EPIDEMIOLOGY OF UNDER FIVE MALNUTRITION: SEX DIFFERENTIAL IN HEALTH CARE AND NUTRITIONAL STATUS (UNDER FIVE MALNUTRITION)

Dear Editor,

This is in reference to the article titled ‘Epidemiology of under five malnutrition: Sex differential in health care and nutritional status (under five malnutrition) (I). The following comments are offered.

• 1.Definition of the population under study in terms of ethnic background, socioeconomic status including dependency ratio and other environmental influences is a prerequisite criterion for any attempt on epidemiological study.
• 2.Classification of malnutrition as per Indian Academy of Paediatrics is graded into four groups based on the national centre health statistics (NCHS) charts. The cut off point taken is 80% of the 50th percentile for the age and sex.
• 3.Anaemia is a nutrient deficiency and usually part of overall malnutrition syndrome. Unless correlation is made between the grade of malnutrition and haemoglobin levels, it will be inappropriate to draw conclusion regarding gender bias leading to lower haemoglobin levels in girls.
• 4.In a greater context, maternal malnutrition reflects the outcome of pregnancies. There is greater incidence of low birth weight babies born to malnourished mothers. A female low birth weight baby subjected to nutritional inadequacy remains nutritionally compromised during the first five years. Hence the important factors of maternal malnutrition and birth weight should be included in the study parameters.