Contrary to popular opinion, malnutrition is not limited to the severely emaciated, or marasmic, children described above. In fact, the Administrative Committee on Coordination/Subcommittee on Nutrition (ACC/SCN) reports that only about 3 percent of children worldwide are severely malnourished ( Administrative Committee on Coordination/ Subcommittee on Nutrition [herafter, ACC/SCN], 1992). By contrast, in 1990, 34 percent of children under five years of age in developing countries suffered from mild to moderate malnutrition or were underweight ( ACC/SCN, 1992). These children do not show the signs of wasting seen among the severely malnourished. Their bodies tend to be in proportion, both shorter and lighter than United States norms ( ACC/SCN, 1992). But the children have less visible nutritional deficiencies, which may have cognitive effects. These deficiencies include iodine, iron, and vitamin A malnutrition, raising the same psychological questions. What do we know about the long-term consequences? What are the chances of psychological recovery? And what are the factors causing the malnutrition? Psychologists are addressing these questions, and being asked to do so by nutritionists more now than ever before. In fact, eminent nutritionist/physician Waterlow noted, "Social and psychological factors may go a long way to explaining why, in an apparently homogeneous community, only some children develop malnutrition. Clearly, food alone will not solve such problems" ( 1992, p. 11).

According to the recent ACC/SCN Report ( 1992), nutrition "refers to physiological processes, influenced by diet and exposure to infection. For children, the outcomes are physical growth, activity, morbidity and mortality, and psychological development" (p. 6 ). Physical growth is usually used as an indicator of nutritional adequacy among children. Commonly, height and weight are measured, and are compared with norms for growth derived from the National Child Health Statistics collected in the United States. The resulting measures are standardized scores of weight for age, weight for height, and height for age. Preferred terms for the former are underweight or overweight, for the second, wasting or obesity, and for the latter, stunting. Variations in weight among children tend to reflect shorter-term nutritional deficiencies, whereas variations in height reflect more chronic and long-term undernutrition. Children who fall more than two standard deviations from the norm on height or weight for age are considered to be undernourished. Anthropometric status (height and weight, most commonly) provides an indicator of the general well-being of children, although it is affected by a number of factors including food intake, infection, and correlated factors of low socio-economic status and environmental degradation. 

Severe malnutrition is a clinical syndrome characterized by a number of specific indicators such as edema and changes in hair color. Malnutrition characterized by total energy deprivation is labeled marasmus, whereas malnutrition in which protein appears to be more limiting is labeled kwashiorkor ( Waterlow, 1992) . . .

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