Protein-calorie malnutrition

Protein-calorie malnutrition (PCM), also known as protein-energy malnutrition (PEM), is a form of malnutrition that is defined by a range of pathological conditions arising from coincidental lack of dietary protein and calories (energy), occurring most frequently in infants and young children, and often associated with infection. It is a major health problem in countries with insufficient food resources or with poorly developed food distribution systems, particularly in parts of Africa, Asia, and Latin America. PCM can lead to growth failure, weakened immunity, increased morbidity, and mortality.

Types

PCM is categorized into two main types based on the severity and the ratio of protein to calories in the diet:

• Kwashiorkor: Characterized by adequate calorie intake but insufficient protein consumption. Symptoms include edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates.
• Marasmus: Results from a severe deficiency in calorie intake. Symptoms include severe muscle wasting, stunted growth, and weakness.

Causes

The primary cause of PCM is a diet lacking in adequate amounts of proteins and calories, which is often compounded by conditions such as poverty, lack of access to quality food, and acute or chronic infections, particularly those leading to diarrhea. Other contributing factors can include early weaning, high birth rates, and inadequate maternal nutrition.

Symptoms

Symptoms of PCM vary depending on the type but generally include:

• Weight loss or failure to gain weight
• Muscle wasting
• Fatigue and lethargy
• Edema in kwashiorkor
• Dermatitis in kwashiorkor
• Delayed growth and development in children

Diagnosis

Diagnosis of PCM involves a combination of dietary history, physical examination, and anthropometric measurements. These can include weight-for-age, height-for-age, and weight-for-height ratios. Laboratory tests may also be conducted to assess protein and calorie deficiencies.

Treatment

Treatment of PCM focuses on addressing the underlying dietary deficiencies and any complications that have arisen. This typically involves:

• Gradual refeeding with a diet high in calories and proteins
• Treatment of any infections
• Supplementation of vitamins and minerals
• Monitoring and supportive care for complications such as dehydration and heart failure

Prevention

Prevention of PCM involves ensuring access to a balanced diet rich in proteins and calories. Public health measures can include:

• Education on nutrition
• Improving food security
• Breastfeeding promotion and support
• Immunization against common childhood infections

See also

• Malnutrition
• Undernutrition
• Food security