Abstract:Introduction: Extreme weather events (EWEs) are weather conditions that exceed normal thresholds and are significantly aggravated by climate change. Children are the most disadvantaged population that is affected by EWEs. Although several studies have examined the impact of EWEs on child undernutrition through multiple pathways, evidence remains inconsistent. This scoping review aimed to map the current literature examining the relationship between EWEs and undernutrition in children under five years of age in Asia, focusing on the type of climate data used, spatial resolution, data integration with nutrition outcomes, and research gaps. Methods: This review followed the PRISMA-ScR checklist. A comprehensive search was conducted across PubMed, Scopus, and the Web of Science on March 1, 2025. The Population-Concept-Context (PCC) framework guided the study’s inclusion criteria: children under five years of age (Population), the associations between EWEs and undernutrition (Concept), and studies conducted in Asia (Context). Peer-reviewed articles in English were eligible without date restrictions. Results: This review examined 16 eligible papers; most studies were cross-sectional (n = 11) and were geographically concentrated in India and Bangladesh. Floods and temperature extremes were the most studied EWEs, and child stunting (height-for-age Z score < -2) was the most commonly examined outcome. Evidence consistently linked floods to increased stunting and underweight, especially in children under three years of age. In contrast, studies investigating the associations between child undernutrition outcomes and drought or excessive rainfall yielded mixed findings. Methodological heterogeneity was evident in the use of exposure thresholds (e.g., SPEI and SPI), spatial resolution (ADM1-ADM4), and exposure-outcome interval, which limited comparability. Longitudinal panel studies (n=3) were uncommon but provided stronger causal inferences. Conclusion: Future research should prioritise longitudinal studies, standardised threshold reporting, and improved spatiotemporal data integration to inform effective interventions and policies for mitigation and adaptation.
Keywords: Global Health Nutrition, Extreme weather events, climate change, undernutrition, Asia, scoping review
