Age: Preschool age children are most seriously affected because of their increased nutritional requirements compared to adults.
Infections occur more frequently in this age group.
The long term intake of insufficient food can result in marasmus before one year.
Kwashiorkor is common after 18 months.
Diet related factors:
Diluted milk formula which is grossely deficient in energy.
Prolonged breast feeding
Delayed introduction and inadequate amount of supplementary feeds.
Introduction of adult diet after prolonged breast feeding. Inability of child to eat sufficient quantity, due to the bulk of adult/family diet.
Diets low in energy & protein.
Role of free radicals and aflotoxins: Free oxygen radicals produced in the body during various infections and the aflotoxin poisoning from food are usually buffered by protein and neutralized by antioxidants such as Vitamin A, C and E and selenium. A child on protein & energy deficient diets in the presence of infection or aflotoxin accumulates toxic, free oxygen radicals, which in turn damage liver cells, leading to kwashiorkor.
Infections:
A overcrowded and an unsanitary living conditions lead to frequent infections like diarrohoea.
Kwashiorkar is often preceded by an episode of infection, diarrhea and respiratory infections being the most common precipitating factors.
Repeated attacks of diarrhea are responsible for poor growth of children.
Acute diarrhea leads to mal absorption of fat and protein.
Infections arouse negative nitrogen balance.
Measles is the other common infectious diseases that occurs during childhood.
The impact of measles is more than that of other infections because of secondary complications and prolonged illness.
During acute infections, appetite is often impaired and the food intake is reduced. Apart from low intake, dietary restriction is often imposed by the mother or family or community.
Mal absorption of nutrient and metabolic losses during infection can also aggravate malnutrition.
Socio-economic factors
Poor economic status, faulty feeding habits due to ignorance and prejudice
Larger families and high birth rate
Superstitions and taboos concerning food are powerful social factors,
Deprivation of maternal care and attention due to work pressure away from home by the mothers.
PEM is basically a problem of poverty Inadequate diet Poor environment High incidence of infections results – in PEM.
Participants