Table 1. Estimated ALRI deaths and disease burden in children under 5 years of age attributed to nutritional risk factors, in 2004.
| Nutritional risk factor | Estimatesa | UN region |
All developing countries | |||
|---|---|---|---|---|---|---|
| Africab | Asiab | Latin Americab | ||||
| Underweightc | Deaths | 238 234 (24.3) | 203 104 (28.1) | 1 542 (3.1) | 442 879 (25.3) | |
| DALYs x 10³ | 8 335 (24.3) | 7 262 (27.9) | 65.69 (3.1) | 15 662 (25.1) | ||
| Stuntingc | Deaths | 243 325 (24.9) | 152 906 (21.1) | 3 540 (7.0) | 399 771 (22.8) | |
| DALYs x 10³ | 8 510 (24.9) | 5 479 (21.1) | 150.0 (7.1) | 14 136 (22.7) | ||
| IUGR-LBWd,e | Deaths | 31 866 (11.9) | 97 297 (22.0) | 1 550 (5.2) | 130 713 (17.6) | |
| DALYs x 10³ | 1 092 (11.9) | 3 330 (22.0) | 53.97 (5.2) | 4 475 (17.6) | ||
| Zinc deficiencyf | Deaths | 66 062 (6.8) | 48 800 (6.7) | 3 135 (6.2) | 117 997 (6.7) | |
| DALYs x 10³ | 2 350 (6.9) | 1 840 (7.1) | 159.2 (7.5) | 4 349 (7.0) | ||
| Suboptimal breastfeeding (0–28 days of age)e,g | Deaths | 115 193 (42.9) | 198 128 (44.8) | 14 394 (48.2) | 327 714 (44.2) | |
| DALYs x 10³ | 3 947 (42.9) | 6 798 (44.8) | 500.9 (48.2) | 11 246 (44.3) | ||
| Suboptimal breastfeeding (> 1 month of age)g | Deaths | 187 304 (19.1) | 141 942 (19.6) | 14 987 (29.8) | 344 234 (19.6) | |
| DALYs x 10³ | 6 536 (19.1) | 5 036 (19.4) | 578.3 (27.3) | 12 150 (19.5) | ||
ALRI, acute lower respiratory infection; DALYs, disability-adjusted life years; IUGR, intrauterine growth restriction; LBW, low birth weight. a Values in parentheses are percentage of all under-five ALRI deaths or DALYs. Because nutritional risk factors are overlapping and often correlated, attributable fractions should not be directly summed across risk factors. b UN region composition available at: http://unstats.un.org/unsd/methods/m49/m49regin.htm c In these analyses, risks of children considered underweight [weight-for-age z score < –1 standard deviations (SD) on the WHO growth curve] or stunted (height-for-age z score < –1 SD) were compared with those classified as ”normal” (> –1 SD on the respective growth curve). d Risks among term neonates weighing between 1500 g and 2499 g were compared with those of birth weight ≥ 2500 g. Neonates weighing < 1500 g were excluded from the analysis because of the strong likelihood of preterm birth. e Estimates for IUGR–LBW and suboptimal breastfeeding in the newborn period only apply to neonates 0–28 days of age and were based on the relative risk of the aggregate outcome “perinatal infections”. Absolute numbers of deaths and DALYs were calculated by assuming that 80% of perinatal infections are ALRIs.81 f Estimates were applied to children aged 6–59 months of age, since the efficacy of zinc supplementation has not been demonstrated in infants < 6 months of age (see text). g For the 0–5 month age range, infants not exclusively breastfed were compared with those exclusively breastfed. For infants 6–23 months of age, those receiving any breast milk were compared with those receiving no breast milk.