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Childhood is the most vulnerable phase in terms of contracting illnesses. Apart from the obvious lack of sense as to what to keep away from and the often disastrous outcome of such acts resulting in injuries and worse, children are often afflicted by a number of illnesses and conditions stemming from their lack of immunity, genetics and environmental factors. Children growing up in the midst of environmental pollution or without getting proper nutrition due to various factors affect them adversely. Protein energy malnutrition, also called PEM disease, is one such disease or condition.
Definition of Protein Energy Malnutrition
Protein energy malnutrition, also referred to as PEM protein energy malnutrition or protein energy deficiency diseases, is a condition caused by insufficient protein, energy and micronutrient intake in the diet, which is not enough to meet the metabolic needs of the child.
PEM protein energy malnutrition is one of the most lethal forms of malnutrition. It strikes children and is known as “the silent emergency”, having at least some part in around half of the 10.4 million deaths of children every year.
What’s the Statistics Say!
As per the World Health Organisation (WHO), the protein energy malnutrition disease affects 25 per cent of children across the world. One hundred fifty million children, 26.7 per cent of all children, are underweight, and 182 million children, 32.5 per cent of the entire child population in the world, suffer from stunted growth.
According to the World Health Organisation, more than 70 per cent of children suffering from PEM malnutrition live in Asia. Protein and energy malnutrition (PEM) is a major problem in India's public health. 42.5 per cent of children in India are underweight, the highest in the world. Forty-eight per cent of all children under the age of 5 years in India are suffering from stunted growth.
So we can see a direct correlation between the incidence of protein energy malnutrition disease and the areas in the world where there is a lack of food security, widespread poverty, limited access to nutritious food and the healthcare services are inadequate. Such areas are vulnerable to the widespread occurrence of PEM disease especially among the population groups like children, pregnant women and the elderly.
Causes of Protein Energy Malnutrition or PEM Malnutrition
The aetiology of protein malnutrition or the main causes for PEM protein and energy malnutrition are as follows:
1. Inadequate Dietary Intake: Protein and energy malnutrition is primarily triggered by the poor quality of the diet available, which is lack in essential proteins, nutrients and calories required by the person.
2. Underlying Health Conditions: PEM protein and energy malnutrition are also brought about by the underlying health conditions of the person. Chronic illnesses and diseases, infections, disorders of the digestive system and certain conditions in the metabolism of a person that cause impairment in the absorption of nutrients from food all compound the situation. This is as per the protein malnutrition definition.
3. Poverty and Food Insecurity: Poverty and food insecurity, are factors that define protein energy malnutrition. Poor economic conditions and economic constraints lead to the lack of food overall and nutritious food in particular.
4. Environmental Factors: Environmental factors such as natural disasters, conflicts between nations and large-scale displacement from homes result in limited access to food supplies.
5. Lack of Awareness and Education: Lack of education leads to people not possessing proper knowledge of nutrition and not following healthy practices as far as their diets are concerned.
Types of Protein Energy Malnutrition
Protein-energy malnutrition types may be enumerated in the following:
1. Marasmus: Marasmus is one type of protein energy deficiency diseases which is caused by severe and acute malnutrition. A person suffering from this has overall deficiencies in calories which results in muscle wasting, severe loss of weight and stunted growth.
2. Kwashiorkor: Kwashiorkor is another type of protein energy malnutrition where in spite of adequate intake of calories, due to deficiency of protein intake, you may suffer from oedema, swelling caused by too much fluid getting trapped in the tissues of the body, dysfunctions of the liver, skin lesions and impairment in the immunity functioning of the body.
>> Also Read: Best Sources of Protein: Get Your Daily Dose with These Healthy Foods
Protein Energy Malnutrition Symptoms
PEM disease symptoms vary as per the degree and type of malnutrition you are suffering from. Generally, the symptoms include the following:
1. Poor Growth: Poor growth, especially in children, is one of the major symptoms of protein energy malnutrition. Children may exhibit stunted growth in height and lack of gain in weight.
