Definition Types Causes Symptoms and Prevention of Protein Energy Malnutrition
Protein-energy undernutrition (PEU) used to be called Protein-energy malnutrition (PEM) previously. In simple terms, this is when there is a deficit of energy in your body as a cause of deficiency of all macronutrients. This can also include a deficiency of micronutrients. Macronutrients in the body include carbohydrates, fat, and protein whereas micronutrients include vitamins and minerals; these are all needed for energy.
As per the World Health Organization, protein energy malnutrition is a disparity between the supply of protein and energy and the body’s need for them to guarantee healthy development/ optimal growth. This can occur all of a sudden or it can occur gradually and can be graded as mind, moderate and severe.
In this article, we will look at some of the protein energy malnutrition symptoms, causes, treatment options, prevention methods, and much more. This is a very common thing in children in developing countries like India and Tanzania where children are not getting the calories and proteins whereas in developed countries it's more common in the older generation.
What are Some of the Protein Energy Malnutrition Symptoms?
Symptoms of secondary PEM can range from mild to severe and change the function of just about every organ within the body. The intensity and the type of symptom depend on the patient’s prior dietary status, nature of the disease, and the velocity at which it is progressing. Some of the protein energy malnutrition symptoms that can be noticed are:
Weakened grip and incapability to do things that require high energy
Physical changes in the body like weak arms and legs, hair colour change to red/yellow, hair loss, weight loss, skin becoming thin, pale, inelastic and dry, etc.
Apathy and irritability
Temporary lactose absence
Liver, heart, or kidney failure
The risk of hip fractures and ulcers is high in older patients
These are just a few of the symptoms, however, there are many more and they may differ from patient to patient.
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What are Some of the Protein Energy Malnutrition Causes?
Protein-energy malnutrition can be classified into two categories:
Primary PEM is usually found in children. It can be caused as a result of child/ elder abuse. Children can suffer from two types of PEM:
a. Kwashiorkor: Children suffer from this because they leave breastfeeding before their age due to reasons like the birth of a younger sibling. Protein-energy malnutrition causes can also be caused by acute illnesses like gastroenteritis. This occurs in places like rural regions of Africa where the food consumed has too many carbohydrates and less protein. This leads to seepages of the cell membrane thus releasing the intravascular fluid and proteins which results in something called oedema. Oedema makes a person more susceptible to diseases and illnesses because it weakens their immunity.
b. Marasmus: this is more common than kwashiorkor and also most common in developing countries. This causes a lot of weight loss and fast and muscle lessening. Marasmus is predominant in children smaller than those children that are affected by kwashiorkor and just like kwashiorkor, this also makes children highly susceptible to infections and diseases as their immunity gets impaired.
Secondary PEM is caused as there are disorders in the gastrointestinal tract. The secondary protein energy malnutrition causes can be infections, trauma, hyperthyroidism, and other serious illnesses and as a result, it causes a loss of appetite and impairs nutrient metabolism.
What is the Diagnosis Process?
Before the protein energy malnutrition treatment, Protein-energy undernutrition can be diagnosed to detect and know about the history of the patient’s diet.
Measurement of height and weight are taken
Fat distribution is checked and anthropometric measurements of the body mass are examined.
Also, the BMI is calculated so that the seriousness of the PEM can be known
Lab tests as also done to measure serum albumin, response to skin antigens, lymphocyte count, and other such tests are done to detect the severity
Many times, to diagnose it, low levels of hormones, lipids, cholesterol, calcium, magnesium, etc. can also be helpful.
What is the Protein Energy Malnutrition Treatment?
There are many ways through which this can be treated. Some of the treatment options are:
Avoiding lactose
Oral feeding
Improving nutritional education to educate and inform people of the various nutrients that are important for the human body and how a deficit can be fatal.
Providing multivitamin supplements
These are only a few of the protein energy malnutrition treatments however there are many more that doctors recommend and provide.
Fun Facts
Did you know that protein energy malnutrition is the old name and it is now called Protein-energy undernutrition or PEU?
Did you know that poverty reduction and nutrition education can help to prevent and reduce this Protein-energy undernutrition?
