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Pathogenesis, Treatment, and Complications of Childhood Malnutrition

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: 5 April 2026 | Viewed by 2463

Special Issue Editor


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Guest Editor
Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA
Interests: infant; child; malnutrition; obesity; diabetes; pediatric nutrition; pediatric endocrinology

Special Issue Information

Dear Colleagues,

Childhood malnutrition contributes to millions of deaths worldwide and predisposes individuals to disordered growth, metabolism, and cognitive function. Despite the vast literature on the subject, there remain a number of unanswered fundamental questions regarding the etiology, pathogenesis, and treatment of the disorder. This Special Issue will explore the following: (a) the roles of maternal nutrition and infant feeding in the development of childhood growth failure and wasting; (b) the roles of hormones, growth factors, cytokines, and metabolites in the pathogenesis of, and adaptation to, acute malnutrition; (c) the effects of nutritional supplementation on short- and long-term recovery from childhood malnutrition; (d) the roles of enteropathogens and the microbiome in development, treatment, and complications of malnutrition; (e) the interplay of inflammation, infection, and immunity in acute and post-discharge mortality; and (f) changes in body composition following nutritional recovery and their relation to long-term cardiometabolic risk.

Prof. Dr. Michael Freemark
Guest Editor

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Keywords

  • maternal nutrition
  • prenatal growth
  • growth failure
  • wasting
  • metabolomics
  • microbiome
  • enteropathy
  • mortality
  • cognition
  • adiposity
  • cardiometabolic risk

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Published Papers (2 papers)

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Research

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21 pages, 839 KB  
Article
The Importance of Socioeconomic Factors Associated with Maternal Nutrition Knowledge and Undernutrition Among Children Under Five
by Arie Dwi Alristina, Rizky Dzariyani Laili, Éva Nagy and Helga Judit Feith
Nutrients 2025, 17(21), 3355; https://doi.org/10.3390/nu17213355 - 24 Oct 2025
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Abstract
Background: Socioeconomic factors may influence maternal nutrition knowledge (MNK), which directly affects the nutritional status of children under five. This study aims to explore the importance of socioeconomic factors associated with MNK and nutritional status. Methods: This cross-sectional study focused on [...] Read more.
Background: Socioeconomic factors may influence maternal nutrition knowledge (MNK), which directly affects the nutritional status of children under five. This study aims to explore the importance of socioeconomic factors associated with MNK and nutritional status. Methods: This cross-sectional study focused on mothers of children aged 36–59 months (n = 657). A structured questionnaire was employed to collect data on socioeconomic factors. Anthropometric measurements were taken to assess nutritional status. The Boruta algorithm, implemented using R Studio version R.4.5.1, was used to identify the most important socioeconomic factors associated with MNK and nutrition status. Results: The analysis revealed that socioeconomic status (SES) emerged as an important factor associated with MNK and nutrition status, particularly stunting and wasting. However, SES was not confirmed as an important factor associated with underweight. This study uncovered a bidirectional relationship between child nutrition outcomes; underweight was found to be an important factor related to stunting and wasting, whereas stunting and wasting were important factors for underweight. Furthermore, infant and young child feeding (IYCF) indicators, such as weaning practices and exclusive breastfeeding (BF), were found to be important factors for stunting and wasting. Conclusions: The interlinkage among forms of undernutrition, where each nutritional outcome is related to other outcomes, underscores the importance of comprehensively addressing child undernutrition, rather than focusing on single outcomes independently. Moreover, the association between SES and MNK, wasting, and stunting supports approaches based on holistic and multi-sectoral strategies to reduce poverty by WASH programs, promote IYCF practices, and improve healthcare access by providing health insurance coverage. Full article
(This article belongs to the Special Issue Pathogenesis, Treatment, and Complications of Childhood Malnutrition)
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Review

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32 pages, 1503 KB  
Review
Adaptive Responses in Severe Acute Malnutrition: Endocrinology, Metabolomics, Mortality, and Growth
by Laura Page, Elizabeth McCain and Michael Freemark
Nutrients 2025, 17(17), 2864; https://doi.org/10.3390/nu17172864 - 4 Sep 2025
Viewed by 1867
Abstract
Malnutrition afflicts millions of the world’s children and predisposes to death from diarrhea and infectious diseases. Children with severe acute malnutrition (SAM) are at highest risk. Our review of the endocrinology and metabolomics of SAM implicates critical roles for white adipose tissue and [...] Read more.
Malnutrition afflicts millions of the world’s children and predisposes to death from diarrhea and infectious diseases. Children with severe acute malnutrition (SAM) are at highest risk. Our review of the endocrinology and metabolomics of SAM implicates critical roles for white adipose tissue and its regulatory hormones and growth factors in the adaptation to nutritional deprivation and the restoration of metabolic homeostasis: white adipose provides substrates and energy for hepatic glucose production and cardiopulmonary and central nervous system function, and products of fat metabolism inhibit muscle glucose uptake and utilization and spare muscle protein. Collectively, these effects maintain glucose availability for the brain, red blood cells, and renal medulla and conserve muscle mass. White adipose tissue also secretes leptin, which facilitates the immune response and may protect against mortality from infection. Euglycemia and survival in SAM are thereby prioritized over linear growth, which is suppressed owing to inhibition of insulin-like growth factor 1 production and action. Diversion of energy from growth serves to maintain essential bodily functions in critically ill malnourished children, who have limited energy reserves. Thus, short-term reductions in growth rate have adaptive benefits in SAM. Under favorable conditions, clinical and metabolic recovery are accompanied by catch-up growth, which can mitigate, and in many cases reverse, the stunting of growth in childhood. Nevertheless, clinical recovery can be complicated by preferential accrual of central fat and a relative deficiency of lean/skeletal mass, with potential long-term complications including insulin resistance, glucose intolerance, and metabolic syndrome. Full article
(This article belongs to the Special Issue Pathogenesis, Treatment, and Complications of Childhood Malnutrition)
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