Acute malnutrition (or wasting) is a life-threatening condition and is defined as a child being too thin for their height, indicating rapid weight loss and a severe lack of energy, protein and other nutrients.
It can also be assessed by measuring the circumference of a child’s upper arm with a calibrated tape, as was done in the UNRWA study.
Children suffering from wasting require regular treatment with therapeutic food over several weeks, or in extreme cases and when possible, hospitalisation. In Gaza, few therapeutic options are available to impacted children.
UNRWA nutrition epidemiologist Dr Masako Horino, who was the lead scientist for the study, said: “Evidence prior to Oct 2023 indicated that children in Palestine refugee families in the Gaza Strip were food insecure and had poor dietary diversity.
“Yet, they were only marginally underweight. This paradox was likely explained by these families’ regular access to food aid. Following two years of war and severe restrictions in humanitarian aid, tens of thousands of pre-school aged children in the Gaza Strip are now suffering from preventable acute malnutrition and face an increased risk of mortality,” Horino added.
In addition, experts say that children’s future health outcomes and subsequent future generations will also be adversely impacted.
“There should also be serious concern for the well documented long-term effects, such as intergenerational consequences of starvation and food restriction in children, including inordinately high risks of non-communicable diseases and reduced life expectancy,” Zulfiqar Bhutta, of Aga Khan University; Jessica Fanzo, of Columbia University; and Paul Wise, of Stanford University School of Medicine, announced in a combined statement. Neither of the three experts quoted is linked to the study.
UNRWA staff screened 219,783 children aged between 6 months and five years between January 2024 and mid-August 2025.
They measured mid-upper arm circumference (MUAC) at 16 functioning health centres and 78 medical points in shelters and tented encampments across five governorates in the Gaza Strip.
The researchers then estimated the prevalence of acute malnutrition, based on the total estimated number of children in that age group in the territory (346,000).
The study tracked wasting among children, estimated population prevalence and highlighted unprecedented increases in child malnutrition following periods of blockades and severe aid restrictions.
Researchers found that during a six-week ceasefire, which allowed increased aid to enter the Gaza Strip from January 2025, wasting declined by March 2025.
The UN Integrated Food Security Phase Classification (IPC) confirmed famine in the governorate of Gaza City on 15 August, with the rest of the Gaza Strip facing critical conditions or the prospect of famine.
UNRWA’s director of health and a senior author of the paper, Dr Akihiro Seita, said things would continue to deteriorate if Israel’s war did not stop.
“Given the long failure to stop the war and prevent encroaching famine despite a global capacity to do so, unless there is a lasting cessation of the conflict coupled with unimpeded, competent, international humanitarian nutritional, medical, economic and social services, a further deterioration in early childhood nutrition with increased mortality are inevitable in the Gaza Strip,” he added.
