In conditions such as marasmus, nutritional deficiency causes cortisol secretions responsible for mobilizing proteins from protein storage organs such as muscles and the subcutaneous tissues. The PEM may result in edema. It also causes retardation in growth. In a deficiency disorder such as kwashiorkor, the person cannot adapt to the conditions put forth on the body due to a deficient diet. The main symptoms of PEM include:
Thin limbs and bones
Frequent watery diarrhea
Retarded mental development
Associated nutritional deficiency such as that of vitamin B complexes which cause the distorted bodily appearance of the child or person.
Nutritional Requirements: Since the deficiency is caused due to malnutrition, the main line of treatment and management should include dietary management. It aims to provide every type of nutrition so that the body does not suffer protein hunger. The two major PEM disorders seen very commonly are:
Marasmus Both of them show varied responses to weight loss due to the mechanism of protein depletion in the body. A person is supposed to intake about 150-200 kcal per kg body weight per day to maintain the average body mass index. Most of this demand is fulfilled by carbohydrates and fats from the food. There should be enough calories from these two substrates so as proteins are spared and utilized by the body for other purposes. The recommended dietary allowance (RDA) for proteins is 5 g of protein per kilogram body weight per day. The fats contribute almost forty percent, and it should be kept in mind that unsaturated fats should be preferred over saturated fats. Electrolytes such as potassium chloride and magnesium chloride are also essential for the proper digestion of substrates. Vitamin A also has a significant role to play in growth.
Treatment of Protein Energy Malnutrition
This problem requires strategic planning to treat the condition, which can be categorized as stages, mainly there are three stages:
The first aim is to resolve the life-threatening state.
The second aim is to restore the nutritional state of the body.
The third stage is to ensure complete rehabilitation.
For example, a severe case of malnutrition, in which the person suffers from dehydration and chronic infection. Therefore, now the aim is to save the person’s life by referring to the hospitals to stabilize him first. Once it is controlled and becomes non-complicated, then restoration of one’s nutritional status becomes the following aim. After securing that and minimizing the threat, rehabilitation is started, to attain healthy muscular, nervous systems. The associated conditions such as hypoglycemia, hypothermia, anemia, and congestive heart failure are also considered during treatment because it is impossible to lead a healthy life with any pre-existing and associated conditions.
Prevention of Protein Energy Malnutrition
The PEM is the consequence of inadequate diet and improper diet intake and is strongly associated with poor hygienic conditions and a lack of medical facilities. The World Health Organization/ Food and Agricultural Organization (WHO/FAO) suggested some precautionary measures to prevent the PEM:
Health promotion includes promoting awareness in the society such as telling people about the feeding of the pregnant and the breastfeeding mothers, about the pros and cons. Family planning and placing gaps between the subsequent births. Adapt government plans related to food and delivery.
Early diagnosis and treatment of the conditions may worsen the requirements, such as diarrhea and vomiting. Diagnosing the growth and developmental milestones of the newborn. Any lag in the development may be indicative of PEM.
Initiatives for education related to nutrition and timely immunization.
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