SynthesisBMJ global health2020
Boys are more likely to be undernourished than girls: a systematic review and meta-analysis of sex differences in undernutrition.
Synthesis in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 163 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
163 citing papers in PubMed, 11 syntheses or guidelines pooled it, 266 citations in OpenAlex.
- Prevalence, trends and inequalities of childhood undernutrition according to a Composite Index of Anthropometric Failure (CIAF): a systematic review and meta-analysis.BMJ global health · 2026Pooled it
- The role of gender in early childcare practices in low- and middle-income countries: a systematic review and meta-analysis.Journal of global health · 2026Pooled it
- Early-life famine exposure and risk of osteoporosis and low bone mineral density: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- Anthropometric deficits and the associated risk of death by age and sex in children aged 6-59 months: A meta-analysis.Maternal & child nutrition · 2023Pooled it
- Neurodevelopmental, cognitive, behavioural and mental health impairments following childhood malnutrition: a systematic review.BMJ global health · 2022Pooled it
- The relationship between wasting and stunting in young children: A systematic review.Maternal & child nutrition · 2022Pooled it
- Growth patterns by sex and age among under-5 children from 87 low-income and middle-income countries.BMJ global health · 2021Pooled it
- The influence of gender and ethnicity on facemasks and respiratory protective equipment fit: a systematic review and meta-analysis.BMJ global health · 2021Pooled it
- Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review.BMJ global health · 2021Pooled it
- The Nutritional Status of Individuals Adopted Internationally as Children: A Systematic Review.Nutrients · 2021Pooled it
- Diarrhea as a Disease of Poverty Among Under-Five Children in Sub-Saharan Africa: A Cross-Sectional Study.Inquiry : a journal of medical care organization, provision and financingPooled it
- Hepcidin is low in children with moderate acute malnutrition and asymptomatic malaria: secondary analysis of a 2×2×3 factorial randomised trial in Burkina Faso.The British journal of nutrition · 2026Trial
- Household Food Insecurity, Growth and Development of Preschool Children: Evidence From Rural Pakistan.Maternal & child nutrition · 2025Trial
- Feeding, caregiving practices, and developmental delay among children under five in lowland Nepal: a community-based cross-sectional survey.BMC public health · 2022Trial
- Trial
- A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes.Scientific reports · 2022Trial
- Assessment of health and nutrition status among children aged 5-9 years in Pakistan: a cross-sectional survey (2020).The Lancet regional health. Southeast Asia · 2026Article
- Estimating the risk of acute malnutrition among under-five children in Uganda: a distributional analysis of socioeconomic and structural inequalities.BMJ paediatrics open · 2026Article
- Revealing Sex Disparities in the Burden of Diarrheal Diseases Among Children Under 5: Global and Asian Trends and Projections, 1990-2050 - A Population-Based Observational Analysis Using GBD 2021 Data.Health science reports · 2026Article
- Patterns of the triple burden of childhood malnutrition in Ecuador by age, sex, ethnicity, and poverty: a cross-sectional population survey.Lancet regional health. Americas · 2026Article
103 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExcess male morbidity and mortality is well recognised in neonatal medicine and infant health. In contrast, within global nutrition, it is commonly assumed that girls are more at risk of experiencing undernutrition. We aimed to explore evidence for any male/female differences in child undernutrition using anthropometric case definitions and the reasons for differences observed.
methodsWe searched: Medline, Embase, Global health, Popline and Cochrane databases with no time limits applied. Eligible studies focused on children aged 0-59 months affected by undernutrition where sex was reported. In the meta-analysis, undernutrition-specific estimates were examined separately for wasting, stunting and underweight using a random-effects model.
results74 studies were identified: 44/74 studies were included in the meta-analysis. In 20 which examined wasting, boys had higher odds of being wasted than girls (pooled OR 1.26, 95% CI 1.13 to 1.40). 38 examined stunting: boys had higher odds of stunting than girls (pooled OR 1.29 95% CI 1.22 to 1.37). 23 explored underweight: boys had higher odds of being underweight than girls (pooled OR 1.14, 95% CI 1.02 to 1.26). There was some limited evidence that the female advantage, indicated by a lower risk of stunting and underweight, was weaker in South Asia than other parts of the world. 43/74 (58%) studies discussed possible reasons for boy/girl differences; 10/74 (14%) cited studies with similar findings with no further discussion; 21/74 (28%) had no sex difference discussion. 6/43 studies (14%) postulated biological causes, 21/43 (49%) social causes and 16/43 (37%) to a combination.
conclusionOur review indicates that undernutrition in children under 5 is more likely to affect boys than girls, though the magnitude of these differences varies and is more pronounced in some contexts than others. Future research should further explore reasons for these differences and implications for nutrition policy and practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.