MODULE 8 ● No protein at all

● Body is not able to synthesize CHON to

PROTEIN ENERGY MALNUTRITION AND produce energy
NATURAL PEPTIDES ● Most common nutritional disorder of
developing countries.
● Food gap is the chief cause of PEM
LEARNING TARGETS: o it is not only the deficiency of proteins but
At the end of the module, students will be able to: inappropriate food (low in energy density,
1. Understand the concept of PEM protein andmicronutrients - Vitamin A,
2. Classify PEM Iron, Zinc)
3. Identify the source and function of some o poor both quantitatively and qualitatively
common natural peptides
1. KWASHIORKOR
• A form of malnutrition due to a diet deficient
MALNUTRITION in protein and energy-producing foods
• Also called the wet, swollen, or edematous
form
OVERNUTRITION UNDERNUTRITION • This condition usually appears at the age of
about 12 months when breastfeeding is
discontinued, but it can develop at any time
OBESITY during a child’s formative years.
• The disease that the first child gets when
the new child comes.
PEM MICRONUTRIENT SYMPTOMS:
DEFICIENCY
• Generalized edema (accumulation of
H2O in the cells)
• Breaking down of skin
• Preservation of subcutaneous fat and
MARASMIC
gross enlargement of the liver with fatty
KWASHIORKOR MARASMUS
KWASHIORKOR infiltration
• Loss of appetite
• Diarrhea
MALNUTRITION • General discomfort
• Apathy
• Caused by a deficiency or excess in one or • Gastrointestinal infection (in some)
more essential nutrients in the diet COMPLICATIONS:
• Characterized by a wide array of health • If treatment comes too late, a child may
problems including weight loss, stunted have permanent physical and mental
growth, weakness, resistance to infection disabilities.
and impairment of intellect
• If left untreated, the condition can lead
• Severe cases may lead to death to coma, shock, or death.
Undernutrition occurs when not enough essential 2. MARASMUS
nutrients are consumed or when they are excreted • Severe lack of protein intake and other
more rapidly than they can be replaced. nutrients
• Also called the dry form of protein-energy
Overnutrition occurs in people who eat too much,
malnutrition.
eat the wrong things, don't exercise enough or take
• In developing countries, marasmus is the
too many vitamins or other dietary replacements.
most common form of PEM in children.
Overweight and obesity are defined as abnormal • Means “to waste away” or “dying away”.
or excessive fat accumulation that presents a risk SYMPTOMS:
to health. A body mass index (BMI) over 25 is • No edema
considered overweight, and over 30 is obese. • Muscle ad fat are wasted
• Liver is shrunk
Micronutrient deficiency diseases: resulting from
• Scaling of skin
a deficiency of specific micronutrients. (More about
this topic in Module 21) • Looks “old”
• Pallid
Protein-energy malnutrition: resulting from • Apathetic
deficiencies in any or all nutrients COMPLICATIONS
● Due to the foods people eat which are low in Complications of untreated marasmus can
protein be serious and may include:
● Also known as protein energy under nutrition • Growth problems in children
 • Joint deformity and destruction *SICKLE-CELL DISEASE
• Loss of strength
• a.k.a “depranocytosis”
• Loss of vision and blindness
• A hereditary blood disease caused by a
• Organ failure or dysfunction deficiency in protein globulin found in RBC
• Unconsciousness and comas • It is characterized by the production of an
ATROPHY abnormal type of hemoglobin- SICKLE CELL
• also known as “muscle wasting”; due HEMGLOBIN (HbS)-in the RBC
to aging or protein deficiency • HbS becomes insoluble when the blood is
• cells are more likely to shrink because deprived of O2 and precipitates forming
no energy is sustaining them elongated crystals that distort the blood cell
• the body assumes a “kin-bone” into the characteristic sickle-shape
appearance” or like that of a living • SCA produces a form of protein energy
mummy malnutrition due not to poor intake, but to
increased energy demand.
3. MARASMIC KWASHIORKOR
• Marasmic kwashiorkor is the third form of SOME COMMON NATURAL PEPTIDES
protein-energy malnutrition that combines NAME SOURCE/FUNCTION
features and symptoms of both marasmus Glutathione Most living cells
and kwashiorkor. (Stimulates tissue
A person with marasmic kwashiorkor may: growth)
• be extremely thin Thyrotropin Releasing Hypothalmic
• show signs of wasting in areas of the Hormone neurohormone
body (governs the release of
• have excessive fluid buildup in other thyrotropin)
Angiotensin II Pressor agent (acts on
parts
the adrenal gland)
Bradykinen Hypotensive vasodilator
Weight for (acts on smooth
With edema Without edema muscles)
age
60-80% of Oxytocin Uterus-contracting
expected KWASHIORKOR UNDERWEIGHT hormone (also
weight stimulates lactation)
<60 % of Somatostatin Inhibits growth
MARASMIC hormone release (used
expected MARASMUS
KWASHIORKOR to treat ulcer)
weight
Endothelin Potent vasoconstrictor
(structurally similar to
OTHER CLASSICIFATION OF UNDERNUTRITION some snake venom)
Glucagon Hyperglycemic factor
• Underweight: underweight for one’s age
(used as anti-diabetic)
(weight for age)
Insulin Pancreatic hormone
• Stunted: A chronic malnutrition manifested by
(used in treatment of
being too short for one’s age (height for age)
diabetes)
• Wasted: An acute malnutrition manifested by
being dangerously thin (weight for height)
Melittin Honey bee venom
(used to treat
rheumatism)
NORMAL HEIGHT FOR AGE

UNDERWEIGHT STUNTED
NORMAL WASTED WASTED
&
STUNTED