Professional Documents
Culture Documents
Protein-Calories, Malnutrition & Nutritional Deficiencies
Protein-Calories, Malnutrition & Nutritional Deficiencies
[PROTEIN-CALORIES, MALNUTRITION
& NUTRITIONAL DEFICIENCIES]
By: ASUBARIO, Olufunmilola Omonike; BALADAD, Alvin Bryan; DE JESUS, Chrislou; GURUNG, Man
Bahadur; KALANGEG, Kristie; MAHALEE, Naphitcharak; MONTHATHONG, Thanapol; PANLASIGUI,
Rikkimae Maria; SAMSON, Chino Paolo; SOLONIO, Natalie|Keith; VALDEZ, Gregorio
Physiology Laboratory Small Group Discussion Output Protein-Calories, Malnutrition & 1
Nutritional deficiency
PROTEIN-CALORIES, MALNUTRITION & NUTRITIONAL DEFICIENCIES
The term marasmus is derived from the Greek word marasmos, which means
withering or wasting. Marasmus involves inadequate intake of protein and calories and
is characterized by emaciation.
The term kwashiorkor is taken from the Ga language of Ghana and means "the
sickness of the weaning." Williams first used the term in 1933, and it refers to an
inadequate protein intake with reasonable caloric (energy) intake. Edema is
characteristic of kwashiorkor but is absent in marasmus.
In 2007, Lin et al stated that "a prospective assessment of food and nutrient
intake in a population of Malawian children at risk for kwashiorkor" found "no
association between the development of kwashiorkor and the consumption of any food
or nutrient."
In 2012, a report from Texas noted an 18-month-old infant with type 1 glutaric
acidemia who had extensive desquamative plaques, generalized non-pitting edema,
and red-tinged sparse hair, with low levels of zinc, alkaline phosphatase, albumin, and
iron. This patient has a variation on kwashiorkor, and the authors suggest that it be
termed acrodermatitis dysmetabolica. On the same note, a boy aged 18 months with
type 1 glutaric academia suffered from zinc deficiency and acquired protein energy
malnutrition.For complex reasons, sickle cell anemia can predispose suffers to protein
malnutrition.Protein energy malnutrition ramps up arginase activity in macrophages and
monocytes
Anemia
Diarrhea
Electrolyte imbalances
Kwashiorkor causes:
Hair discoloration
For the hospitalized patient, kwashiorkor may occur in patients who suffer from:
Life-threatening illness
Sepsis
Severe burns
Trauma
Behavioral retardation
Diarrhea
Loss of appetite
Physiology Laboratory Small Group Discussion Output | Protein-Calories, Malnutrition & 4
Nutritional deficiency
Low body temperature (hypothermia)
Mental retardation
Marasmus causes:
Stunted growth
Weight loss
Diagnosis
A thorough physical examination and a health history that probes eating habits
and weight hanges, focuses on bodyfat composition and muscle strength, and assesses
gastrointestinalsymptoms, underlying illness, and nutritional status is often as accurate
as blood tests andurinalyses used to detect and document abnormalities.
Treatment
Treatment is designed to provide adequate nutrition, restore normal body comp
osition, and curethe condition that caused the deficiency. Tube feeding or intravenous fe
eding is used to supplynutrients to patients who can't or won't eat protein-rich foods.
In patients with severe PEM, the first stage of treatment consists of correcting flui
d andelectrolyte imbalances, treating infection with antibiotics that don't affect protein s
ynthesis, andaddressing related medical problems. The second phase involves replenis
hing essential nutrientsslowly to prevent taxing the patient's weakened system with mor
e food than it can handle.Physical therapy may be beneficial to patients whose muscles
have deteriorated significantly.
NUTRITIONAL DEFICIENCIES
1. Nutritional deficiencies, known as malnutrition, are the result of your body not
getting enough of the nutrients it needs.
2. Children are more at risk for serious complications due to nutritional deficiencies
than adults.
The body requires many different vitamins and minerals that are crucial for both
development and preventing disease. These vitamins and minerals are often referred to
as micronutrients. They aren’t produced naturally in the body, so you have to get them
from your diet. A nutritional deficiency occurs when the body doesn’t absorb the
necessary amount of a nutrient. Deficiencies can lead to a variety of health problems.
These can include problems of digestion, skin problems, stunted or defective bone
growth, and even dementia.
The amount of each nutrient you should consume depends on your age. In the United
States, many foods that you buy in the grocery store (such as cereals, bread, and milk)
are fortified with nutrients that are necessary to prevent nutritional deficiency. But
sometimes your body is unable to absorb certain nutrients even if you are consuming
them.
IRON DEFICIENCY
The most widespread nutritional deficiency worldwide is iron deficiency. Iron
deficiency can lead to anemia, a blood disorder that causes fatigue, weakness, and a
variety of other symptoms.
Iron is found in foods such as dark leafy greens, red meat, and egg yolks. It helps
your body make red blood cells. When you’re iron deficient, your body produces fewer
red blood cells. The red blood cells it produces are smaller and paler than healthy blood
cells. They’re also less efficient at delivering oxygen to your tissues and organs.
