Protein Energy
Malnutrition
Presented by:
Hadiya-Tu-Rahmeen
Introduction
• A condition caused by inadequate intake of protein and energy.
• Affects children and adults, particularly in low-income regions.
Types of PEM
• Marasmus:
• Severe deficiency of both protein and calories.
• Mainly occurs in infants between 6months to 1 year old
• Symptoms: Extreme weight loss, muscle wasting, lethargy .
• Kwashiorkar:
• Protein deficiency with adequate calorie intake.
• Most common in ages of 3 to 5
• Symptoms: Edema, skin lesions, swollen belly, hair discoloration.
Kwashiorkor
• Causes:
• Diets high in carbohydrates but low in protein.
• Early weaning and inadequate complementary feeding.
• Chronic infections leading to poor nutrient absorption.
Symptoms:
• Edema (swelling in legs and feet).
• Hair discoloration and loss.
• Skin lesions and peeling.
• Swollen belly due to fluid retention.
• Irritability and lethargy.
Effects:
• Weak immune function leading to frequent infections.
• Muscle wasting and stunted growth.
• Cognitive impairments and delayed development.
• Increased risk of mortality in severe cases.
Diagnosis
• Clinical assessment of symptoms.
• Anthropometric measurements (MUAC, weight-for-height).
• Laboratory tests (serum albumin, electrolyte levels).
Management and
Treatment of
Kwashiorkor
• Immediate Interventions:
• Provide protein-rich nutritional rehabilitation..
• Medical Treatment:
• Treat infections with antibiotics.
• Correct vitamin A, zinc, and iron deficiencies.
Marasmus
• Causes of Marasmus
• Inadequate Caloric Intake – Insufficient consumption of food,
especially protein and carbohydrates.
• Poor Nutritional Practices –Lack of breastfeeding, or improper feeding.
• Chronic Illnesses – Diseases like tuberculosis, HIV/AIDS, or chronic
diarrhea that impair nutrient absorption.
• Poverty & Food Insecurity – Limited access to nutritious food due to
socio-economic conditions.
• Infections & Parasitic Diseases – Increase the body's energy demands
Symptoms of Marasmus
• Severe weight loss (emaciation)
• Muscle wasting and thin limbs
• Prominent bones with loose, sagging skin
• Growth retardation
• Dry, wrinkled skin
• Irritability or apathy
• Frequent infections due to weakened immunity
Effects of Marasmus
• Delayed physical and mental development
• Increased risk of infections due to weakened immune response
• Electrolyte imbalances
• Organ dysfunction (e.g., heart, liver, kidneys)
• Permanent cognitive impairment if untreated in early
childhood
• Increased mortality risk
Diagnosis of Marasmus
• Clinical Assessment – Observing weight, muscle mass, and
skin condition
• Anthropometric Measurements – Checking weight-for-
age, height-for-age, and mid-upper arm circumference (MUAC)
• Blood Tests – Checking for anemia, electrolyte imbalances,
and infections
• Nutritional History – Evaluating dietary intake and feeding
practices
Management and Treatment
• Emergency Nutritional Support – Providing ready-to-
use therapeutic food (RUTF)
• Gradual Refeeding – Starting with low-calorie, easy-to-
digest foods to prevent refeeding syndrome
• Hydration & Electrolyte Correction – Oral
rehydration solutions (ORS) and IV fluids if necessary
• Treatment of Infections – Antibiotics for bacterial
infections and deworming for parasites
