What is the disease caused by protein nutrition deficiency?

According to UNICEF, undernutrition causes at least one-third of young children's deaths globally, and severe cases lead to diseases caused by protein nutrition deficiencies. This article explores the specific conditions, their symptoms, and treatment.

Quick Summary

Protein-Energy Malnutrition (PEM) is a serious condition that can lead to disorders like Kwashiorkor and Marasmus, causing severe wasting, edema, and stunted growth in children.

Key Points

• Kwashiorkor is Edematous Malnutrition: Caused by a predominant lack of protein, it is characterized by fluid retention (edema) causing a swollen abdomen and limbs.

• Marasmus is Wasting Malnutrition: Resulting from a deficiency of both protein and calories, Marasmus causes severe wasting of body fat and muscle, leading to an emaciated appearance.

• Immune System Failure is a Major Complication: Both conditions weaken the immune system, making patients highly susceptible to infections, which are often the ultimate cause of death.

• Diagnosis Relies on Physical Signs and History: Healthcare providers diagnose these diseases through physical examination, checking for edema or wasting, and reviewing the patient's dietary history.

• Treatment Requires Caution and Medical Supervision: Refeeding must be done slowly under medical care to prevent refeeding syndrome and correct dangerous electrolyte imbalances.

• Prevention Involves Public Health Efforts: Addressing issues of poverty, improving food security, and providing nutritional education are key to preventing protein deficiency diseases on a broader scale.

Protein-Energy Malnutrition: An Overview

Protein-Energy Malnutrition (PEM), or Protein-Energy Undernutrition (PEU), describes a spectrum of conditions resulting from insufficient intake of protein, calories, or both. While prevalent in developing countries, PEM can also occur in industrialized nations due to illness or specific diets. The most severe forms lead to distinct diseases: Kwashiorkor, Marasmus, and Marasmic Kwashiorkor.

The Primary Diseases Caused by Protein Deficiency

Kwashiorkor: Predominantly Protein Deficiency

Kwashiorkor is a severe form of malnutrition primarily due to protein deficiency despite potentially adequate calorie intake. It often affects children transitioning from breast milk to a high-carbohydrate, low-protein diet. A hallmark symptom is edema (fluid retention), causing swelling in the limbs and abdomen.

Other symptoms of Kwashiorkor include:

• Hair changes (dry, brittle, discolored)
• Skin lesions (dry, peeling, scaly)
• Fatty liver
• Muscle atrophy (often hidden by edema)
• Stunted growth
• Apathy and irritability

Marasmus: Protein and Calorie Deficiency

Marasmus is a severe wasting disease caused by an overall deficiency of protein, carbohydrates, and fats. It results from insufficient food intake, leading to extreme loss of muscle and body fat. Marasmus is characterized by visible emaciation and lacks the edema seen in Kwashiorkor.

Symptoms of Marasmus include:

• Severe weight loss
• Extreme wasting of fat and muscle
• Emaciated appearance
• Stunted growth
• Dry skin and brittle hair
• Impaired immune system

Comparison of Kwashiorkor and Marasmus

Feature	Kwashiorkor	Marasmus
Primary Deficiency	Protein	Protein and calories
Edema (Swelling)	Present	Absent
Appearance	Bloated belly, moon face	Emaciated, wasted
Muscle Wasting	Depleted (masked by edema)	Severe and visible
Body Fat	Often retained	Almost completely lost
Liver	Often enlarged	Typically not enlarged

Causes and Risk Factors for Protein Deficiency Diseases

Protein deficiency diseases arise from various factors:

• Poverty and Food Scarcity: Limited access to nutritious food is a major cause in developing countries.
• Infections and Illnesses: Conditions like diarrhea can increase nutrient needs and decrease absorption.
• Weaning Practices: Transitioning infants to low-protein diets contributes to Kwashiorkor.
• Underlying Health Conditions: Diseases affecting nutrient absorption (e.g., Crohn's) or increasing metabolic demand (e.g., cancer) can be factors. Anorexia nervosa is also a risk.
• Inadequate Nutritional Education: Lack of knowledge about dietary needs is a contributing factor.
• Aflatoxins: Exposure to these mold toxins has been linked to Kwashiorkor.

Treatment and Prevention

Treating severe protein-energy malnutrition requires careful management to prevent refeeding syndrome. The WHO recommends a phased approach:

1. Stabilization: Addressing immediate life-threatening issues like hypoglycemia and dehydration.
2. Nutritional Rehabilitation: Gradual introduction of nutrient-dense feeding under medical supervision.
3. Follow-up: Educating caregivers on nutrition, hygiene, and prevention.

Prevention involves improving food security, public health, and nutritional education. Promoting breastfeeding and balanced diets is crucial.

For more detailed information on treating severe malnutrition, refer to the World Health Organization's guidelines(https://iris.who.int/bitstream/handle/10665/375033/WHO-EURO-2023-8931-48703-72392-eng.pdf?sequence=5).

Conclusion

Kwashiorkor and Marasmus represent severe forms of malnutrition caused by protein and/or calorie deficiencies. Kwashiorkor is characterized by edema, while Marasmus involves severe wasting. Both are critical conditions, especially for children. Treatment requires careful medical and nutritional support. Preventing these diseases necessitates addressing poverty, food insecurity, and promoting nutritional education.

Frequently Asked Questions

What is the primary difference between Kwashiorkor and Marasmus?

The main difference is the presence of edema. Kwashiorkor, primarily caused by protein deficiency, leads to fluid retention and swelling. Marasmus, caused by a general lack of calories and protein, results in severe wasting and emaciation without edema.

What are the common symptoms of Kwashiorkor?

Common symptoms include bilateral pitting edema (swelling of ankles, feet, and face), a bloated belly, dry and brittle hair, dermatitis (skin lesions), an enlarged fatty liver, and stunted growth.

What does a person with Marasmus look like?

A person with Marasmus appears visibly emaciated and shriveled. They have lost significant body fat and muscle, with bones often prominent under the skin and a head that appears large in relation to the rest of the body.

Who is most at risk for developing Kwashiorkor?

Kwashiorkor most commonly affects children, particularly those between the ages of 3 and 5 in regions experiencing food insecurity. It often occurs after a child is weaned from protein-rich breast milk and given a carbohydrate-heavy diet.

Can Kwashiorkor and Marasmus occur at the same time?

Yes, a condition known as Marasmic Kwashiorkor can occur. This is the most severe form of protein-energy malnutrition, exhibiting symptoms of both severe wasting and edema.

How are these protein deficiency diseases treated?

Treatment involves medical supervision, starting with stabilizing life-threatening conditions like dehydration and hypoglycemia. Feeding begins slowly with nutrient-dense formulas to prevent refeeding syndrome, and it progresses to a balanced diet.

What are the long-term effects of Kwashiorkor and Marasmus?

Survivors, especially children, may suffer from lasting effects, including permanent physical and mental disabilities, stunted growth, and a higher risk of liver disease. Early and proper intervention leads to better outcomes.