Did you know the clinical tool used to measure this is known as a Z-score which is used to describe someone’s weight for height and height for age relative to population?
FAQs on Protein Energy Malnutrition in Children and Adults
1. What is protein energy malnutrition?
Protein energy malnutrition is a severe form of undernutrition caused by inadequate intake of protein, calories, or both. It commonly affects infants and young children in developing regions and results in impaired growth and weakened immunity.
- Occurs due to insufficient dietary energy and essential amino acids
- Leads to muscle wasting, weight loss, and delayed development
- Includes clinical forms like marasmus and kwashiorkor
2. What are the main types of protein energy malnutrition?
The main types of protein energy malnutrition are marasmus and kwashiorkor. These conditions differ based on the severity and type of nutrient deficiency.
- Marasmus: Caused by severe deficiency of both calories and protein; characterized by extreme wasting and thin body
- Kwashiorkor: Caused mainly by protein deficiency with adequate calorie intake; characterized by edema and swollen abdomen
3. What is the difference between marasmus and kwashiorkor?
The difference between marasmus and kwashiorkor lies in the type of nutrient deficiency and clinical features. Marasmus results from overall calorie deficiency, while kwashiorkor mainly results from protein deficiency.
- Marasmus: Severe wasting, no edema, very low body weight
- Kwashiorkor: Edema (swelling), fatty liver, skin and hair changes
- Marasmus shows loss of subcutaneous fat; kwashiorkor shows fluid retention
4. What are the symptoms of protein energy malnutrition?
The symptoms of protein energy malnutrition include growth failure, muscle wasting, and weakened immunity. The severity depends on whether it is marasmus or kwashiorkor.
- Severe weight loss and thin limbs
- Edema, especially in legs and face (in kwashiorkor)
- Stunted growth and delayed development
- Hair discoloration and skin lesions
- Increased susceptibility to infections
5. What causes protein energy malnutrition?
Protein energy malnutrition is caused by inadequate intake or absorption of protein and calories. It is often linked to poverty, food insecurity, and recurrent infections.
- Lack of balanced diet rich in protein and energy
- Early weaning onto low-protein foods
- Chronic infections like diarrhea
- Poor maternal nutrition
6. How does protein energy malnutrition affect the body?
Protein energy malnutrition affects the body by impairing growth, reducing muscle mass, and weakening the immune system. The deficiency disrupts normal physiological processes.
- Decreased muscle protein synthesis leading to wasting
- Reduced production of plasma proteins causing edema
- Impaired immune response increasing infection risk
- Delayed cognitive and physical development in children
7. Who is most at risk of protein energy malnutrition?
Infants, young children, pregnant women, and people in low-income regions are most at risk of protein energy malnutrition. Rapid growth and limited food access increase vulnerability.
- Children under 5 years of age
- People living in famine or poverty-stricken areas
- Individuals with chronic illnesses
- Elderly with poor dietary intake
8. How is protein energy malnutrition diagnosed?
Protein energy malnutrition is diagnosed through clinical examination, anthropometric measurements, and laboratory tests. Assessment focuses on growth and body composition.
- Measurement of body weight and height-for-age
- Mid-upper arm circumference (MUAC)
- Presence of edema
- Blood tests for low serum albumin
9. How can protein energy malnutrition be prevented?
Protein energy malnutrition can be prevented by ensuring adequate intake of balanced nutrients, especially protein and calories. Early nutritional intervention is essential.
- Exclusive breastfeeding for the first 6 months
- Introduction of protein-rich complementary foods
- Balanced diet with cereals, pulses, milk, eggs, or legumes
- Improved sanitation and infection control
10. Why is protein important in preventing protein energy malnutrition?
Protein is important in preventing protein energy malnutrition because it provides essential amino acids needed for growth, tissue repair, and enzyme production. Without adequate protein, the body cannot maintain normal structure and function.
- Supports muscle development and body growth
- Helps synthesize enzymes and hormones
- Maintains plasma protein levels to prevent edema
- Strengthens immune defense mechanisms
