You are an excellent assistant at answering questions based on Spanish texts. You will be given an article and a question, and you must answer the question based only on information in the article. The response should be extracted from the context verbatim.

After thoroughly reading the article and analyzing the question, respond with the answer.

Title:
Diarrhea

Context:
Diarrheal disease may have a negative impact on both physical fitness and mental development. "Early childhood malnutrition resulting from any cause reduces physical fitness and work productivity in adults," and diarrhea is a primary cause of childhood malnutrition. Further, evidence suggests that diarrheal disease has significant impacts on mental development and health; it has been shown that, even when controlling for helminth infection and early breastfeeding, children who had experienced severe diarrhea had significantly lower scores on a series of tests of intelligence.

Question:
What is the cause of childhood malnutrition?

diarrhea