2.28 Protein-Energy Malnutrition

Protein deficiency rarely occurs alone. Instead it is often coupled with insufficient energy intake. As a result, the condition is called protein-energy malnutrition (PEM). This condition is not common in the U.S., but is more prevalent in less developed countries. Kwashiorkor and marasmus are the two forms of protein energy malnutrition. They differ in the severity of energy deficiency as shown in the figure below.

Figure 2.281 The 2 types of protein-energy malnutrition

Kwashiorkor is a Ghanaian word that means “the disease that the first child gets when the new child comes1.” The characteristic symptom of kwashiorkor is a swollen abdomen. Energy intake could be adequate, but protein consumption is too low.

Figure 2.282 A child suffering from kwashiorkor2

The video below does a nice job showing the symptoms of the condition.

Web Link

Video: Kwashiorkor (1:17)

Marasmus means “to waste away” or “dying away”, and thus occurs in individuals who have severely limited energy intakes.

Figure 2.283 Two individuals suffering from marasmus3

The video below shows individuals suffering from this condition.

Web Link

Video: Marasmus (2:24)

References & Links

1. Byrd-Bredbenner C, Moe G, Beshgetoor D, Berning J. (2009) Wardlaw’s perspectives in nutrition. New York, NY: McGraw-Hill.

2. http://en.wikipedia.org/wiki/File:Starved_girl.jpg

3. http://en.wikipedia.org/wiki/File:Starved_child.jpg


Kwashiorkor – http://www.youtube.com/watch?v=eTU3iPWAWXg

Marasmus – https://www.youtube.com/watch?v=LDCi3eda4WM