Kwashiorkor

1. Bianca Galvan Maeve Bisain March 8, 2012 Kwashiorkor

2. Background • Kwashiorkor is a word that originated from Ghana which means “the disease that the first child gets when the new child comes.”

3. Background… • From birth, an infant in developing areas of the world is usually breastfed. Often by the time the child reaches 1 to 1.5 years of age, the mother is pregnant again, and the new child gets the preference for breastfeeding. The older child’s diet then abruptly changes from nutritious human milk to starchy roots and gruels, a thin mixture of grains or legumes in milk or water.

4. Protein-Calorie Malnutrition • In developing areas of the world, people often have diets low in calories and also in protein. This state of under nutrition stunts the growth of children and makes them more susceptible to disease throughout life. • People who consume too little protein calories can eventually develop protein-calorie malnutrition (PCM). When an inadequate intake of nutrients, including protein, is combined with an already existing disease, especially an infection, a form of malnutrition called Kwashiorkor can develop.

5. Causes, incidence, and risk factors • Kwashiorkor is most common in areas where there is: • Famine • Limited food supply • Low levels of education (when people do not understand how to eat a proper diet) • This disease is more common in very poor countries. It often occurs during a drought or other natural disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to malnutrition. • Kwashiorkor is very rare in children in the United States. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people in nursing homes in the United States do not get enough protein in their diet. • When kwashiorkor does occur in the United States, it is usually a sign of child abuse and severe neglect.

6. Protein is found in… • meats, poultry, and fish • legumes (dry beans and peas) • tofu • eggs • nuts and seeds • milk and milk products • grains, some vegetables, and some fruits (provide only small amounts of protein relative to other sources)

7. RDA

8. RDA…

9. Symptoms • Changes in skin pigment • Decreased muscle mass • Diarrhea • Failure to gain weight and grow • Fatigue • Hair changes (change in color or texture) • Increased and more severe infections due to damaged immune system • Irritability • Large belly that sticks out • Lethargy or apathy • Loss of muscle mass • Rash (dermatitis) • Shock (late stage) • Swelling (edema)

10. Treatment • Getting more calories and protein will correct kwashiorkor, if treatment is started early enough. However, children who have had this condition will never reach their full potential for height and growth. • Treatment depends on the severity of the condition. People who are in shock need immediate treatment to restore blood volume and maintain blood pressure. • Calories are given first in the form of carbohydrates, simple sugars, and fats. Proteins are started after other sources of calories have already provided energy. Vitamin and mineral supplements are essential.

11. Treatment… • Since the person will have been without much food for a long period of time, eating can cause problems, especially if the calories are too high at first. Food must be reintroduced slowly. Carbohydrates are given first to supply energy, followed by protein foods. • Many malnourished children will develop intolerance to milk sugar (lactose intolerance). They will need to be given supplements with the enzyme lactase so that they can tolerate milk products. • Getting treatment early generally leads to good results. Treating kwashiorkor in its late stages will improve the child's general health. However, the child may be left with permanent physical and mental problems. If treatment is not given or comes too late, this condition is life-threatening.

12. Day 1 • Breakfast • 1 Omelette w/ cheese and ham = 156 kcals & 11g protein • 1 cup of 2% milk = 122 kcals & 8g protein • Morning snack • 1 cup Fresh orange juice = 112 kcals & 2g protein • 1 Almond granola bar = 117 kcals & 2g protein

13. Day 1… • Lunch • 1 cup Cream of chicken = 220 kcals & 6g protein • 1 cup water • Afternoon Snack • 2 tbs Creamy peanut butter = 188 kcals & 8g protein • ½ Fresh apple = 55 kcals & ½g protein • 4 oz apple juice w/ water = 55 kcals

14. Day 1… • Dinner • 1 Sloppy Joe = 358 kcals & 18g protein • 1 cup of 2% milk = 122 kcals & 8g protein • Total: 1505 kcals & 63.5g protein

15. Day 2 • Breakfast • 1 Omelettew/ sausage =167 kcals & 11g protein • 1 cup of 2% milk = 122 kcals & 8g protein • Morning Snack • 6 pieces of Honey Graham crackers 184 kcals & 4g protein • 1 cup of 2% milk = 122 kcals & 8g protein

16. Day 2… • Lunch • 1 Turkey sandwich w/ whole wheat = 360 kcals & 27g protein. • 1 cup of 2% milk = 122 kcals & 8g protein. • Afternoon Snack • 1 cup Fresh Kiwi =108 kcals & 2g protein • 1 cup water

17. Day 2… • Dinner • 1 corndog = 460 kcals& 17g protein • 1 cup Fresh orange juice = 112 kcals & 2g protein • Total: 1451 kcals & 87 grams protein

18. Day 3 • Breakfast • ½ cup of Cheerios = 55.5 kcals & 2g protein • 1 cup of 2% milk = 122 kcals & 8g protein • Morning Snack • 4 oz apple juice w/ water = 55 kcals • 1 medium banana = 105 kcals & 1g protein

19. Day 3… • Lunch • 1 grilled cheese sandwich w/ whole wheat = 431 kcals & 20g of protein • 1 cup of 2% milk = 122 kcals & 8g protein. • Afternoon Snack • ½ cup Broccoli w/ cheese sauce (cooked) = 115 kcals & 7g protein • 4 oz apple juice w/ water = 55 kcals

20. Day 3… • Dinner • ½ cup White rice long grain = 102.5 kcals & 2g protein • 1.5 oz Chicken breast teriyaki = 59 kcals & 9g protein • 1 cup water • Total: 1222 kcals & 57g protein

21. Questions • What does Kwashiorkor mean? -The disease that the first child gets when the new child comes. • Kwashiorkor affects ______ and _____. -Children and elderly • What is the obvious symptom for Kwashiorkor? -Large belly that sticks out

22. Resources • Board, A.D.A.M. Editorial. "Causes, Incidence, and Risk Factors." Kwashiorkor. U.S. National Library of Medicine, 18 Nov. 0000. Web. 07 Mar. 2012. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002571/>. • "Drugs Information OnlineDrugs and Diseases Reference Index." Kwashiorkor. Causes, Symptoms, Treatment Kwashiorkor. Web. 07 Mar. 2012. <http://drugster.info/ail/pathography/151/>. • Food Composition Table. New York: McGraw-Hill, 2009. Print. • "Protein." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 31 Oct. 2011. Web. 07 Mar. 2012. <http://www.cdc.gov/nutrition/everyone/basics/protein.html>. • "USDA/ARSChildren's Nutrition Research Center at Baylor Collegeof Medicine." Daily Values vs. Nutritional Recommendations for Children. Web. 07 Mar. 2012. <http://www.bcm.edu/cnrc/consumer/archives/percentDV.htm>. • Wardlaw, Gordon M., and Anne M. Smith. Contemporary Nutrition. 7th ed. New York: McGraw-Hill, 2009. Print.