Food Science

1. PROTEIN MALNUTRITION
(PCM or PEM, Protein-Calorie (Energy) Malnutrition,
Kwashiorkor)

2.  deficient intake of protein of good
biologic value
 impaired absorption of protein, as in
chronic diarrheal states
 abnormal losses of protein in proteinuria
 Infection
 hemorrhage or burns
 failure of protein synthesis, as in chronic
liver diseases
ETIOLOGY

3.  a clinical syndrome resulted from a severe
deficiency of protein & inadequate caloric intake
 the most serious and prevalent form in
industrially underdeveloped areas
 “deposed child” may become evident from early
infancy to 5 yr of age, usually after weaning
 height and weight are accelerated with treatment
but never equal those of consistently well-
nourished children.
KWASHIORKOR

5.  Early clinical evidence----vague, including
lethargy, apathy, and irritability
 Inadequate growth, lack of stamina, loss
of muscular tissue, increased
susceptibility to infections, and edema
 Dermatitis and dyspigmentation
 Secondary immunodeficiency
 Anorexia, flabbiness of subcutaneous
tissues, and loss of muscle tone
CLINICAL MANIFESTATIONS

6.  Lethargy, apathy
 Inadequate growth, loss of muscular tissue
 Infections, and edema and dermatitis
 Flabbiness of subcutaneous tissues, and loss of
muscle tone

7.  Liver enlargement early or late
 Fatty infiltration
 Edema usually develops early (failure to gain
weight may be masked by edema, which is
often present in internal organs before it can
be recognized in the face and limbs)
 Renal plasma flow, glomerular filtration rate,
and renal tubular function are decreased
 The heart may be small in the early stages
and enlarged later

8.  Concentration of serum albumin decreased
 Aminoaciduria
 Ketonuria in the early stage
 Low blood glucose values
 Potassium and magnesium deficiencies
 Amylase, esterase, transaminase, lipase,
alkaline phosphatase, pancreatic enzymes
decreased
 normocytic, microcytic, or macrocytic Anemia
 Bone growth delayed and GH increased
LABORATORY DATA

9. Diagnosis
 The feeding history
 Low body weight, loss of muscular
tissue and disturbances of system
functions
 Laboratory data
 Excluding other diseases

10.  Underweight: weight for age is lower than -2SD
 Stunting: height for age is lower than -2SD
 Wasting: weight for height is lower than -2SD
Comparing with children in the same
age group (or height) and sex:
One or two or three may present to one
child. Having any one of the three, the child
can be diagnosed malnutrition.

11.  Protein deprivation: chronic
infections, diseases in which there
is an excessive loss of protein
through urine or stool
 The diseases of metabolic inability
to synthesize protein
DIFFERENTIAL DIAGNOSIS

12.  Diet containing an adequate
quantity of protein of good biologic
quality
 Adequate dietary instruction and
food distribution
 Treatment of diseases
PREVENTION

13. Immediate management of any acute
problems such as those of severe
diarrhea, renal failure, and shock and,
ultimately, the replacement of missing
nutrients are essential.
TREATMENT