For newborn babies, the best source of vitamin A is breast milk. For everyone
else, it’s important to eat plenty of foods that are high in vitamin A. These include:
milk
eggs
green vegetables, such as kale, broccoli, and spinach
orange vegetables like carrots, sweet potatoes, and pumpkin
reddish yellow fruits, like apricots, papaya, and peaches
DRY BERIBERI
WET BERIBERI
Wet beriberi is the term used for thiamine deficiency with cardiovascular
involvement. The chronic form of wet beriberi consists of 3 stages. In the first stage,
peripheral vasodilation occurs, leading to a high cardiac output state. This leads to salt
and water retention mediated through the renin-angiotensin-aldosterone system in the
kidneys. As the vasodilation progresses, the kidneys detect a relative loss of volume
and respond by conserving salt. With the salt retention, fluid is also absorbed into the
circulatory system. The resulting fluid overload leads to edema of the dependent
extremities.
By the time significant edema occurs, the heart has been exposed to a severely
high workload in order to pump the required cardiac output needed to satisfy end organ
requirements. Parts of the heart muscle undergo overuse injury, which results in the
physical symptoms of tachycardia, edema, and high arterial and venous pressures.
These changes can lead to myocardial injury, expressed as chest pain.
Folate is especially important for fetal development. It plays a crucial role in the
formation of a developing child’s brain and spinal cord. Folate deficiency can lead to
severe birth defects, growth problems, or anemia.
VITAMIN D DEFICIENCY
According to the Vitamin D Council, about 40 percent of the population worldwide
is affected by vitamin D deficiency. Dark skinned individuals are at a higher risk of
vitamin D deficiency.
Vitamin D is essential for healthy bones. It helps the body maintain the right
levels of calcium in order to regulate the development of teeth and bones. A lack of this
Physiology Laboratory Small Group Discussion Output | Protein-Calories, Malnutrition & 10
Nutritional deficiency
nutrient can lead to stunted or defective bone growth. Osteoporosis, caused by a lack of
calcium and vitamin D, can lead to porous and fragile bones that break very easily.
Vitamin D is found naturally in only a few foods. Foods with vitamin D include:
CALCIUM DEFICIENCY
Calcium helps your body develop strong bones and teeth. It also helps your
heart, nerves, and muscles work they way they should. A calcium deficiency often
doesn’t show symptoms right away, but it can lead to serious health problems over time.
If you aren’t consuming enough calcium, your body will use the calcium from your bones
instead, leading to bone loss. Calcium deficiencies are related to low bone mass,
weakening of bones due to osteoporosis, convulsions, and abnormal heart rhythms.
They can even be life-threatening. Postmenopausal women experience greater bone
loss due to changing hormones and have more trouble absorbing calcium.
The best sources of calcium are dairy products such as milk, yogurt, cheese,
calcium-set tofu, and small fish with bones. Vegetables like kale and broccoli also have
calcium, and many cereals and grains are calcium-fortified.
The usual cause of nutritional deficiencies is a poor diet that lacks essential
nutrients. The body stores nutrients, so a deficiency is usually caught after it’s been
without the nutrient for some time.
Your doctor will discuss your diet and eating habits with you if they suspect
you have a nutritional deficiency. They will ask what symptoms you’re
experiencing. Make sure to mention if you have suffered from any periods of
constipation or diarrhea, or if blood has been present in your stool.
Your nutritional deficiency may also be diagnosed during routine blood tests,
including a complete blood count (CBC). This is often how doctors identify anemia.
Treatments
The treatment for a nutritional deficiency depends on the type and the severity of
the deficiency. Your doctor will find out how severe the deficiency is, as well as the
likelihood of long-term problems caused by the lack of nutrients. They may order further
testing to see if there is any other damage before deciding on a treatment plan.
Symptoms usually fade when the correct diet is followed or supplemented.
Dietary Changes
A doctor may advise you on how to change your eating habits in the case of a
minor deficiency. For example, anemia sufferers should include more meat, eggs,
poultry, vegetables, and cereals.
Your doctor may refer you to a dietitian if your deficiency is more severe. They
may recommend keeping a food diary for a few weeks. When you meet with the
dietitian, you’ll go over the diary and identify changes you should make.
Typically, you will meet with the dietitian regularly. Eventually, you may have a
blood test to confirm that you’re no longer deficient.
Supplements
The federal government’s Dietary Guidelines for Americans recommends that
you get most of your nutrients from food. In some cases, you may need to take
supplements or a multivitamin. It may also be necessary to take an additional
supplement to help your body absorb the supplements, such as taking calcium and
Physiology Laboratory Small Group Discussion Output | Protein-Calories, Malnutrition & 13
Nutritional deficiency
vitamin D together. The frequency and dosage of a supplement will depend on how
severe the deficiency is. This will be decided by your doctor or a dietitian.
Parenteral Administration
In very severe cases, such as when a nutritional deficiency doesn’t respond to
oral medications, it may be necessary for the nutrient to be given parenterally (through
the veins or muscles). This can carry the risk of additional side effects. It’s usually done
in a hospital.
chills
backache
dizziness
fever
muscle pain
fainting
In rare cases, it can even cause a severe allergic reaction. Once you have been
given the treatment, your doctor will have you do a repeat blood test to confirm
that it was successful. You may need to attend the hospital for repeat
appointments until you’re no longer deficient.
References:
1. Guyton, AC; Hall, JE: Textbook of Medical Physiology, 11 th edition. Elsevier Inc. 2006.
3. en.wikipedia.org
4. http://www.healthline.com/health/malnutrition#LongTerm7
5.http://bestpractice.bmj.com/best-practice/monograph/641/basics/pathophysiology.html
6. http://emedicine.medscape.com/