Foods for Kwashiorkor: Essential Diet and Nutrition

October 27, 2025 •

3 min read

According to the World Health Organization (WHO), kwashiorkor is a form of severe acute malnutrition (SAM) caused by protein deficiency. Treating this condition requires a careful, gradual reintroduction of nutrient-dense foods, with a focus on specific foods for kwashiorkor to ensure a safe recovery.

Quick Summary

This article details the specific foods and nutritional strategies used to treat kwashiorkor, covering the two-phase approach of stabilization and rehabilitation. It highlights key nutrients like protein, calories, and micronutrients, and provides safe food recommendations.

Key Points

Start Slow: In the stabilization phase, use low-protein, low-lactose therapeutic formulas like F-75 to prevent refeeding syndrome and correct initial metabolic problems.
Prioritize Protein: Once stable, shift to a high-protein, high-calorie diet with foods like milk, eggs, lean meat, and legumes to promote rapid catch-up growth.
Include Micronutrients: Kwashiorkor treatment must include supplements of essential vitamins and minerals, especially zinc, vitamin A, and potassium.
Monitor for Refeeding Syndrome: Closely supervise the initial feeding period for dangerous shifts in electrolytes like phosphorus, potassium, and magnesium.
Utilize Local Foods: Incorporate culturally appropriate and accessible protein sources like soy, peanuts, beans, and millets to support long-term recovery.
Increase Energy Gradually: Start with cautious calorie intake and increase it steadily as the patient's digestive system adapts to prevent complications.
Consider Plant-Protein Combinations: Combine plant-based foods like maize and soya to achieve a more complete amino acid profile, particularly in resource-limited settings.

Understanding the Nutritional Needs for Kwashiorkor Recovery

Kwashiorkor, a severe form of protein-energy malnutrition, requires a carefully managed dietary intervention to correct nutritional imbalances and promote healing. The initial refeeding phase is critical and must be done cautiously to prevent refeeding syndrome, a potentially life-threatening complication. The treatment is typically divided into two phases: stabilization and rehabilitation.

The Stabilization Phase: Slow and Steady

In the first phase of treatment, the goal is to stabilize the patient by correcting severe metabolic imbalances without overwhelming the system. The focus is on providing low-lactose, low-osmolality feeds in small, frequent amounts. Protein intake is introduced gradually. The WHO recommends therapeutic milk formulas, such as F-75, which are specifically designed to address these early needs.

Foods appropriate for the stabilization phase often include:

Therapeutic Milk Formulas: F-75 is a key component, providing controlled amounts of energy, protein, and electrolytes.
Electrolyte Solutions: Special rehydration formulas like ReSoMal are used to correct dehydration and electrolyte deficiencies without excess sodium.
Simple Carbohydrates: Cooked rice or banana can be introduced gradually to provide energy in a way that is gentle on the digestive system.

The Rehabilitation Phase: Catch-Up Growth

Once a patient is stable, the goal shifts to promoting rapid catch-up growth and rebuilding lost muscle mass. This phase requires a high-energy, high-protein diet. Therapeutic foods like F-100 milk formula or Ready-to-Use Therapeutic Food (RUTF) are often used, as they are energy-dense and nutrient-rich.

During the rehabilitation phase, a wider variety of foods can be introduced, such as:

High-Protein Animal Sources: Skimmed milk powder, eggs, lean meats, and fish are excellent sources of high-biological-value protein, which is easily absorbed by the body.
High-Protein Plant Sources: Soya beans, peanuts, beans, lentils (dal), and other legumes provide essential protein, especially where animal products are not readily available or affordable. Combined plant-based diets can offer a good mix of amino acids.
Nutrient-Dense Staples: Including a mix of rice, corn, millet, and potatoes ensures a balanced carbohydrate and calorie intake.
Fruits and Vegetables: Papaya, sweet potatoes, and green leafy vegetables (like amaranth) are crucial for providing essential vitamins, minerals, and antioxidants, especially β-carotene.

A Comparison of High-Protein Food Sources


Food Type	Protein Source	Advantages	Considerations
Animal-Based	Milk, eggs, lean meat, fish	High biological value protein; easily digestible amino acids; rich in Vitamin B12.	Can be expensive or culturally restricted; potential for lactose intolerance in severe cases.
Plant-Based	Soya beans, legumes, nuts, seeds	Accessible and affordable; can be combined to form a complete protein.	May have lower protein quality if not combined; can be bulky for small appetites; phytic acid can interfere with mineral absorption.
Therapeutic Formulas	F-75, F-100, RUTF	Formulated to precise nutritional needs; contain added vitamins and minerals; easy to prepare.	Requires specific ingredients and preparation; may not be locally available.

Considerations for Successful Feeding

Micronutrient Supplementation

Kwashiorkor is often accompanied by deficiencies in micronutrients like vitamins A, B12, folic acid, zinc, and potassium. Therefore, supplementation is a crucial part of treatment, often beginning early in the recovery process. Zinc is particularly important for rebuilding tissue and improving intestinal function.

Preventing and Managing Refeeding Syndrome

Refeeding syndrome is a severe risk during the initial feeding phase. It occurs when a sudden increase in nutrition causes dangerous shifts in fluid and electrolyte levels. This is why feeding must be started slowly with low-osmolality formulas. Careful monitoring of potassium, magnesium, and phosphate levels is essential to prevent complications like cardiac arrhythmia and respiratory failure.

The Importance of Local and Culturally Appropriate Foods

While specialized formulas are important, particularly in hospital settings, long-term recovery depends on the availability and acceptance of local, nutrient-dense foods. Health programs often work to educate communities on utilizing local, indigenous crops like pigeon peas, bambara nuts, and various millets to create balanced, high-protein diets.

Conclusion

Treating kwashiorkor successfully hinges on a two-pronged approach that first stabilizes the patient's delicate metabolic state before transitioning to aggressive nutritional rehabilitation. Key foods for kwashiorkor include therapeutic milk formulas in the initial phase, followed by a wide range of nutrient-rich animal and plant proteins, as well as fruits and vegetables. By following proven guidelines and carefully monitoring progress, the devastating effects of protein deficiency can be reversed. It is a process that requires medical supervision, a consistent food supply, and long-term support to ensure a full and lasting recovery. For more detailed guidelines on the clinical management of severe acute malnutrition, consult the WHO's Pocket Book of Hospital Care for Children.

Frequently Asked Questions

The very first food given is typically a therapeutic milk formula, such as F-75, designed to be low in protein and lactose but rich in electrolytes and essential nutrients, to safely begin nutritional rehabilitation and prevent refeeding syndrome.

With early and proper nutritional management following WHO guidelines, patients can begin to recover within weeks. The rehabilitation phase, where rapid weight gain occurs, can last several weeks.

Yes, plant-based foods like soya beans, peanuts, and other legumes can be effective sources of protein, especially when combined to provide a complete amino acid profile. However, animal-based proteins like milk often provide superior results.

Feeding is started slowly to prevent refeeding syndrome, a dangerous condition that occurs when sudden refeeding causes rapid and severe shifts in electrolytes, leading to complications like heart failure.

Kwashiorkor is primarily a severe protein deficiency that causes fluid retention (edema), whereas marasmus is a general caloric deficiency leading to severe weight loss and muscle wasting.

Essential micronutrients include potassium, magnesium, zinc, and vitamins, such as vitamin A and B12. Supplements are often administered to correct these deficiencies.

In the initial stabilization phase, fats are introduced cautiously. Later, in the rehabilitation phase, healthy fats from sources like fortified therapeutic foods or plant-based oils are important for providing dense calories to support catch-up growth.