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Protein-energy malnutrition is a form of malnutrition caused due to a deficiency of dietary protein or required energy.
- It can also be caused by a deficiency of micronutrients, which include vitamins and minerals.
- Protein-energy malnutrition is also known as protein-energy undernutrition.
- The World Health Organization defines PEM as an imbalance in the body's supply and demand for energy and protein.
- Proteins are one of the essential elements of our balanced diet required to perform vital body functions.
- It acts as an energy currency for our body.
- The required amount as per recommended dietary allowance (RDA) is 0.8g proteins per kg body weight.
- In this article, we will cover a wide range of topics, including symptoms, treatment, and preventive methods of PEM.
| Table of Content |
Key Terms: Protein Energy Malnutrition, Protein-energy Undernutrition, Kwashiorkor, Marasmus, Proteins, Types of Protein Energy Malnutrition
What is Protein Energy Malnutrition?
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Our food provides us with the essential nutrients that our body needs, including vitamins, fibre, minerals, fats, proteins, carbohydrates, and water.
- Deficiency of any of these nutrients can lead to health problems like PEM.
- Protein-energy malnutrition can be classified as mild, moderate, and severe depending on the duration, age, and onset of the disease.
- The two primary causes of PEM's prevalence are poverty and misinformation in underdeveloped countries.
- This deficiency leads to weight loss, slow growth, and weakened immunity.
- Protein-energy malnutrition is quite common in children and adults suffering from depression.
- It is also common in people suffering from diseases like cancer or AIDS.
- Due to this health condition, one might suffer from an increasing risk of infections, weak muscles and reduced physical and cognitive development.
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Types of Protein Energy Malnutrition
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Primary energy malnutrition can be further divided into two categories: Primary PEM and Secondary PEM.
Primary PEM
Primary PEM is mainly found in children who might be suffering from child/ elder abuse. This type of malnutrition is further divided into two categories, namely Kwashiorkor and Marasmus, which are discussed below:-
Kwashiorkor, a severe type of malnutrition, is caused by poor growth and stunted development of an individual.
- It is mostly seen in developing countries with high levels of malnutrition and poverty.
- Due to kwashiorkor, an individual might develop thin and fragile skin with symptoms of discoloration and peeling.
- The individual might suffer from edema (swelling) in the legs and sometimes on the face and hands, which is caused due to fluid retention.
- The age group most affected by this rare disease includes children between 3 to 5 years of age.
- Swelling and abdominal pain are two other common symptoms of kwashiorkor.
- Some patients may also suffer from loss of appetite and fatty liver disease.
Marasmus
Marasmus is caused by a shortage of any one of the three macronutrients—protein, lipids, or carbohydrates. Due to this, the vital organs of the body cannot perform normal functions.
- The primary symptoms of marasmus include rapid loss of muscle and fat, followed by electrolyte imbalances in children.
- Like kwashiorkor, this disease is also prevalent in children.
- Lack of energy and enthusiasm can be seen in children suffering from marasmus.
- Individuals might suffer from growth retardation, both physically and mentally and develop complications such as weakness and irritability.
- Due to marasmus, you must develop chronic diarrhoea and gastrointestinal disturbances.
Protein Energy Malnutrition
Secondary PEM
Secondary PEM is another form of protein energy malnutrition which results from the following:
- Gastro-intestinal tract infection/ disease
- Hyperthyroidism
- Decrease in the appetite of an individual
- Impairment of nutrient metabolism.
- Increasing the risk of hip fractures.
- Development of ulcers in elderly patients
- Reduction in the respiratory rate, heart size and cardiac output of an individual
- Weight loss and protrusion of bones
Symptoms of Protein Energy Malnutrition
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Symptoms of protein energy malnutrition may vary, but the most commonly observed are:
- Diarrhoea
- Muscle Loss
- Liver, kidney and heart Failure
- Loss of appetite
- Rapid hair fall and baldness
- Fatigue
- Dry Skin
- Pale Face
- Poor Immunity
Diagnosis of Protein Energy Malnutrition
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Clinical diagnosis of protein energy malnutrition is done using the patient's medical history, physical examination, and body mass index (BMI) readings. Patients suffering from alcoholic liver disease are most severely affected by PEM, which varies according to the root cause and duration of the condition.
There are also some tests through which any serious issues related to protein energy malnutrition can be diagnosed, such as:
- Total blood count (CBC)
- Serum Test
- Urine Test
- Transferrin
Treatment of Protein Energy Malnutrition
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There are numerous treatments available for protein-energy malnutrition which include
- Proper breastfeeding up to 1 year of age
- Staying away from lactose
- Adding essential nutrients to the diet
- Nutritional support and education
- Providing food supplements such as multivitamins, proteins, etc.
Things to Remember
- Protein energy malnutrition is primarily associated with low or improper nutrient intake of proteins.
