Protein-energy malnutrition results when your body is lacking the calories it needs from protein, carbohydrates and fats. There are three forms of protein-energy malnutrition that include marasmus, kwashiorkor and marasmic-kwashiorkor. Marasmus symptoms can be seen by the naked eye. You can literally see a person wasting away to nothing. Kwashiorkor symptoms are less noticeable. You may see edema, or fluid retention, in the abdomen and laboratory tests are also preformed. A combination of the two is called marasmic-kwashiorkor.
You probably already know that a diet lacking in protein, carbohydrate and fat will result in weight loss. When protein-energy malnutrition occurs during times of growth in children and teenagers, permanent damage can occur. Children may have shorter stature and developmental delays. Protein-energy malnutrition can also be life-threatening if you have infections, burns or difficulty digesting or absorbing nutrients. These conditions need larger amounts calories for your body to use to get healthy again. If calories are lacking, your condition may worsen and death may occur.
Marasmus occurs when you are malnourished for long periods of time. Muscle and fat stores will decrease in your body and will be used for energy. You will appear extremely thin and weak. The elderly are most vulnerable to marasmus because of limited access to food, living alone, lack of transportation and low income.
Kwashiorkor can occur when you are deprived of good sources of protein from a few days to a few weeks. Maramus occurs over years while kwashiorkor occurs more rapidly. Kwashiorkor is stress-induced. For example, if you are in an accident and have severe burns, kwashiorkor may result. Burns require almost double the amount of calories you typically eat to heal your body. Your body will quickly use the protein stores in your blood and kwashiorkor may develop if high protein foods are not consumed. Kwashiorkor is more severe than marasmus because it can result in death more rapidly.
Marasmic-kwashiorkor can occur if you are malnourished for a long time and was just in a severe accident. You will appear very thin and weak and laboratory results will show a decrease in blood proteins such as albumin. Your immune system will also have a slower reaction time because your body needs calories for it to do its job effectively.
Protein-energy malnutrition is diagnosed by anthropometrics such as height, weight, arm circumference and body mass index. Laboratory work is also conducted to assess blood proteins and immune status. You may also have the following physical characteristics: dry, thin hair and skin, sunken cheeks, reduction in activity, edema, anemia and skin lesions.
After life-threating conditions such as infections and burns are stable, improving nutritional status is the next step in treatment. Small, frequent feedings are started to reduce signs and symptoms of nausea and vomiting. You should consume protein sources from meat, poultry, fish, eggs and dairy products because they contain all the essential amino acids needed for growth and repair.
- Mishra, S., Bastola, S, & Jha, B. (2009). Biochemical nutritional indicators in children with protein energy malnutrition attending Kanti Children Hospital, Kathmandu, Nepal. Kathmandu University Medical Journal. 7(26):129-134.
- Shils, M., Shike, M. et al. (2006). Modern Nutrition in Health and Disease. Lippincott Williams & Wilkins: Baltimore.