Protein Energy Malnutrition Kwashiorkor Marasmus

1. Protein Energy
Malnutrition
By - Garima Chawla
Roll no. 27
BPT 1ST Year

2. • Also called as Protein – calorie malnutrition
• According to WHO, it is “ the cellular imbalance between the
supply of nutrients and energy and body’s demand for them to
ensure growth, maintenance, and specific functions. ”
• Nutritional disorder
• Prevalent in infants and pre-school children
~GC

3. Causes of Protein – Energy Malnutrition
~GC

4. Two extreme forms of PEM….
1.Kwashiorkor
2.Marasmus
~GC

5. Kwashiorkor
• Term was coined by Cicely Williams to a nutritional disease
affecting the people of gold coast.
• It means ‘ sickness of the deposed child’ i.e sickness the
older child gets, when the next child is born.
• Whereas a classification by WHO is based on body weight as
a percentage of standard body weight. (80-60% incase of
kwashiorkor)
• Predominantly found in children between 1-5 years of age.
~GC

6. • Cause : deficiency of proteins along with
adequate calorie intake
• Clinical symptoms :-
i. Stunted growth
ii. Edema (particularly on legs & hands)
iii. Diarrhea
iv. Discoloration of hair and skin
v. Anemia
vi. Poor wound healing
~GC

7.  Biochemical Alterations…  Treatment..
• Hypoalbuminemia : Albumin values less than
2 g/dL is a biochemical marker.
• IgG increases due to associated infections
• Fatty liver : decreased lipoprotein synthesis.
• Hypokalemia (low potassium levels) and
dehydration due to diarrhoea.
• Hypomagnesemia (low level of serum
magnesium)
• Ingestion of Protein – rich foods or
the dietary combinations to provide
about 3-4 g of protein/kg body
weight/day will control kwashiorkor.
• A mixture of three parts of vegetable
proteins (Bengal gram or peanuts) and
one part of milk protein is found to be
very effective. It is monitored by
disappearance of edema, rise in serum
albumin level and gain in weight.
~GC
~GC

8. Marasmus
• Marasmus literally means ‘ to waste’.
• Predominantly found in children under one
year of age.
• Observed in children given watery gruels to
supplement mother’s breast milk.
• Cause : deficiency of calories
~GC

9. • Clinical Symptoms :-
i. Growth retardation
ii. Emaciation – muscle wasting
iii. Anemia
iv. Weakness
v. Dry & Atrophic skin
vi. Facial appearance like an old man
• Biochemical Alteration :-
i. Serum Cortisol Increased
ii. Hypoglycemia : low blood sugar levels
• Treatment : ingestion of adequate amount of
Proteins, fats & carbohydrates.
~GC

11. References…
• Biochemistry by U. Satyanarayana , U. Charapani
• DM Vasudevan Textbook of Biochemistry for Medical Students
• Imedscholar.com
• Brainly.in