What type of malnutrition is kwashiorkor quizlet?

October 25, 2025 •

3 min read

Globally, undernutrition accounts for nearly half of all deaths in children under five years old. Kwashiorkor, a serious form of severe acute malnutrition (SAM), primarily results from a severe protein deficiency, often while the child consumes enough calories.

Quick Summary

Kwashiorkor is a type of severe protein-energy malnutrition caused primarily by a severe protein deficiency, often in the presence of adequate or near-adequate calorie intake. It is clinically distinguished by the presence of edema and other severe metabolic disturbances.

Key Points

Protein-Energy Malnutrition: Kwashiorkor is a type of severe acute malnutrition (SAM) that falls under the umbrella of protein-energy malnutrition (PEM).
Protein Deficiency: The defining nutritional cause of kwashiorkor is a severe deficiency of protein, often in individuals whose diets contain sufficient calories from carbohydrates.
Edema is a Key Sign: The presence of bilateral pitting edema, or fluid-induced swelling, is the most crucial clinical feature distinguishing kwashiorkor from other forms of malnutrition.
Distinction from Marasmus: Unlike kwashiorkor's protein deficiency, marasmus is characterized by a severe deficiency of all macronutrients (protein, carbohydrates, and fats), leading to severe wasting and emaciation without edema.
Multifactorial Causes: While protein deficiency is key, the etiology of kwashiorkor is complex and can involve other factors like antioxidant deficiencies, gut microbiome alterations, and infections.
Associated Symptoms: Beyond edema, common signs of kwashiorkor include skin lesions, hair discoloration (flag sign), an enlarged fatty liver, and a compromised immune system.
Gradual Treatment: Management of kwashiorkor requires careful and gradual nutritional rehabilitation to prevent complications like refeeding syndrome.
Risk of Long-Term Effects: If left untreated, kwashiorkor can be fatal and may lead to lasting developmental and physical deficits, especially in young children.

Understanding Severe Acute Malnutrition (SAM)

Severe acute malnutrition (SAM) represents a major global health challenge, especially for young children in areas with limited resources. Kwashiorkor is a specific manifestation of SAM, often contrasted with marasmus, another significant form. Though both are critical conditions, they result from different primary deficiencies and display distinct clinical signs.

Kwashiorkor: Protein Deficiency Predominant

Kwashiorkor is known as edematous malnutrition due to its characteristic fluid retention or swelling (edema). It typically affects children between one and four years old, commonly after they transition from breast milk to diets high in carbohydrates but critically low in protein. The name "kwashiorkor" originates from the Ga language and means "the sickness the baby gets when the new baby comes," reflecting its frequent onset after a younger sibling arrives and displaces the older child from breastfeeding.

The symptoms of kwashiorkor are linked to several factors:

Hypoalbuminemia: A severe lack of protein, particularly albumin, in the blood disrupts osmotic balance, causing fluid to leak into tissues and result in swelling in the ankles, feet, and abdomen.
Oxidative Stress: Reduced antioxidant levels in children with kwashiorkor may contribute to cellular damage.
Multi-Organ Dysfunction: The condition can impact multiple organ systems, including suppressing the immune system and causing fatty liver disease.
Microbiome Alterations: Changes in the gut microbiome are increasingly recognized as contributing to the development of kwashiorkor.

Marasmus: Energy and Protein Deficiency

In contrast, marasmus is a non-edematous form of SAM stemming from a severe deficiency in all macronutrients—protein, carbohydrates, and fats. The hallmark of marasmus is severe wasting (low weight-for-height) as the body catabolizes its own tissues for energy, leading to an emaciated appearance.

The Overlap: Marasmic Kwashiorkor

Some children present with features of both conditions, a state termed marasmic kwashiorkor. This combined form is often considered the most severe manifestation of malnutrition, exhibiting both significant wasting and edema.

Comparison of Kwashiorkor and Marasmus


Feature	Kwashiorkor	Marasmus
Primary Deficiency	Severe protein deficiency (often with adequate calories)	Severe deficiency of protein, carbohydrates, and fats
Key Clinical Sign	Bilateral pitting edema (swelling)	Severe wasting (emaciation) and weight loss
Body Fat	Subcutaneous fat is often preserved initially	Almost completely absent, leading to a wrinkled skin appearance
Hair Changes	Can be sparse, brittle, and discolored (flag sign)	Sparse and brittle, but usually not discolored
Fatty Liver	Enlarged and fatty liver is a common feature	No fatty liver is typically seen
Appetite	Poor or absent appetite (anorexia)	Hungry and food-seeking behavior is common
Age of Onset	Typically older toddlers (1–4 years), especially post-weaning	Younger infants, often due to inadequate milk supply

Treating Kwashiorkor and Marasmus

Treatment protocols for both severe malnutrition types adhere to international standards, such as those from the World Health Organization. A cautious, staged approach is vital to prevent refeeding syndrome, a potentially life-threatening complication. Treatment phases include:

Stabilization: Initial focus on correcting immediate dangers like low blood sugar, low body temperature, dehydration, and electrolyte imbalances. Antibiotics are often used due to weakened immunity.
Nutritional Rehabilitation: Once stable, feeding is introduced gradually with specialized therapeutic formulas to support growth.
Psychosocial Support: Providing emotional care and stimulation is important, particularly for apathetic children.
Follow-up: Sustained recovery requires ongoing education and reliable access to nutritious food.

Conclusion

Kwashiorkor is a distinct form of protein-energy malnutrition primarily characterized by protein deficiency and its resulting edema. While different from marasmus, which involves a deficiency of all macronutrients and causes wasting, both are critical medical emergencies. Timely and appropriate treatment offers the possibility of full recovery, although delayed intervention can lead to long-term growth and developmental issues. Combating global malnutrition necessitates addressing poverty, enhancing nutritional education, and ensuring consistent access to balanced diets. For more information on the global fight against malnutrition and efforts by international organizations, consult the World Health Organization website.

Frequently Asked Questions

Yes, kwashiorkor is a primary example of severe protein malnutrition, specifically a form of edematous protein-energy malnutrition.

The main clinical difference is the presence of edema in kwashiorkor, caused by severe protein deficiency, versus the severe wasting and emaciation seen in marasmus, which is caused by a deficiency of both protein and calories.

The most defining sign is swelling (edema) in the ankles, feet, and abdomen. Other symptoms include an enlarged fatty liver, skin changes, hair discoloration, and a suppressed immune system.

The swelling, or edema, is a result of hypoalbuminemia, where low levels of protein (albumin) in the blood cause an imbalance of osmotic pressure, forcing fluid to leak into the body's tissues.

While it most commonly affects children, kwashiorkor can occur in adults, though it is rare. In developed countries, cases might be linked to underlying health conditions, fad diets, or neglect.

Treatment involves carefully reintroducing a diet with sufficient calories and protein, often starting with therapeutic formulas, and correcting fluid, electrolyte, and micronutrient deficiencies under medical supervision.

Prevention focuses on improving access to nutritious, protein-rich foods, promoting good public health practices, and educating families on proper nutrition, especially for young children.