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Immune Dysfunction in Acute Undernutrition: Driver of Acute and Chronic Disease Outcomes Immune dysfunction in SAM predisposes children to acute infections including enteric and respiratory illnesses, measles and malaria, while survivors experience growth failure and long-term metabolic disorders [104,105,106] Both acute undernutrition and obesity precipitate micronutrient insufficiency, which exacerbates the severity of these conditions in mutually reinforcing cycles [51, 107,108,109] Enteropathy, characterized by gut mucosal degeneration, villous atrophy and impaired gut structure, occurs through a cascade of nutrient deficiency-induced biochemical, physiological and histological changes [108, 109]