Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Upcoming SlideShare
What to Upload to SlideShare
Next
Download to read offline and view in fullscreen.

41

Share

Download to read offline

Protein energy malnutrition

Download to read offline

protein energy malnutrition

Related Books

Free with a 30 day trial from Scribd

See all

Related Audiobooks

Free with a 30 day trial from Scribd

See all

Protein energy malnutrition

  1. 1. PROTEIN ENERGY MALNUTRITION By Dev Ram Sunuwar, M.Sc. Nutrition and Dietetics
  2. 2.  A pathological state resulting from relative or absolute deficiency of one or more essential nutrients Comprises four forms: a) Undernutrition b) Overnutrition c) Imbalance d) Malabsorption The world health organization (WHO) defines Malnutrition as – “The cellular imbalance between the supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance, and specific functions." MALNUTRITION
  3. 3. •Marasmus •Kwashiorkor •Xeropthalmia •Nutritional anemias •Iodine deficiency disorders On a global scale, there are five main nutritional deficiency diseases that are being accorded the highest priority action-
  4. 4. “ A range of pathological conditions arising from simultaneous deficiency of “proteins & energy” and commonly associated with infections”. • PEM is the single most important cause of childhood morbidity and mortality. • Severe form of PEM is found in about 5% children below the age of 5 yrs . •About 50-60% have mild to moderate PEM. Protein Energy Malnutrition
  5. 5. The term protein energy malnutrition has been adopted by WHO in 1976. Highly prevalent in developing countries among <5 children; severe forms 1-10% & underweight 20-40%. All children with PEM have one or more micronutrient deficiency. Epidemiology
  6. 6. The term marasmus is derived from the Greek word “marasmos”, which means “withering or wasting away”. Marasmus involves inadequate intake of protein and calories and is characterized by emaciation. The term kwashiorkor is taken from the Ga language of Ghana and means "the sickness of the weaning." Williams first used the term in 1933, and it refers to an inadequate protein intake with reasonable caloric (energy) intake. Edema is characteristic of kwashiorkor but is absent in marasmus. Children may present with a mixed picture of marasmus and kwashiorkor, and children may present with milder forms of malnutrition. For this reason, Jelliffe suggested the term protein-calorie (energy) malnutrition to include both manifestations. Protein Energy Malnutrition (PEM) or Protein Calorie Malnutrition (PCM ) is the name given to various degrees of nutritional disorders caused by inadequate quantities of protein and energy in the diet. This is one of the most widespread deficiency disease in India and Nepal
  7. 7. Classification of PEM (FAO/WHO) Body weight as percentage of standard Oedema Deficit in weight for height Kwashiorkor 60 – 80 + + Marasmic kwashiorkor < 60 + ++ Marasmus < 60 0 ++ Nutritional dwarfing < 60 0 Minimal Underweight child 60 – 80 0 +
  8. 8. PEM(Clinical diagnosis)
  9. 9. The most common cause of malnutrition is poverty. PEM is primarily due to two factors: • An inadequate intake of food both in quantity and quality • Infections like – Diarrhoea, Respiratory Infections, Measles, Intestinal worm infestation • These infections increase requirements for calories, proteins and other nutrients, while decreasing their absorption and utilization. ETIOLOGY / CAUSES OF PROTEIN ENERGY MALNUTRITION
  10. 10. Malnutrition is a serious problem in Nepal, as in other countries of South Asia, and is a major threat to the health of infants, adolescent girls and pregnant & lactating mothers. National studies over the last 50 years show malnutrition rates in children under 5 years of age persist at rates around 50%. Malnutrition in Nepal
  11. 11. Malnutrition glance in Nepal 57 57 49 41 36 15 11 13 11 10 42 43 39 29 27 0 10 20 30 40 50 60 NDHS 1996 (1991-1995) NDHS 2001 (1996-2000) NDHS 2006 (2001-2005) NDHS 20011 (2006-2010) NDHS 20016 (2012-2016) Stunting Wasting Underweight
  12. 12. Poor hygiene and poor environmental conditions Large familysize Poor maternal health and nutritional status Poor maternal nutrition during Pregnancy Failure of Lactation Premature termination of breast feeding Delayedweaning Social and cultural feedingpractices Low birth weight Mal-absorption states like- Short bowel syndrome (small intestineinsufficiency) The other main factors causing PEM
  13. 13. Protein energy malnutrition(PEM) manifests intwo differentforms: NutritionalMarasmus Protein and calorie deficiency Common in infants and childrenbelow 3 years of age. Onset is more between 6-18 months of age. Kwashiorkor Common in childrenbelow 3yrs Onset is more between18months to 24months Protein deficiency only
  14. 14. MARASMUS  The term marasmus is derived from the Greek marasmos, which means wasting.  Marasmus involves inadequate intake of protein and calories and is characterized by emaciation.  Marasmus represents the end result of starvation where both proteins and calories are deficient.  Marasmus represents an adaptive response to starvation.  In Marasmus the body utilizes all fat stores before using muscles.
  15. 15.  Seen most commonly in the first year of life due to lack of breast feeding and the use of dilute animal milk.  Poverty or famine and diarrhoea are the usual precipitating factors  Ignorance & poor maternal nutrition are also contributory. EPIDEMIOLOGY & ETIOLOGY
  16. 16. Kwashiorkor can occur in infancy but its maximal incidence is in the 2nd yr of life following abrupt weaning Kwashiorkor is not only dietary in origin. Infective,psycho-socical, and cultural factors are also operative. Kwashiorkor is an example of lack of physiological adaptation to unbalanced deficiency where the body utilized proteins and conserves S/C fat. One theory says Kwashiorkor is a result of liver insult with hypoproteinemia and oedema. Food toxins like aflatoxins have been suggested as precipitating factors. Etiology
  17. 17. CLINICAL FEATURES OF KWASHIORKOR
  18. 18.  “Prevention of PEM is the fight against poverty and ignorance”.  It must be appreciated that there is no single shot solution to the treatment or prevention of PEM.  It is a complex problem involving each of the social, economic, educational, political, administrative, medical and health dimensions. An integrated effort involving all these and also awareness and a positive attitude towards the condition might help to limit it. Prevention and control of PEM
  19. 19. A) Health Promotion
  20. 20. B)Specific Health Protection
  • SumiPatra1

    Jul. 13, 2021
  • indumathiharish

    Jun. 8, 2021
  • VishrantiGiri1

    Jun. 4, 2021
  • BhuvanNexa

    May. 28, 2021
  • ShubhamSangavkar

    May. 4, 2021
  • DaheGarad

    Apr. 21, 2021
  • TakumiKagawa1

    Apr. 16, 2021
  • shaniahmmbaga

    Apr. 14, 2021
  • AnayaPriya

    Apr. 12, 2021
  • aruntvRobo

    Apr. 6, 2021
  • JagadeeshYadav9

    Mar. 22, 2021
  • VaibhaviBedekar

    Mar. 18, 2021
  • pavithrapavi117

    Feb. 27, 2021
  • ShiNceFraNcis

    Jan. 27, 2021
  • parasharswati

    Jan. 19, 2021
  • shayarvikas

    Jan. 7, 2021
  • darbinarai

    Nov. 5, 2020
  • AbdulhakimMaiwadaSada

    Oct. 26, 2020
  • AnjaliPawariya

    Oct. 3, 2020
  • anjani1998

    Sep. 24, 2020

protein energy malnutrition

Views

Total views

18,403

On Slideshare

0

From embeds

0

Number of embeds

0

Actions

Downloads

281

Shares

0

Comments

0

Likes

41

×