- Malnutrition may result from insufficient breastfeeding or a diet lacking in nutritional value as well as quantity.
- Age, gender, and health condition of a person determine what nutrients they need.
- Kwashiorkor and marasmus are the most common examples of primary energy malnutrition.
- Over time, children with severe PEM begin to show a weakened immune response.
- Children are most likely to suffer from these diseases, particularly between the ages of 6 months and 3 years.
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Sample Questions
Ques. Who is more likely to suffer from protein energy malnutrition? (1 mark)
Ans. Children are most affected by protein-energy malnutrition because they consume less protein.
Ques. How can malnutrition be prevented? (3 marks)
Ans. Malnutrition is a major reason for increasing child mortality in developing countries. The primary cause of such an issue is poverty and lack of knowledge. Therefore it can be prevented by:
- Education: A mass number of people are still unaware of the nutritional requirements of women and infants, and basic dietary needs. Therefore, education is essential in order to prevent severe conditions like PEM.
- Nutritional Support: The government in collaboration with different organisations are implementing various initiatives for poor and nutrient-deficient children.
Ques. What is a balanced diet and what is its significance in treating protein energy malnutrition? (2 marks)
Ans. The diet which is required by a body to perform vital functions is considered a balanced diet. Severe deficiency diseases like protein energy malnutrition can also be treated by the proper consumption of a balanced diet. Furthermore, it includes seven essential nutrients that are as follows:-
- Water,
- Roughage,
- Carbohydrates
- Fats
- Proteins
- Vitamins
- Minerals
Ques. What are the food sources of protein through which PEM can be prevented? (2 marks)
Ans. Protein contributes to a healthy body weight by making you feel happy and full. The importances sources of protein that should be added in a regular diet are:
- Milk
- Pulses
- Eggs
- Soyabean
- Dry Fruits
Ques. What are the differences between macronutrients and micronutrients? (3 marks)
Ans. The difference between macronutrients and micronutrients are as follows:
| Macronutrients | Micronutrients |
|---|---|
| These are nutrients required by the body in large amounts. | The body also requires micronutrients but only in small amounts. |
| Kwashiorkor and Marasmus occurs due to deficiency of macronutrients. | Deficiency of micronutrients also causes serious diseases like Goitre, Rickets, Anaemia etc. |
| It is measured in Kilograms. | It is measured in milligrams. |
| Examples: Proteins, Carbohydrates, Fats | Examples: Magnesium, Iron, Calcium |
Ques. Are there any medical procedures or medications that can fully cure protein energy malnutrition? (2 marks)
Ans. No, as of right now, no medication has been found to fully treat PEM. On the other hand, it can be avoided with a diet rich in proteins. Enhancing nutrition education to better enlighten the public about the different nutrients that the human body needs and how deficiency can be lethal.
Ques. Which is more dangerous: overconsumption or deficiency of protein? State the reasons. (2 marks)
Ans. If protein consumption is excessive or less, the normal functioning of the body gets disrupted.
- Therefore, in both cases, the person may be likely to develop serious health problems.
- Due to protein deficiency, muscles become weak, and growth stops.
- On the other hand, excessive consumption over a long period can affect vital organs like the heart, kidneys, and digestive system.
Ques. What are the major differences between kwashiorkor and marasmus? (5 marks)
Ans. The difference between kwashiorkor and marasmus are as follows:
| Kwashiorkor | Marasmus |
|---|---|
| A type of PEM in which a person suffers from extreme protein deficiency is called kwashiorkor. | Marasmus occurs due to deficiency of vitamins, minerals and calories. |
| The affected age group by this disease is mainly children between 6 months to 3 years of age. | It is seen more often in children between 6 months to 1 year of age. |
| The primary symptoms include edema. | Edema is not observed. |
| Sudden body weight loss is not observed. | In this case, a child may suffer from severe body weight loss. |
Ques. Name the disease caused by deficiency of carbohydrate and how it is associated with PEM? (2 marks)
Ans. It is necessary for healthy digestion, control of blood sugar levels, and the functioning of the brain. Deficiency of carbohydrates along with protein and fat may cause marasmus which is a type of PEM. The risk factors are as follows:
- Hypoglycemia
- Ketosis
- Heart Disease
Ques. Is kwashiorkor associated with weight gain? (2 marks)
Ans. Though this isn't always the case, children with kwashiorkor commonly show low body fat percentage. Although the youngster may seem to be a normal weight or even chubby, this appearance is caused by fluid bloating rather than deposits of fat or muscle.
Ques. How does obesity differ from kwashiorkor? (2 marks)
Ans. Both obesity and kwashiorkor are severe health conditions. The accumulation of excessive body fat, which can harm a person's health, is the hallmark of obesity. On the other hand, kwashiorkor results from acute protein deficiency.
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