PROTIEN ENERGY

MALNUTITION
BY VARSHA A
INTRODUCTION
Defined as
impaired growth
primarily due to
inadequate intake
of food both in
macronutrients
and in
micronutrients
• WHO defines it as :

A range of pathological conditions arising from

coincidental lack in varying proportions of proteins
and calories , occurring most frequently in infants
and children and is commonly associated with
infections.
 UNDERNUTRITION
• inadequate consumption
• poor absorption
• excessive loss of nutrients

OVERNUTRITION
• excessive intake of specific nutrients
DETERMINED THROUGH
MEASUREMENT OF
 Age
 Height & Weight
 Skin fold thickness
INDICATORS OF MALNUTRITION

INDICATOR INTERPRETATION

STUNTING LOW CHRONIC

HEIGHT FOR AGE MALNUTRITION

WASTING LOW ACUTE

WEIGHT FOR MALNUTRITION
HEIGHT
UNDERNUTRITION LOW ACUTE AND
WEIGHT FOR AGE CHRONIC
MALNUTRITION
 EPIDEMIOLOGY
• Death - 35% children <5 years
• 21% total global DALYs lost <5 yrs
• Rural areas – 46% Urban population – 33%.
ETIOLOGY
Immediate determinants:
• LBW
• inadequate diet
• infections.
Underlying determinants:
• food health care
Basic determinants :
• Political
• economic
• Socio cultural
• environment
• Mild malnutrition :common between 9
months and 2yr.
• Features
1) Growth failure
2) Infection
3) Anemia
4) Activity diminished
5) Skin and hair changes rarely occur
• Moderate to severe malnutrition:
Is associated with one of classical syndromes like marasmus ,
kwashiorkor or with manifestations of both
 Severe PEM
HYPOALBUMINA
PROTEIN INTAKE ALBUMIN
EMIA
SYNTHESIS

PV
CO

ARTERIAL
GFR BP RBF
PERITUBULAR HS
PRESSURE
FILTRATION RENIN-
TUBULAR ANGIOTENSIN,
REABSORPTN OF NA,H2O ALDOSTERONE

ADH Na,water
retention
EDEMA
THAN
K
YOU