 When a person is not getting enough food or not getting the right

sort of food, malnutrition is just around the corner. Even if

people get enough to eat, they will become malnourished if the
food they eat does not provide the proper amounts of
micronutrients - vitamins and minerals - to meet daily
nutritional requirements.

 Disease and malnutrition are closely linked. Sometimes disease

is the result of malnutrition, sometimes it is a contributing
cause. In fact, malnutrition is the largest single contributor to
disease in the world, according to the UN's Standing Committee
on Nutrition (SCN).
 Protein-Energy deficiency
 Marasmus
 Kwashiorkor

 Iron deficiency
 Vitamin A
 Iodine deficiency
 Zinc deficiency
Table 1. WHO Classification of Malnutrition

Evidence of Malnutrition Moderate Severe (type)

Yes (edema protein-energy
Symmetric edema No
malnutrition [PEM])*

Standard deviation (SD) score -3

SD score <-3 (ie, severe wasting) ||
Weight for height†
(< 70%)
SD score <-2 (70-90%)

SD score- 3
SD score <-3 (ie, severe stunting) (<
Height for age
85%)
SD score <-2 (85-89%)

Table taken from: http://emedicine.medscape.com/article/984496-clinical#b4

P.S. pwede naman natin na wag na tong isama.. 
 Marasmus is a condition primarily caused by a
deficiency in calories and energy; observed in infants
who are breastfeeding when the amount of milk is
markedly reduced or, more frequently, in those who are
artificially fed.
 Marasmus is a serious worldwide problem that involves more
than 50 million children younger than 5 years. According to the
World Health Organization (WHO), 49% of the 10.4 million
deaths occurring in children younger than 5 years in developing
countries are associated with PEM.
Marasmus
shrunken wasted appearance
 Failure to thrive
 irritability or apathy
 Chronic diarrhea
 infants generally present with feeding
difficulties
 Kwashiorkor, also known as “edematous malnutrition”
because of its association with edema (fluid retention),
is a nutritional disorder most often seen in regions
experiencing famine. It is a form of malnutrition caused
by a lack of protein in the diet. People suffering from
kwashiorkor typically have an extremely emaciated
appearance in all body parts except their ankles, feet,
and belly, which swell with fluid.
 Kwashiorkor
 change in skin and hair color (to a rust color) and texture
 fatigue
 diarrhea
 loss of muscle mass
 failure to grow or gain weight
 edema (swelling) of ankles, feet, and belly
 damaged immune system, which can lead to more frequent
and severe infections
 irritability
 flaky rash
 shock
Laboratory Tests (di ako sure kung ito
lahat or may dagdag pa, pwede
nmn i-edit natin)
Laboratory tests adapted from the WHO include the following:
 Blood glucose: Hypoglycemia is present if the level is lower than
3 mmol/L.
 Examination of blood smears by microscopy or direct detection
test: Presence of parasites is indicative of infection. Direct test is
suitable but expensive.
 Hemoglobin: A level lower than 40 g/L is indicative of severe
anemia.
 Urine examination and culture, Multistix: More than 10
leukocytes per high-power field is indicative of infection. Nitrites
and leukocytes are tested on Multistix also.
 Stool examination by microscopy: Parasites and blood are
indicative of dysentery.
 Albumin: Although not useful for diagnosis, it is a guide to
prognosis; if albumin is lower than 35 g/L, protein synthesis is
massively impaired.
 HIV test: HIV test should not be routinely performed; if
completed, it should be accompanied by counseling of the child's
parents and the result should be confidential.
 Electrolytes: Measuring electrolytes is rarely helpful and it may
lead to inappropriate therapy. Hyponatremia is a significant
finding.
 If kwashiorkor is suspected, your doctor will first examine you to
check for an enlarged liver (hepatomegaly) and swelling. Next,
blood and urine tests may be ordered to measure the level of
protein and sugar in your blood.
 Other tests may be performed on your blood and urine to
measure signs of malnutrition and lack of protein. These tests
may look for muscle breakdown and assess kidney function,
overall health, and growth. These tests include:
 arterial blood gas
 blood urea nitrogen (BUN)
 blood levels of creatinine
 blood levels of potassium
 urinalysis
 complete blood count (CBC)
 World Food Programme, (2016). Malnutrion and Types of Malnutrition.
Retrieved from: https://www.wfp.org/hunger/malnutrition
 Healthline, (2015). Kwashiorkor: Understanding Kwashiorkor. Retrieved from:
http://www.healthline.com/health/kwashiorkor#Overview1
 Medscape, (2016). Marasmus. Retrieved from:
http://emedicine.medscape.com/article/984496-overview#a10