Marasmus is a severe form of protein-energy malnutrition (PEM) resulting from an inadequate intake of both calories and protein over a prolonged period. The body's inability to acquire sufficient fuel leads to progressive adaptations to survive starvation. This causes the mobilization of the body's own tissues for energy, beginning with fat and then consuming muscle. Consequently, people with marasmus become visibly emaciated and severely underweight. This article will explore the key characteristics of marasmus, contrast it with the related condition kwashiorkor, and discuss its causes, treatment, and prevention within the broader context of nutrition diet.
The Core Characteristic: Severe Wasting
For those encountering questions like, 'Which of the following is a characteristic of marasmus Quizlet?', the most critical feature to remember is severe wasting. This distinguishes it from other forms of malnutrition. The term 'marasmus' comes from the Greek word marainein, meaning 'to waste away,' which perfectly describes the condition. The following points elaborate on this key characteristic:
- Emaciation and a 'Skin and Bones' Appearance: The most striking feature of marasmus is the profound depletion of subcutaneous fat and muscle mass. This leaves the individual, often a young child, appearing severely emaciated with protruding ribs, joints, and facial bones. The skin may become loose, dry, and wrinkled due to the loss of underlying tissue.
- Low Body Mass Index (BMI): A key diagnostic criterion for marasmus is a significantly low BMI for one's age. For children, this is defined as weight-for-height being below a certain standard deviation, often less than 60% of the expected weight for their age.
- 'Old Man' Facies: The loss of fat and muscle tissue, particularly in the face, can give a marasmic child a characteristic wizened or aged appearance.
Marasmus vs. Kwashiorkor: A Critical Comparison
Another form of severe malnutrition often contrasted with marasmus is kwashiorkor. While both are types of protein-energy malnutrition, their characteristics are different, and the distinction is often tested in educational settings. The main difference lies in the type of nutrient deficiency and the resulting physical signs. The table below summarizes the key differences:
| Feature | Marasmus | Kwashiorkor |
|---|---|---|
| Primary Deficiency | All macronutrients (calories, protein, fats) | Primarily protein, with typically adequate (or high) carbohydrate intake |
| Appearance | Wasted, extremely emaciated, 'skin and bones' | Puffy or swollen, with edema |
| Edema (Swelling) | Absent | Present, especially in the hands, feet, face, and abdomen |
| Subcutaneous Fat | Markedly absent | Preserved or present |
| Appetite | Can be ravenous or anorexic | Poor or diminished |
| Liver | Usually not enlarged | Enlarged due to fatty liver |
Beyond the Physical: Other Signs of Marasmus
While severe wasting is the hallmark, marasmus manifests with a range of other symptoms as the body's systems shut down to conserve energy. These include:
- Lethargy and Apathy: Marasmic individuals often appear tired, apathetic, and withdrawn due to low energy levels.
- Weakened Immune System: The body's defenses are severely compromised, leaving the individual highly susceptible to infections, which can worsen malnutrition.
- Low Vital Signs: To conserve energy, the body lowers its metabolic rate, resulting in low body temperature (hypothermia), slow heart rate (bradycardia), and low blood pressure (hypotension).
- Dry Skin and Brittle Hair: The lack of nutrients affects skin health and hair, causing it to become dry, thin, and brittle.
- Delayed Growth and Development: In children, marasmus can cause stunted physical growth and developmental delays, with potentially lasting cognitive impacts.
Causes and Contributing Factors
Marasmus is primarily a public health issue driven by socioeconomic factors, but it can also be triggered by underlying medical conditions.
- Poverty and Food Scarcity: The most common cause is chronic food insecurity, where adequate calories and protein are simply unavailable due to poverty or famine, especially in developing countries.
- Infections: Chronic or repeated infections, such as diarrhea, measles, or HIV, can deplete the body's energy reserves and interfere with nutrient absorption, accelerating the onset of marasmus.
- Inadequate Infant Feeding Practices: In regions with food scarcity, early cessation of breastfeeding and replacement with diluted, nutrient-poor formula can lead to marasmus in infants.
- Underlying Medical Conditions: In developed nations, marasmus can occur due to eating disorders like anorexia nervosa or other health conditions that cause malabsorption, such as cystic fibrosis or chronic kidney disease.
Nutritional Treatment and Rehabilitation
Treating marasmus requires a cautious, multi-phased approach under medical supervision to avoid the potentially fatal risk of refeeding syndrome.
- Stabilization: The initial focus is on correcting dehydration, electrolyte imbalances, and infections. A specialized rehydration solution, such as ReSoMal, may be used.
- Nutritional Rehabilitation: Refeeding is started slowly with liquid formulas containing a carefully balanced mix of carbohydrates, proteins, and fats. The calorie count is gradually increased, especially for children needing to catch up on growth.
- Follow-up and Prevention: Education for caregivers on proper nutrition, hygiene, and disease prevention is crucial to avoid relapse. A balanced diet rich in calories and protein is the best long-term prevention strategy.
Conclusion: A Wasting Disease
To answer the Quizlet question, "Which of the following is a characteristic of marasmus?", the most accurate response is related to severe wasting and the 'skin and bones' appearance. Marasmus is a complex nutritional disorder caused by a lack of total energy and protein, leading to the depletion of the body's fat and muscle stores. It is fundamentally different from kwashiorkor, which is marked by edema. The treatment is a delicate process of rehydration and gradual nutritional rehabilitation. Understanding these distinctions is vital for grasping the impact of severe malnutrition on the body.
