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Wasting requires treatment with therapeutic food over several weeks and, sometimes, hospitalization.

The study, published Wednesday in The Lancet medical journal, is the most comprehensive study of child hunger in the region to date, the authors said. It relied on screenings of nearly 220,000 children from dozens of health centers and medical sites in Gaza between January 2024 and mid-August.

“Tens of thousands of preschool-aged children in the Gaza Strip are now suffering from preventable acute malnutrition and face an increased risk of mortality,” said Dr. Masako Horino, the study’s lead scientist, in a statement.

In a commentary accompanying the study, three experts in child health, nutrition and public policy who were not involved in the research called it the “some of the most definitive evidence” of the extent of malnourishment.

“It is now well established that the children of Gaza are starving and require immediate and sustained humanitarian assistance,” wrote Jessica Fanzo of Columbia University, Paul Wise of Stanford University and Zulfiqar Bhutta of Aga Khan University in Pakistan and the Hospital for Sick Children in Canada.

Food shortages and starvation

Israeli Prime Minister Benjamin Netanyahu of starvation during the war triggered by a deadly Hamas attack on Oct. 7, 2023, saying they were “lies” promoted by Hamas.

But experts and aid groups have warned for months that Israel’s restrictions of food and aid into Gaza and a relentless military offensive were causing starvation, particularly in children and pregnant women.

Gaza’s health ministry said 461 people, including 157 children, have died from complications of malnutrition since the war started, most of them in 2025. Hospitals have been overwhelmed with malnourished children, amid a severe shortage of therapeutic foods, according to the ministry. The U.N. and many independent experts consider figures from the health ministry, which is part of the Hamas-run government, to be most reliable.

For the study, trained nurses used calibrated tapes to measure the circumference of children’s mid-upper arms, a standard tool for evaluating nutritional stress. Very thin arms, less than 125 millimeters, or 4.9 inches, correlate with very thin bodies, the scientists said.

Restricted aid

Rates of malnutrition decreased during periods when aid was allowed into Gaza, such as a in early 2025. But the children's conditions worsened when supplies were blocked for weeks or months at a time, the study found.

Israel has restricted aid to varying degrees throughout the war, imposing a total siege for weeks starting in March for over two months. In May, it began allowing a trickle of aid. A controversial began in May, limiting aid distribution to four sites around Gaza and requiring Palestinians to pass through Israeli military lines to get aid. were killed by Israeli forces in and around those sites, according to the U.N.

Edesia, a U.S.-based nonprofit food aid organization, said it was able to send shipments of therapeutic food to Gaza. The group shipped 1,500 boxes of the products on Sept. 28 and plans to send nearly 15,000 boxes by air and sea over the next month, according to founder Navyn Salem.

The study follows an August report by U.N.-backed food security experts that in parts of Gaza. The Integrated Food Security Phase Classification, the world’s leading authority on food crises, had been warning that hundreds of thousands of Palestinians were facing catastrophic levels of hunger for months. Experts said lack of data had prevented a declaration of famine earlier.

Two workers involved in the malnutrition screening program were among 21 UN Relief and Works Agency health workers who have been killed in Gaza. Overall, more than 370 agency staff have been killed in the conflict, the group said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.