Now I have not played C:DDA in a long while. In the past, killing child zombies would make you really unhappy. But the more you did it, the less it affected you. Eventually you would feel nothing from mowing down countless zombies, who also happened to be children. I would assume that this would still be the case now too.
You mentioned malnutrition. Again from past experience, your character (in previous versions) used to require certain vitamins from what they ate. If you became low on any specific type, you would suffer an affliction related to that deficiency. This was later disabled by default through a mod labeled something along the lines of “disable nutritional needs”. I am actually downloading the most recent experimental of Cataclysm right now to play, so I can take a look at how to enable this system for you.
Edit:
Taking a look at this
It seems that vitamin needs are part of the base game now.
Also, something to note, the “stats through skills” mod is still available in world generation. It increases your stats when you learn a certain amount of related skills. I am not sure about the exact numbers, but I believe you can edit the ratios to your liking (don’t quote me on that).
This is all based on my quick researching (in game and on the internet), so I may be missing something. But I hope this helps!