Protein Energy Malnutrition and Hidden Hunger:-

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Protein  Energy Malnutrition and hidden Hunger:-   

                            What is PEM Protein energy malnutrition?

According to World Health Organization, protein energy malnutrition (PEM) refers to “an imbalance between the supply of protein and energy and the body's demand for them to ensure optimal growth and function”.


                     What is primary PEM and secondary PEM?

 

Protein-energy can be classified into: Secondary PEM is caused by disorders in the gastrointestinal tract. It is also caused by infections, trauma, and much more.

 

Primary PEM includes kwashiorkor and marasmus which are highly prevalent in children in rural areas of Africa and other developing nations in the world.

 

                          Types of Protein Energy Malnutrition:-

Types include:-

  • Kwashiorkor (protein malnutrition predominant)
  • Marasmus (deficiency in calorie intake)
  • Marasmic kwashiorkor (marked protein deficiency and marked calorie insufficiency signs present, sometimes referred to as the most severe form of malnutrition).
  •  


                              Causative and Risk factors of PEM:-

The degree of protein–energy malnutrition disorders including kwashiorkor and marasmus may vary in a given population depending on many factors including:

  • The political and economical situation of the area
  • The level of education amongst the people
  • The sanitatary conditions
  • The climatic conditions
  • Food production and availability
  • Cultural food preferences in the area
  • Breast-feeding preference among the female population
  • Prevalence of infectious diseases
  • The existence and effectiveness of governmental nutrition programs
  • The quality of health services.

                            Clinical Symptoms of PEM:-

Symptoms of secondary PEM can be range from mild to severe and change the function of just about every organ within the body. The intensity and the type of symptom depend on the patient’s priorty dietary status, nature of the disease, and the velocity at which it is progressing. Some of the protein energy malnutrition symptoms that can be noticed are:

·         Weakened grip and incapability to do things that require high energy

·         Physical changes in the body like weak arms and legs, hair colour change to red/yellow, hair loss, weight loss, skin becoming thin, pale, inelastic and dry, etc. 

·         Apathy and irritability

·         Temporary lactose absence 

·         Liver, heart, or kidney failure

·         The risk of hip fractures and ulcers is high in older patients.

These are just a few of the symptoms, however, there are many more and they may differ from patient to patient.



                                   Management of PEM:-

Diagnosis Process:-

                             Before the protein energy malnutrition treatment, Protein-energy undernutrition can be diagnosed to detect and know about the history of the patient’s diet. 

·         Measurement of height and weight are taken 

·         Fat distribution is checked and anthropometric measurements of the body mass are examined. 

·         Also, the BMI is calculated so that the seriousness of the PEM can be known

·         Lab tests as also done to measure serum albumin, response to skin antigens, lymphocyte count, and other such tests are done to detect the severity

·         Many times, to diagnose it, low levels of hormones, lipids, cholesterol, calcium, magnesium, etc. can also be helpful. 


Treatment Process:-

                There are many ways through which this can be treated. Some of the treatment options are:

· Avoiding lactose food

·  Oral feeding

· Improving nutritional education to educate or inform people of the various nutrients that are important and essential for the human body and how a deficit can be fatal. 

·   Providing multivitamin supplements to prevent micronutrient deficiency.

 

These are only a few of the protein energy malnutrition treatments but there are many more that doctors recommend and provide. 

 

              What is Hidden Hunger?

According to the Global Hunger Index: The Challenge of Hidden Hunger, more than two billion people are suffering from hidden hunger or micronutrient deficiency. Often its difficult to detect, micronutrient deficiency weakens the immune system, stunts physical and intellectual growth and  it can even lead to death.

Malnutrition, like hunger can be hidden in plain sight, as undernourishment can be overlap with obesity. Our bodies might not be starving due to a lack of calories because due to a lack of essential micronutrients.


This is part of what is known as the triple burden of malnutrition — the coexistence of:

  • Undernutrition and/or food insecurity: 1 billion people go hungry because they do not get enough food to eat.
  • Overweight and obesity: 5 billion people are overweight often because they consume too many empty calories.
  • Micronutrient deficiency: 3 billion people are malnourished because they lack nutritious food.

Nutrition’s Role in Reducing Hidden Hunger and Malnutrition

                                                     Nutrition is key to human well-being. Micronutrients such as vitamins and minerals are as essential as macronutrients such as protein, fat, and carbohydrates because of the role they play in supporting our overall health.



Although micronutrients such as iron, vitamin A, vitamin D, iodine, folate, and zinc are only required by the body in very small amounts, their deficiencies can result in covert or hidden symptoms that are difficult to detect clinically, such as:

1.    General fatigue 

2.    Reduced ability to fight infections 

3.    Impaired cognitive function, such as a loss of attention, concentration and focus, memory, and mood

4.    Implications for long-term health such as increasing one’s risk for chronic diseases

Leading a healthy, adequate, and nutritious diet is essential to fight hidden hunger, but nutrition education also has a part to play in helping people make healthier choice.

Ultimately, understanding the nutritional information available on food labels can empower people to make smarter eating decisions, choosing from a variety of foods and beverages that are higher in nutrient density throughout the day.

Nutrient density is a measure of how much nutrition you get per serving or per calorie eaten. It’s an important metric to develop a healthy diet.

When choosing between two food items with the same calorie amount, nutrient-dense food choice can provide your body with the protein, fiber, healthy fats, vitamins, and minerals we need every day, while low nutrient-dense choice may provide empty calories from sugar and saturated fat with no other significant nutrients.

The Global Impact of Our Nutrition for Zero Hunger Initiative

As the international community has committed to ending hunger, achieving food security, and improved nutrition by 2030, food and food-related assistance lie at the heart of the struggle to break the cycle of poverty and bring hunger down to zero.

Through our Nutrition for Zero Hunger (NFZH) initiative, we are partnering with leading organizations, such as the World Food Program USA, Feed the Children, and The Hunger Project who act as driving forces to improve food security and nutrition.

Globally, we are working on ensuring access to good nutrition in vulnerable communities in rural China and supporting children’s education programs in Malaysia that promote healthy foods and adapting global food systems to meet the growing rates of hunger. We plan to reach many more people affected by the many facets of hunger and malnutrition by 2030.


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