Biomarkers Make the Case for a Comprehensive Approach to Diagnosing Severe Acute Malnutrition.

* Abbreviations: MUAC — : mid-upper arm circumference SAM — : severe acute malnutrition WHZ — : weight-for-height z score Aim 2.2 of the 2015 United Nations Sustainable Development Goals is to “end all forms of malnutrition” by 2030.1 Nevertheless, severe acute malnutrition (SAM) continues to pose a major threat to global child health, especially throughout sub-Saharan Africa and South Asia, even in nonconflict and nonfamine areas. Malnutrition is linked to approximately one-half of the deaths of children <5 years old worldwide,2 and an estimated 10 000 additional malnutrition-associated deaths among children are expected to be occurring globally during the coronavirus disease 2019 pandemic, because of interruptions in health and nutrition services.3 Food insecurity, household size, rural–urban disparities, and gaps in health literacy are commonly cited risk factors for SAM in low- and middle-income countries.4 SAM and its complications can be difficult to recognize unless objective diagnostic measures are applied, namely weight-for-height z score (WHZ) and mid-upper arm circumference (MUAC). Use of the MUAC dates back to the 1950s, an innovation of post–World War II humanitarianism. It was first proposed to the World Health Organization as a metric for the nutritional assessment of children <5 years of age in 1966,5 but … Address correspondence to Jonathan P. Strysko, MD, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104. E-mail: stryskoj{at}chop.edu