Review

Malnutrition continues to be a major public healthproblem throughout the developing world, par-ticularly in southern Asia and sub-Saharan Afri-ca.1–5 Diets in populations there are frequently deficient in macronutrients (protein, carbohydrates and fat, leading to protein–energy malnutrition), micronutrients (electrolytes, minerals and vitamins, leading to specific micronutrient de-ficiencies) or both.3,6–8 The high prevalence of bacterial and parasitic diseases in developing countries contributes greatly to malnutrition there.3,5,9–11 Similarly, malnutrition increases one’s suscepti-bility to and severity of infections, and is thus a major com-ponent of illness and death from disease.3,5,12–14 Malnutrition is consequently the most important risk factor for the bur-den of disease in developing countries.12,15 It is the direct cause of about 300 000 deaths per year and is indirectly re-sponsible for about half of all deaths in young children (Fig