Weight and health
Sally Robinson in Priorities for Health Promotion and Public Health, 2021
Protein-energy malnutrition means that the body is deficient in many nutrients, particularly in protein and energy (calories). Starvation means suffering or death due to lack of food. In these circumstances, the body normally turns to its stored glycogen and body fat to provide energy so that it can function. Once these are depleted, the body breaks down its own muscles and tissues to obtain energy to keep its organs, such as the heart, working. If starvation continues, muscles shrink, weight is lost; body temperature falls; concentration becomes difficult; weakness and fatigue set in; sleep deteriorates; skin becomes dry and may develop downy hair; fertility falls and immunity against infections lowers. Increasingly, chemicals such as sodium, potassium and magnesium become imbalanced and calcium is leeched out of bones, making them fragile. The major organs shrink, become strained and eventually fail, culminating in death.
The Specific Human Health Impacts of Natural Disasters
Emily Ying Yang Chan in Public Health Humanitarian Responses to Natural Disasters, 2017
Disrupted food production/distribution caused by drought can lead to reduced food intake, malnutrition and various nutrient deficiencies. Specifically, people who reduce their food consumption may encounter protein-energy malnutrition and morbidities related to micronutrient deficiencies (such as iron-deficiency anaemia, scurvy due to vitamin C and vitamin A deficiency that increases the risk of developing measles). Undernutrition is a major cause of morbidity and mortality, particularly among children and pregnant women. Inadequate maternal nutrition may result in intrauterine growth retardation, low birth weight or various gestational problems. A study investigating 7,874 adults born between 1954 and 1964 during the famine in China revealed that exposure to famine during the foetal stage was associated with a higher risk of developing metabolic syndrome during adult life. In addition, undernutrition during the developmental stage can cause impairment in physical and cognitive abilities (Li et al., 2011) (see also Knowledge Box 4.6).
Diagnosis
Jennifer Doley, Mary J. Marian in Adult Malnutrition, 2023
In 1981, medical experts from across the world contributed to the creation of a WHO publication titled “The Treatment and Management of Severe Protein-Energy Malnutrition”.9 Its purpose was to provide guidelines for the treatment of severe protein-energy malnutrition in children. In this document, protein-energy malnutrition was classified as marasmus, kwashiorkor, or a mixed form, marasmic kwashiorkor.9 The leading diagnostic signs for marasmus were described as those of starvation: an “old man’s face”, an emaciated body that is “only skin and bones”, accompanied by “irritability and fretfulness”.9 Kwashiorkor was described as edema and apathy, often accompanied by discoloration of the hair and, especially if the edema is severe, by “flaky paint” dermatosis.9 The WHO publication also classified protein-energy malnutrition in children by the presence of edema and the degree of underweight as defined by the National Center for Health Statistics (NCHS) classification “weight for length” reference values.9 This definition became the basis for the diagnosis of malnutrition in children and is listed in the International Classification of Diseases (ICD), also published by the WHO.
In-patient outcomes of patients with diabetic ketoacidosis and concurrent protein energy malnutrition: A national database study from 2016 to 2017
Published in Postgraduate Medicine, 2021
Asim Kichloo, Hafeez Shaka, Zain El-Amir, Farah Wani, Jagmeet Singh, Genaro Romario Velazquez, Ehizogie Edigin, Dushyant Dahiya
Protein-energy malnutrition (PEM) is a nutritional deficiency that is a consequence of inadequate protein or energy, meaning caloric intake [4]. This can result in either kwashiorkor, a disease mainly affecting children characterized by edema and/or ascites and is a consequence of severely restricted protein intake, or marasmus, which is marked by bodily tissue wasting particularly in the subcutaneous fat and muscles, and is a consequence of severely restricted energy intake [4]. Marasmus and kwashiorkor can be present simultaneously resulting in marasmic kwashiorkor, and can mask malnutrition because of an edematous presentation [4]. Protein wasting, also referred to as protein-energy wasting, can occur in patients with DM, specifically if they have end-stage renal disease or are on maintenance dialysis [5]. Although literature describes the concurrence of PEM in patients with DM, there is a paucity of objective clinical data on the differences in clinical outcomes in patients hospitalized with DKA with and without PEM.
Dietary intake of HIV-seropositive clients attending Longisa County Hospital Comprehensive Care Clinic, Bomet County, Kenya
Published in South African Journal of Clinical Nutrition, 2020
Kenneth Kipngeno Tonui, Eunice Njogu, Agatha Christine Onyango
According to the WHO,1 HIV-seropositive adults require approximately 50% to 100% more proteins than non-HIV-infected adults. Irregular consumption of legumes, meats, eggs and fish by the HIV-seropositive respondents in the current study meant that the protein needs were rarely met. As such, the respondents were more predisposed to protein energy malnutrition. The most frequently consumed source of protein was milk. While it is true that milk is a high biological value protein (animal-based protein), there is always the need to complement plant and animal proteins to enhance the nutritional status of an individual. The most probable reason for reduced consumption of proteins by the respondents is the reduced production of such foods in the study area. The commonly consumed staple food crop in the study location (Bomet County) is maize,8 which is milled into flour and consumed as porridge. In addition, beans are grown in this area. On another note, irregular consumption of certain protein types such as fish by the respondents is a result of cultural norms, whereby fish is not considered as a food by the Kalenjin and Maasai cultures whose members are the major residents in the areas surrounding the study setting.9,10
Relationship Between Appetite-Related Peptides and Frailty in Older Adults
Published in Endocrine Research, 2023
Burcu Candemir, İbrahim İleri, Mehmet Muhittin Yalçın, Aydın Tuncer Sel, Berna Göker, Özlem Gülbahar, İlhan Yetkin
Preserving body composition and weight depends on the relationship between anabolic and catabolic mechanisms. The balance between the orexigenic and anorexigenic hormones has been suggested to be essential to maintain this relationship and to avoid frailty.5 However, in general, a decrease in energy intake is higher than a decrease in energy expenditure, hence leading to weight loss in many older adults. Over time, this leads to protein-energy malnutrition, sarcopenia, and weakness.6 Some studies have suggested that the decrease in some orexigenic peptides, such as ghrelin, is associated with loss of muscle strength and functional capacity during the aging process.6,7 Moreover, the results of a cross-sectional study has suggested thatthe decrease in ghrelin concentration might not be a part of the physiological aging process, but is related to unhealthy aging.8 Low ghrelin levels in older adults has been demonstrated to be associated with poor nutritional status and lower functional capacity, however, a certain relationship between ghrelin levels and frailty has not been established yet.7
Related Knowledge Centers
- Chronic Kidney Disease
- Entorhinal Cortex
- Kwashiorkor
- Neocortex
- Sertoli Cell
- Cachexia
- Immune System
- Adipose Tissue
- Marasmus
- Retroperitoneal Space