Introduction and definition

Lesson 8 : Protein Energy Malnutrition

Introduction and definition

PEM is a consequence not only of inadequate food intake but also of

    1. Poor living conditions
    2. Unhygienic environment
    3. Lack of health care

It is primarily a disuse of socioeconomic inequalities and mal distribution of food and health.

The WHO defined protein energy malnutrition (PEM) as a range of pathological conditions arising from co-incident lack in varying proportions of proteins and energy occurring most frequently in infant and young children commonly associated with infection (WHO 1972). The intensity of pathological condition of PEM ranges from mild to moderate to severe degrees.

The term kwashiorkor was first introduced by Cicely Williams in 1935. This is local name used by the Gatribe in Accra, West Africa and means “disease of the displaced child”. PEM is due to inadequate intake of food and is not due to lack of dietary protein alone.

Protein Energy Malnutrition is a major public health problem in many developing countries and it continues to be a major public health problem. It affects mostly children below 5 years of age of poor under privilege communities. Condition is serious during post-weaning stage and is often associated with infection. Respiratory infections and diarrohoea precipitates severe PEM and death.

The term protein energy malnutrition covers a wide spectrum of clinical stages ranging from severe forms like kwashiorkor and marasmus to milder forms in which main detectable manifestation is growth retardation. Oedema is the striking feature of kwashiorkor, while severe growth retardation and wasting are the cardinal features of marasmus. Combined forms showing oedema and wasting is described as marasmic kwashiorkor.
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