The Critical Need to Adopt an Appropriate Screening Tool for Malnutrition to Assist Third World Country Development

As the First World seeks to lay the groundwork to enable developing nations to join the international community as equal partners, one simple and critical step has been ignored for too long. The evidence for the pernicious effects of malnutrition on brain development and intellectual maturity is overwhelming, has been present for decades, and we are discovering more every day. Malnutrition has been shown to alter brain development, lower IQ compared to socially comparable cohorts, interfere with the development of higher executive function, and disrupt appropriate societal behavior. Mid-upper arm circumference (MUAC) of 12.5 cm is the standard promoted by the WHO and other international agencies to screen for malnutrition in children 6-60 months, but we present data from various studies (including our own) to show that the standard has never been rational and misses a large percentage of children in their most critical years of growth and development, particularly those who are approaching school age. If there is a good faith desire on the part of the most economically advanced countries to help the developing nations to pull out of generations of poverty, one of the easiest and most critical steps is to adopt a more appropriate screening program for undernutrition. We recommend the immediate abandonment of 12.5 cm as the screening tool for children between 6 and 60 months and adoption of 14 cm as a more appropriate screening tool.