K.C.

Ho

Hw 20 pg 205 # 10

10. What are the health consequences of ingesting inadequate protein and energy? Describe
marasmus and kwashiorkor. How can the two conditions be distinguished, and in what ways do
they overlap? (197-99)

The consequence of deprivation of protein, energy, or both is protein-energy malnutrition

(PEM). PEM strikes mostly children with poor growth, and leads to weight loss and wasting in
adults. Acute PEM is recent severe food deprivation and children are thin for their height.
Chronic PEM is long-term food deprivation and children are short for their age. Undeveloped
and poor countries, homeless, substandard housing residents, rural residents, those with drug and
alcohol addiction, and anorexic or bulimic patients are frequent victims of PEM. The two forms
of PEM are marasmus and kwashiorkor. Marasmus is chronic PEM for mostly infants 6-
18months old. Extreme waste and weaken of muscle and fat. Brain development and learning
ability are impaired. Less hormones made slows metabolism, lowers body temperature because
of little to NO fat for insulation. Mental and behavioral development delayed, need warmth and
love. Growth ceases, very little enzymes, GI tract lining deteriorate, so they can’t digest and
absorb food.

Kwashiorkor is acute PEM; first child suddenly loses protein-rich breast milk to starchy cereal
when second child comes. Sets in around 18 months to 2 year old. Less severe loss of weight and
fat, some muscle wasting. Lack of Proteins and hormones to maintain fluid balance, so fluids
leak to tummy and swell limbs with edema. Lack of proteins to carry fat out of liver causes belly
to bulge with fat liver. Liver doesn’t make enough proteins to carry toxins out of body lead to
inflammation and infections. Not enough tyrosine to make melanin so child’s hair loses color,
skin is patchy and scaly, unhealing sores. Irons run free with no protein carriers, thus promoting
bacterial growth and free radicals.

Their overlap is edema of kwashiorkor and wasting of marasmus. That is when the child suffers
from both malnutrition and infections. A child with marasmus can later develop kwashiorkor,
because marasmus can be body’s adaptation to starving and kwashiorkor can develop when that
adaptation fails.