The American journal of clinical nutrition
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Weight, height, and arm circumference were measured in 7304 children 1 to 5 years old in Columbia, Costa Rica, the Dominican Republic, India, and Pakistan. Previously developed indices using these measures were applied to assess nutritional status, and the agreement between measures was compared. Weight for age and height for age deficits increased with age while weight for height deficits diminished. ⋯ Good agreement in malnutrition diagnoses was found between a weight for height limit of 90% of standard and a weight for age limit of 75% of standard. A cut-off point of 80% of standard weight for height was too low to detect most malnourished children. An age-constant arm circumference limit of 13.5 cm identified nearly all children with severe or acute malnutrition by weight for age or weight for height.
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Nutrition has been traditionally taught in medical schools with emphasis on clinical management of disease states with modified diets. However, the science of nutrition can no longer be considered only in terms of the diagnosis and treatment of nutritional deficiency diseases. Prevention of disease-care rather than cure-must be emphasized. Using the nutrition concepts that evolved from the 1972 Williamsburg Conference encompassing the science and the sociology of nutrition, the author offers a proposal for action-a sequential nutrition curriculum design for years, I, II, and III of undergraduate medical education based on the experiences of the Nutrition Division, Department of Community Medicine, Mount Sinai School of Medicine-City University of New York.