The relationship of growth failure (chronic undernutrition) to the prevalence of clinically severe protein-energy malnutrition and to growth retardation in protein-energy malnutrition.

A total of 72 of 276 children from a rural Mexican village were chronically undernourished as judged by their growth failure between 6 and 36 months of age. Fourteen of the 72 and five of the remaining 204 children developed clinically severe protein-energy malnutrition (PEM) as judged by clinical signs other than weight or length. This amounted to an 8-fold higher prevalence of PEM in the group of children with growth failure. When children were grouped into quartiles of length at 6 months by sex, quartile was not related to the subsequent occurrence of PEM or to the age when PEM developed. However, analysis indicated that the growth of children with PEM and growth failure had slowed relative to their quartiles before PEM developed; they were also retarded according to the Harvard standards. The children with PEM were then compared to others with a similar growth history (growth failure, no growth failure) who never developed PEM. PEM children did not differ significantly in over weight or length and displayed a significant difference in upper arm muscle circumference at only one age. The 14 with growth failure and PEM had poorer overall growth, including arm muscle circumference, than the five with PEM and no growth failure.