The relationship between energy intake and diarrhoeal disease in their effects on child growth: biological model, evidence, and implications for public health policy

Abstract

This paper summarizes several earlier publications, and presents the results graphically to show that the same synergistic relationship holds across both urban and rural populations as well as across populations with differing levels of diarrhoea and malnutrition. The effect of inadequate energy intake on nutrition status depends on the level of diarrhoea, just as the negative effect of diarrhoea on nutrition status depends on the level of energy intake. The public health implications of these findings are threefold: an immediate strategy to improve child nutrition should focus on mechanisms to improve energy intake and dietary quality; environmental conditions that put young children at risk for diarrhoea have to be improved; and efforts must be made to promote breast-feeding exclusively through at least the first four months of life and partially through 24 months. -from Authors