Protein Energy Malnutrition: Kwashiorkor and Marasmus

Inadequate intake of dietary protein causes Protein Energy Malnutrition (PEM), which may also be accompanied by deficiencies of vitamins and minerals. PEM can lead to two related disorders:

Kwashiorkor: a protein-deficiency disorder generally seen in children between one and three years of age. Affected children are underweight and show stunted growth, poor brain development, loss of appetite, anaemia, a protruding (distended) belly, slender limbs, bulging eyes, oedema (swelling) of the lower legs and face, and changes in skin and hair colour.

Marasmus: a more prolonged form of PEM, found in infants under one year of age, in which protein deficiency is combined with an overall low food-calorie intake. It impairs physical growth and retards mental development; subcutaneous fat disappears, the ribs become prominent, the limbs become thin, the skin becomes dry, thin and wrinkled, body weight is lost, and — because the digestive glands themselves atrophy (waste away) — digestion and absorption of food also stop. Unlike Kwashiorkor, Marasmus does not cause oedema. …