Khyra died of bronchial pneumonia and septicaemia
A seven-year-old girl kept prisoner by her mother and mother's partner died after being starved for weeks or months, a court has heard.
Khyra Ishaq died of an infection, Birmingham Crown Court was told.
Prosecutors allege it was murder because the couple intended to cause Khyra serious harm.
Khyra's mother Angela Gordon, 34, and Junaid Abuhamza, 30, both of Leyton Road, Handsworth, Birmingham, deny murdering Khyra on 17 May last year.
Jurors have been told UK doctors had rarely seen such a severe case of malnutrition.
Khyra's body mass index at the time of her death was so low that it did not register on available medical charts, the court was told.
The court heard a lock had been fitted high up on the kitchen door to keep Khyra, and five other children in the care of the couple, away from the food in the home.
Prosecutor Timothy Raggatt QC showed the jury photographs of fully-stocked kitchen cupboards and a fridge packed with food.
The court was told Khyra and the other children were occasionally fed porridge, dry bread and fruit.
They would have to eat with their hands on the floor of the small upstairs room they shared.
Mr Raggatt said if the children were caught stealing food they were made to stand outside in the cold, beaten with a cane, or made to overeat until they were sick.
He said the pair had murdered Khyra, even though she died from an infection, because they had intended to cause her really serious harm.
"It's just as much murder... as if they had shot, stabbed, beaten or strangled Khyra to death," he said.
A post-mortem examination revealed the "mechanism" of death to be bronchial pneumonia and septicaemia.
"Although that is the mechanism of death, the cause of her succumbing in that way was acute malnutrition," Mr Raggatt said.
Jurors were told that Khyra's life changed after her natural parents split up and Ms Gordon and Mr Abuhamza became a couple.
Khyra was removed from school and Miss Gordon refused to admit visitors to the house - including school staff and police a short time later.
Referring to defence case statements, Mr Raggatt said that while Ms Gordon denied deliberately depriving Khyra of food, Mr Abuhamza acknowledged that he was party to her unlawful killing.
"He's likely only to contest the question of his guilt of murder," he said.
Mr Abuhamza has admitted five counts of child cruelty relating to the other children, while Ms Gordon denies five counts of child cruelty between December 2007 and May 17 2008.
The trial was adjourned until Monday.