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Protein-Energy Malnutrition (PEM)

Protein-Energy Malnutrition (PEM). Aka…Protein Calorie Malnutrition (PCM). Protein-Energy Malnutrition. PEM most often affects children 500 million children are malnourished Live in poverty Adults may also be affected At greatest risk are: Those living in poverty Elderly living alone

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Protein-Energy Malnutrition (PEM)

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  1. Protein-Energy Malnutrition(PEM) Aka…Protein Calorie Malnutrition (PCM)

  2. Protein-Energy Malnutrition • PEM most often affects children • 500 million children are malnourished • Live in poverty • Adults may also be affected • At greatest risk are: • Those living in poverty • Elderly living alone • Addicts • Those with eating-disorders • Those with long-term illness

  3. Protein-Energy Malnutrition • Most common is Africa, Central America, South America, Middle East, SE/E Asia • Also see in US • Homeless • inner-city • rural poverty

  4. © 2008 Thomson - Wadsworth

  5. World Hunger • Food Shortages • Political turbulence and government policies may contribute to food problems. • Armed conflicts often interfere with humanitarian efforts to get food to people. • Natural disasters contribute to world hunger © 2008 Thomson - Wadsworth

  6. Types of PEM • Protein-Energy Malnutrition (PEM) • also called protein-kcalorie malnutrition (PCM) • Classifying PEM – text version • Maramus – severe protein and calorie deficit • Kwashiorkor – moderate calorie deficit, severe protein deficit, and infection

  7. Kwashiorkor – always edema • Rapid onset, inadequate protein intake often after illness • Older infants and young children, 18 months to 2 years of age • Edema and fatty liver • Apathy, irritability, sadness • Loss of appetite • Infections linger, more common • Some muscle wasting • Growth is 60-80% weight-for-age • Loss of hair and skin pigments • Skin scaly, crackeed © 2008 Thomson - Wadsworth

  8. Marasmus – Chronic PEM • Infancy, 6 to 18 months of age • Diet inadequate to meet needs for calories, protein, essential FA….watery cereal is primary food • Small for their age, < 60% weight-for-age, develop slowly • Severe weight loss and muscle wasting, including the heart • Anxiety and apathy • Cold, no energy • Hair and skin problems as in Kwashiorkor • No edema or fatty liver

  9. Health Effects and Recommended Intakes of Protein • PEM - Infections lead to death in many cases • Lack of antibodies to fight infections • Fever • Fluid imbalances and dysentery - contributes to kwashiorkor developing, weakens immune system even more • Anemia – due to lack of hemoglobin • Heart failure and possible death – due to all of the above • Rehabilitation • Nutrition intervention must be cautious, slowly increasing protein. • Programs involving local people work better.

  10. PEM in Haiti © 2008 Thomson - Wadsworth

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