2. Muscle Wasting: Protein energy malnutrition may result in loss of muscle mass as the muscle tissues get destroyed or wasted. This will result in weakness.
3. Oedema: PEM disease may cause oedema and swelling of body tissues as they retain extra fluids.
4. Fatigue and Weakness: PEM leads to a marked loss of energy and stamina in the person suffering from the same.
5. Skin and Hair Damages: PEM may result in your hair becoming dry and brittle and breaking or falling off easily. You may also suffer from rashes on your skin.
6. Impaired Immune Function: PEM disease leads to your immunity system getting impaired and as a result, you become more susceptible to various infections.
7. Cognitive Impairment: Protein-energy malnutrition may lead to impairment in the cognitive abilities of children. Children affected by PEM may have difficulty in cognitive development and learning.
Diagnosis and Treatment of Protein Energy Malnutrition
Protein-energy malnutrition is diagnosed by thorough examinations which include a physical examination, an understanding of the medical history of the patient, laboratory diagnostic tests and nutritional assessments.
Strategies to treat PEM disease include the following
1. Nutritional Rehabilitation: This involves reintroducing nutrient-rich foods in a gradual and planned manner to restore the energy and protein balance in the person suffering from PEM.
2. Medical Management: PEM is often caused by underlying medical conditions affecting the health of the patient. Medical treatment aims to treat the conditions which are causing the malnutrition.
3. Supplementary Feeding: Patients are given supplements which are high in proteins and other therapeutic foods to help the recovery process.
4. Monitoring and Support: The patient needs to visit the doctor treating the protein energy deficiency disease regularly. Such follow-up visits will allow the doctor to monitor the progress made and to provide the patient with appropriate and timely counselling on the course of nutrition to follow and the overall health condition.
Prevention of Protein Energy Malnutrition Disease
Preventing protein energy malnutrition requires a holistic approach in order to address both the underlying and immediate causes. Such a comprehensive approach will require intervention and participation by the government and policymakers. Some strategies to be adopted to prevent the incidence of protein-energy malnutrition are:
1. Promoting Nutritious Diets: People need to be encouraged to partake and be provided with a diet that includes meals that have a proper balance of proteins, vitamins and minerals.
2. Improving Food Security: More and more people need to be provided access to diverse and wholesome food which must be affordable at the same time.
3. Health Education: The population overall needs to be made aware of concepts and details of proper nutrition. Knowledge needs to be spread about ideal practices to feed children including about breastfeeding.
4. Public Health Intervention: The government needs to implement programmes to improve facilities of sanitation and healthcare. Poverty needs to be addressed.
Impact of Protein Energy Malnutrition
Protein-energy malnutrition may have a very longstanding impact on health, overall well-being and on development of society and a country. The impact includes:
1. Growth Stunting: PEM disease may result in impaired physical and mental growth in children, negatively affecting their cognitive abilities and development.
2. Increase in Mortality Risk: People affected by protein-energy malnutrition often damage their immunity and are more susceptible to diseases, infections and complications which may lead to a higher incidence of death among such patients.
3. Long-term Health Effects: People suffering from protein-energy malnutrition may suffer from chronic conditions health-wise. Along with impairment to their immunity, they are also susceptible to cardiovascular diseases and diabetes.
4. Socioeconomic Burden: People suffering from protein energy malnutrition are not able to have their productivity at a level at par with others who are medically fit. Such people also fall ill more frequently and thereby incur higher medical and health-care costs. Once a person suffers from protein-energy malnutrition, it may set off an intergenerational cycle of malnutrition in his family and among his descendants.
In Conclusion
Protein-energy malnutrition (PEM) is a critical challenge to health care across the globe. It has far-reaching implications at every level, be it the individual, community, society or country level. It is essential to address the combination of complex factors responsible for the incidence of malnutrition. A concerted effort is required from all stakeholders, individuals, communities, society, governments and policy makers to be able to offer access to nutritious food, and proper health-care services and to raise awareness in this regard.
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