Pregnancy; D011322:Primary Prevention / Q000379:methods*; D012140:Respiratory Tract Diseases / Q000517:prevention & control; D014881:Water Supply
chemical_list: D004044:Dietary Proteins; D018977:Micronutrients