Severe Adult Malnutrition: The limits of human adaptation to starvation

Severe adult malnutrition is a common feature in both emergencies and developmental situations. This book provides a review of the history and issues surrounding adult malnutrition before going on to examine new data on the diagnosis and treatment of adult malnutrition. Drawing heavily on studies conducted during the height of severe famines in Somalia 1992, Sudan 1993 and Angola 1993, it presents original data on the most extreme cases of adult starvation ever reported in medical literature. The book establishes screening and diagnostic criteria to assess malnourished adults under the operational conditions seen during famine relief programmes. It provides evidence that measurement of middle upper arm circumference is an efficient tool for assessing admissions. Arm circumference measurements can be combined with simple clinical signs such as oedema, apparent dehydration and the ability to stand, to produce prognostic models useful in assessing admissions. The book also examines the ideal protein content of rehabilitation diets, concluding that diets with lower levels of protein can substantially reduce mortality during the initial phase of treatment.