Impact of Children's Nutritional Status on Adverse Infection Outcomes

About this Research Topic

Background

According to the latest 2023 report from the World Health Organization (WHO), infectious diseases remain the leading cause of death in children under 5 globally, accounting for 45% of all fatalities, with pneumonia (23%), diarrhea (9%), sepsis (7%), and meningitis (5%) as the primary lethal conditions. There are significant regional disparities in the global disease burden: the mortality rate from infections among children in sub-Saharan Africa is 18 times higher than in high-income countries, with pneumonia mortality reaching 11.2 per 1,000 live births (compared to 0.7‰ in Europe). Additionally, 80% of global malaria deaths in children under 5 occur in this region (averaging 1,000 deaths per day). Southeast Asia faces dual threats of severe dengue fever progression (3.2%) and multidrug-resistant Salmonella Typhi infections (accounting for 8% of fever cases), while respiratory syncytial virus (RSV) in European countries leads to a hospitalization rate of 48 per 1,000 infants under one year old, highlighting the complexity of pathogen distribution.

Non-communicable diseases have also emerged as a significant global health burden in recent years. The 2023 Global Child Nutrition Report reveals that child nutrition and health are confronting a complex "double burden" crisis, severely threatening global sustainable development goals. Globally, 22.3% (approximately 149 million) of children under 5 suffer from stunting, and 6.8% (about 45 million) experience wasting, with higher prevalence in impoverished regions such as sub-Saharan Africa, South Asia, Yemen, and Somalia. In contrast, childhood obesity and overweight have evolved into a global public health issue over the past three decades: 5.7% (around 39 million) of children under 5 are overweight, and 2.3% (about 16 million) are obese. Among adolescents aged 5–19, the overweight/obesity rate has surged from 4% in 1975 to 18% in 2023, a more than fourfold increase. In developed countries, 32% of obese adolescents (12–18 years) already exhibit insulin resistance (HOMA-IR > 3.0), with a 3.5-fold increased risk of cardiovascular disease in adulthood. This double burden is not only observed between countries but also within nations: in China, the stunting rate among rural children (11.2%) is 2.6 times that of urban children (4.3%), while the obesity rate among urban adolescents (17.3%) far exceeds that of their rural counterparts (8.9%), reflecting disparities in resource allocation and lifestyle between urban and rural areas.

Children with extreme nutritional statuses also exhibit paradoxical metabolic manifestations. Nutrition can significantly impact the prognosis of infectious diseases through multiple mechanisms: malnutrition leads to immune deficiencies such as thymic atrophy, reduced CD4+ T lymphocytes, and insufficient IL-2 secretion, while also promoting sepsis through intestinal damage. Conversely, obesity-induced chronic low-grade inflammation (characterized by adipose tissue macrophage infiltration and sustained release of TNF-α/IL-6) may exacerbate cytokine storms and immune exhaustion post-infection.

This special issue aims to systematically evaluate the association between the dual burden of child malnutrition (including wasting, stunting, underweight, and overweight/obesity) and severe outcomes of infectious diseases. We will focus on exploring the relationship between nutritional abnormalities and infection risk/poor prognosis, as well as analyzing the mechanisms by which different nutritional statuses influence disease progression.

By compiling research from leading experts in the field, this special issue seeks to provide a scientific basis for developing integrated prevention and control strategies for child nutrition and infection, thereby reducing the incidence of severe infections and improving clinical outcomes to enhance global child health. The findings will inform public health policy-making, promote the establishment of an integrated "nutrition-infection" dual-intervention system, and contribute to achieving child health-related Sustainable Development Goals (SDGs).

We invite authors to submit original research, reviews, meta-analyses, and case reports on the following topics:

1. Epidemiology and Disease Burden of Child Nutritional Disorders

Global or regional trends in child malnutrition (wasting, stunting) and overweight/obesity, and their association with infectious diseases (e.g., pneumonia, diarrhea, sepsis, malaria).

2. Biological Mechanisms Linking Nutritional Abnormalities to Infection Risk

Immune deficiencies caused by malnutrition (e.g., protein-energy deficiency), such as thymic atrophy and impaired T-cell function.
The impact of obesity-related chronic low-grade inflammation (e.g., adipose tissue macrophage infiltration, pro-inflammatory cytokine release) on infection susceptibility.
The role of gut microbiota dysbiosis in the relationship between nutritional abnormalities and infection risk.

3. Impact of Nutritional Status on Severe Infection Outcomes

Differences in severe disease progression, hospitalization duration, and mortality rates among malnourished or obese children with infections.
The influence of metabolic abnormalities (e.g., insulin resistance, dyslipidemia) on the prognosis of sepsis, severe pneumonia, and other conditions.
Evaluation of nutritional interventions (e.g., micronutrient supplementation, dietary adjustments) in improving infection outcomes.

4. Nutrition and Infection in Special Populations

Nutrition and health outcomes in preterm/low birth weight infants (survival rate, mortality, quality of life, neurodevelopment, and other short- and long-term outcomes)
Characteristics of antibiotic-resistant infections in children with nutritional abnormalities.
The role of nutritional therapy in rare infectious diseases.

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• Hypothesis and Theory
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Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: 1. Epidemiology and Disease Burden of Child Nutritional Disorders

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