When my daughter was ten and a half months old, she qualified as “wasted,” which UNICEF describes as “the most immediate, visible and life-threatening form of malnutrition.” My wife and I had been trying hard to keep her weight up, and the classification felt like a pronouncement of failure. Her birth weight had been on the lower end of the scale but nothing alarming: six pounds, two ounces. She appeared as a dot on a chart in which colored curves traced optimal growth; fifteenth percentile, we were told. She took well to breast-feeding and, within a month, had jumped to the twentieth percentile, then to the twenty-sixth. We proudly anticipated that her numbers would steadily climb. Then she fell behind again. At four months, she was in the twelfth percentile. At nine and a half, she was below the fifth.
By revealing how our variable bodies respond to a wide range of environments, it challenges us to rethink universal health benchmarks. These standards inform everything from how we define malnutrition and micronutrient deficiencies to how we estimate the risks of growth abnormalities, metabolic disorders, and cardiovascular dysfunction.
Our pediatrician was worried. Ease off the lentils and vegetable smoothies, we were warned; we needed to get more calories into our babe. Ghee, peanut butter—we were to drench her food in these and other fats and wash them down with breast milk and formula. And that’s what we did. When we came back a month later, though, we learned that she had dropped further—and crossed into “wasted” territory.
————————————-
Maybe in a decade, the one-size-fits-all curves will give way to standards that recognize the different shapes of different populations, and the advice will shift to match. But, for now, we live in the space between two realities—the numbers on a spreadsheet and the child in our arms. ♦
Manvir Singh, an assistant professor of anthropology at the University of California, Davis, has written for The New Yorker since 2022 on topics including evolution, cognitive science, and cultural diversity. He is the author of “Shamanism: The Timeless Religion.”