KWASHIORKOR

also called Protein Malnutrition, condition caused by severe protein deficiency. Protein malnutrition is most often encountered in tropical and subtropical regions in which the diet is high in starch and low in proteins. Kwashiorkor is common in young children weaned to a diet consisting chiefly of cereal grains, cassava, plantain, and sweet potato or similar starchy foods. The condition in children was first described in 1932 and was termed kwashiorkor, meaning deposed child (deposed from the mother's breast by a newborn sibling) in one African dialect and red boy in another dialect. The latter term comes from the reddish orange discoloration of the hair that is characteristic of the disease. Other symptoms include dry skin and skin rash, potbelly and edema, weakness and nervous irritability, and digestive disturbances with diarrhea, anemia, and fatty infiltration of the liver. The consumption of dried skim milk has proved effective in treating kwashiorkor. As long-term preventive measures, such international groups as the World Health Organization and the Food and Agriculture Organization of the United Nations have actively encouraged the successful development of high-protein plant mixtures based on local food preferences and availability. Reports have suggested that protein malnutrition in early life may lead to an adult predisposition to certain diseases such as cirrhosis of the liver and may cause stunted mental development. There is strong evidence that an adequate level of dietary protein is a protection against the disease. In addition to protein-deficient diet, other causes of kwashiorkor include intestinal malabsorption, chronic alcoholism, kidney disease, and infection, burns, or other trauma resulting in the abnormal loss of body protein. Protein malnutrition is often associated with deficiencies of one or more other nutrients and of calories. When the caloric intake is inadequate and the level of dietary protein is barely adequate, protein malnutrition may still develop, for some of the protein is metabolized to supply the body's energy needs. The term protein-calorie malnutrition, or marasmus, covers the whole spectrum of deficiencies caused by lack of protein or calories or both. When both calories and protein are lacking, young children (usually one to four years old) may suffer from a general wasting of body tissues and become acutely emaciated and fail to grow; additions to the diet that provide both calories and good-quality protein can effect cures in a relatively short time.