Question

In a child, height for age < -2 SD. What is the likely cause?

• A. Chronic malnutrition
• B. Acute malnutrition
• C. Recent infection
• D. No malnutrition

Hint:

Ask yourself: which nutritional parameter takes months to years to show a deficit -- height or weight?

Answer 1

The Correct Option is A

Step 1: Understand anthropometric indices in children.

• Height-for-age (HFA): Measures linear growth. Low HFA (below -2 SD) is called stunting. Reflects chronic, long-standing nutritional deprivation over months to years.
• Weight-for-height (WFH): Measures body proportion. Low WFH is called wasting -- reflects acute, recent undernutrition or acute illness over weeks.
• Weight-for-age (WFA): Measures overall growth. Low WFA is called underweight -- a composite of both acute and chronic malnutrition.

Step 2: Match HFA < -2 SD to causation. Height (linear growth) is a slow-changing parameter. The growth plate responds to sustained nutritional deficiency over months-years, leading to stunted linear growth. It cannot be shortened by a recent, brief infection or acute illness alone.

• Acute malnutrition or recent infection affect weight (wasting) but not height significantly in the short term.
• Chronic, recurrent undernutrition over an extended period is the hallmark cause of stunting (HFA < -2 SD).

Conclusion: Height-for-age < -2 SD indicates stunting, which is caused by chronic malnutrition.