|Who's Hungry? And how do we know? Food Shortage, poverty and deprivation (United Nations University - UNU, 1998, 199 pages)|
|2. Measuring hunger|
1. The World Bank most commonly used a cut-off set at 90 per cent of the calorie requirements estimated by the FAO/WHO/UNU committee in 1971; the FAO defined its cut-off as 1.4 times the basal metabolic rate (BMR). In neither case do the cut-offs employed allow for more than minimal physical activity for adults, and the newer common cut-off of 1.54 BMR still allows only for light activity (Uvin 1994).
2. Counting breast-feeding bouts over shorter periods is problematic because daytime consumption may or may not be reflective of night-time consumption: when children sleep with their mothers, nursing may follow a similar pattern around the clock; where they do not, there may be little or no night-time nursing.
3. Sukhatme and Margen (1982) interpret interindividual variation observed cross-sectionally as reflecting intra-individual variability; they also interpret the autocorrelation of daily individual intakes as evidence of a homoeostatic, self-regulating process. Although neither of these interpretations is implausible, interindividual variation could reflect stable differences across individuals and autocorrelation of intakes could result from external influences that vary cyclically over a span of days (such as different eating patterns on weekends and weekdays). Even if the evidence for energy intake and efficiency of use as a self-regulating process were definitive, the conclusion that intake levels observed only as the low point in a fluctuating series could be maintained indefinitely without damage seems questionable.
4. Smallness on any of the anthropometric indicators may result from illness rather than from compromised nutrition, though in most cases it is likely to be a combination of the two. Smallness may also result from normal variation or genetic potential, and one of the challenges this presents is to set cut-off points for anthropometric measurements that identify nutritional problems without also including children who are simply small.
5. Mid-upper arm circumference has been shown to predict risk of death better than either weight for height or height for age (Briend et al. 1987).