protein-energy malnutrition

Protein-energy malnutrition (PEM) is a condition characterized by a deficiency in dietary protein and energy, leading to severe health issues. It can manifest in various forms, depending on the balance of nonprotein and protein sources of energy.

Types of PEM:

• Primary PEM: This type occurs due to inadequate food intake, often found in children and rarely in elders.
• Secondary PEM: This type is caused by illnesses affecting appetite, digestion, absorption, metabolism, and/or increased energy/protein demand (Source: [8]).

Forms of PEM:

• Marasmus: A severe deficiency of calories and protein that tends to develop in infants and very young children, causing weight loss and depletion of fat and muscle (Source: [11]).
• Kwashiorkor: A type of malnutrition characterized by severe protein deficiency, causing fluid retention and a swollen, distended abdomen (Source: [7]).

Symptoms of PEM:

• Weight loss or poor weight gain
• Slowing of linear growth
• Fatigue
• Apathy at rest
• Muscle wasting and weakness (Source: [5])
• Edema (swelling) in the case of kwashiorkor

Prevalence of PEM:

• Up to half of all patients admitted to the hospital have malnutrition to some degree, with a prevalence of acute and chronic protein-energy malnutrition being more than 50% in children's hospitals (Source: [2]).

Protein-energy malnutrition is a significant public health concern, particularly in vulnerable populations such as children and the elderly. It can lead to severe health issues, including muscle wasting, weakness, and even death if left untreated.

Protein-energy malnutrition (PEM) is a condition characterized by a deficiency of macronutrients, including proteins, carbohydrates, and fats. The signs and symptoms of PEM can vary depending on the severity and duration of the condition.

Physical Signs:

• Weight Loss: Unintentional weight loss is a common symptom of PEM [5].
• Muscle Wasting: Muscles shrink and bones protrude due to lack of protein and energy [4].
• Skin Changes: The skin becomes thin, dry, inelastic, pale, and cold [4].
• Hair Loss: Hair falls out easily and becomes sparse due to protein deficiency [7].

Behavioral and Psychological Signs:

• Apathy and Irritability: People with PEM may become weak and inefficient, leading to apathy and irritability [6].
• Fatigue and Weakness: Fatigue and weakness are common symptoms of PEM [8].

Other Signs:

• Edema: Fluid retention in the tissues can occur due to severe protein deficiency [3].
• Poor Growth: In children, PEM can lead to poor growth and development [14].
• Increased Hunger: People with PEM may experience increased hunger due to lack of energy and nutrients [7].

It's essential to note that these signs and symptoms can vary in severity and may not be immediately apparent. If you suspect someone has protein-energy malnutrition, it's crucial to seek medical attention for proper diagnosis and treatment.

References:

[3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8

Protein-energy malnutrition (PEM) can be diagnosed through various diagnostic tests and physical examinations.

Laboratory Tests

Several laboratory tests are used to assess protein nutritional status, including:

• Serum albumin levels [2][4]
• Prealbumin (PAB) levels [2][6]
• Transferrin levels [4]
• Creatinine levels [4]
• Blood urea nitrogen (BUN) levels [4]

These tests can help identify individuals with protein-energy malnutrition, but they are not specific to PEM and may be influenced by other factors.

Physical Examination

A physical examination is also an essential tool in diagnosing PEM. Healthcare providers may look for signs such as:

• Weight loss [7]
• Muscle wasting
• Edema (swelling)
• Hair loss
• Poor wound healing

In children, healthcare providers may observe signs of kwashiorkor, a severe form of PEM, including:

• Muscle wasting
• Edema
• Hair loss
• Poor appetite
• Fatigue

Screening Tools

Several screening tools are available to assess the risk of protein-energy malnutrition. These tools typically ask questions about recent weight loss, food intake, body mass index (BMI), and disease severity [8].

Diagnostic Criteria

The diagnosis of malnutrition should be based on either a low BMI (<18.5 kg/m^2) or on the combined finding of weight loss together with either reduced BMI or muscle wasting [9].

It's worth noting that there are no specific laboratory tests or indices that are satisfactory for the assessment of protein-energy malnutrition [5]. A comprehensive approach, including physical examination and laboratory tests, is essential for accurate diagnosis.

References:

[1] Mar 11, 2019 — Complete blood cell (CBC) count · Electrolyte levels (potassium, calcium, phosphate, magnesium) · Blood urea nitrogen · Serum albumin and ... [2] by U Keller · 2019 · Cited by 641 — Serum visceral proteins such as albumin and prealbumin have traditionally been used as markers of the nutritional status of patients. [3] Physical examination may include measurement of height and weight, inspection of body fat distribution, and anthropometric measurements of lean body mass. [4] Jul 5, 2022 — Measures of protein nutritional status include serum albumin, retinol-binding protein, prealbumin, transferrin, creatinine, and BUN levels. [5] Sep 20, 2017 — There are no specific laboratory tests, group of tests, or indices that are satisfactory for the assessment of protein energy malnutrition. [6] by S Bharadwaj · 2016 · Cited by 616 — Historically, serum proteins such as albumin and prealbumin (PAB) have been widely used by physicians to determine patient nutritional status. [7] Healthcare providers can often diagnose kwashiorkor by physically examining the child and observing its telltale physical signs. They will ask about the child's ... [8] Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index and disease severity. [9] by T Cederholm · 2015 · Cited by 2306 — The diagnosis of malnutrition should be based on either a low BMI (<18.5 kg/m^2), or on the combined finding of weight loss together with either reduced BMI ( ...

Protein-energy malnutrition (PEM) can be treated with various medications, depending on the underlying cause and severity of the condition.

Appetite Stimulants: Appetite stimulants such as megestrol acetate [5] and dronabinol [6] may be used to increase appetite and improve nutritional intake in patients with PEM. These medications can help stimulate hunger and improve food intake, which is essential for recovery from malnutrition.

Anti-inflammatory Interventions: Anti-inflammatory interventions such as corticosteroids [7] may be used to reduce inflammation and improve nutritional status in patients with PEM. Corticosteroids can help decrease inflammation and promote healing, which can improve overall health and nutritional status.

Anabolic Agents: Anabolic agents such as oxandrolone [8] may be used to promote muscle growth and improve nutritional status in patients with PEM. These medications can help stimulate muscle growth and improve overall health, which is essential for recovery from malnutrition.

It's worth noting that the use of these medications should be individualized and based on the specific needs and circumstances of each patient. Additionally, dietary changes and supplements are also an essential part of treating protein-energy malnutrition [9].

References: [5] by TA Ikizler · 2013 · Cited by 842 — Appetite stimulants, anti-inflammatory interventions, and newer anabolic agents are emerging as novel therapies. [6] by I Trehan · 2013 · Cited by 445 — Adding routine antibiotic agents to nutritional therapy may increase recovery rates and decrease mortality among children with severe acute malnutrition. [7] Potas- sium supplements can be started once the patient is receiving oral feeds. The solution should be given in divided doses with the feeds. Iron and folic ... [8] by SL Mathewson · 2021 · Cited by 49 — This review overviews determinants and treatments of protein-energy malnutrition. [9] Find out about treatments for malnutrition, including dietary changes and supplements, feeding tubes, and care and support services.