Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.
Protein-Energy Malnutrition (PEM)
If you suddenly decided to stop eating protein, do you know what would happen? Well, for starters your muscles would not be happy. Because you are not taking in protein through your diet, your body steals it from your muscles and repurposes your muscle proteins into proteins that keep you alive, like enzymes and hormones.
And, if you are planning on avoiding protein-containing foods, then I would suggest that you also avoid anybody with a cold, because insufficient protein means an insufficient immune system. Life without protein would not be fun and would leave you feeling so fatigued that it would be very difficult to find enough energy to carry out your normal daily activities, because you would much rather sprawl out on the couch for a mid-afternoon nap.
Fortunately, people living in developed countries, like the United States, rarely have trouble getting enough protein in their diet; in fact, citizens of the U.S. may be more likely to suffer from health effects associated with the intake of too much protein. It's a different story for those living in developing countries, where protein deficiency is a major problem due to a lack of high-protein foods, like meats and high-quality plant proteins.
In this lesson, we will learn about health consequences associated with protein-energy malnutrition (PEM), which is a form of malnutrition brought on by an insufficient intake of protein and/or energy, as well as health problems associated with high-protein diets.
Protein-energy malnutrition is a potentially fatal disorder, and is a leading cause of death among children living in developing countries. PEM can affect anyone, but children are especially susceptible because sufficient protein is needed to support their growing bodies. One type of PEM is kwashiorkor, which happens when protein is deficient, but overall energy is adequate. In other words, a child with this type of malnutrition typically takes in sufficient calories (i.e. energy), but the foods are too low in protein to support the child's health.
Kwashiorkor is a native word of Ghana, which is a republic in West Africa. If we translate the word, it means 'the disease that the first child gets when a second child is born.' Now, at first glance this might seem like an odd name, but it does describe how this condition can come about. In undeveloped regions, an older child may have to stop breast feeding, because the mother is pregnant with another child. The older child misses out on the protein from the breast milk and is switched to a diet similar to older members of the family. The food provides the child with calories but is often low in protein, leading to the disease.
I bet you've seen pictures of a child with this disorder; they can be identified by the characteristic swollen belly that results from fluids building up in the abdomen. You can use this familiar image to help you recall this term if you think that a child with kwashiorkor has fluids washing into their core. Sufficient protein is needed for proper growth and immune function, so a child with kwashiorkor will have slowed growth and be prone to infections.
Another form of protein-energy malnutrition is marasmus, which happens when both protein and energy are deficient. A child with this disorder is not going to get enough calories of any type. Knowing this makes it is easy to see why the word marasmus, which is the Greek word for to waste away, is used to describe this form of malnutrition.
A child with marasmus will look emaciated because the muscles and body fat are burned up to provide energy. Children with marasmus will suffer from some of the same symptoms as children with kwashiorkor, such as an impaired immune system and slowed growth, but will not have the characteristic swollen abdomen due to the overall wasting away of the body.
In contrast to the health effects we have been looking at associated with a lack of protein, we see some people in developed countries choose to follow a high-protein diet or use protein and amino acid supplements in hopes that the additional protein will improve health and boost muscle growth. Supplementation is rarely needed to meet basic protein needs in places like the U.S., and there is only weak evidence to support any noticeable health benefits from increasing protein intake over the required level.
To understand why, it might help you to think of your body as a reservoir guarded by a dam. If you put too much water in a reservoir, the excess will spill over the dam and be lost. Likewise, if you feed your body more protein than it needs, the excess will spill out through your kidneys as the nitrogen-containing waste product urea and be lost through urine. This makes the kidneys work harder than usual, and because you are excreting more waste, more water is required and lost through the urine.
So, health effects of high-protein diets may include dehydration or overworked kidneys. This extra work by the kidneys might not be a problem for an otherwise healthy individual, but could worsen problems in a person with existing kidney disease. High-protein diets also tend to be high in saturated fats and low in fiber because the main foods come from animal sources. A diet high in saturated fat and low in fiber can be linked to an increased risk of heart disease and cancer.
Let's review. Protein-energy malnutrition (PEM) is a form of malnutrition brought on by an insufficient intake of protein and/or energy. PEM is a potentially fatal disorder and tends to affect children. One type of PEM is kwashiorkor, which happens when protein is deficient, but overall energy is adequate. This disorder can be recognized by the characteristic swollen belly that results from fluids washing into the core or abdominal region.
Another type of PEM is marasmus, which happens when both protein and energy are deficient. A child with marasmus will look emaciated as if the body is wasting away. Children with either type of PEM will suffer from slowed growth and an increase in infections.
Following a high-protein diet or using protein and amino acid supplements may cause the loss of urea, which is a nitrogen-containing waste product through the urine. This can lead to dehydration and overworked kidneys. And, a high-protein diet often contains foods that are high in saturated fat and low in fiber, which has been linked to an increased risk of heart disease and cancer.
By the end of this lesson, you could:
- Understand the meaning of PEM
- Analyze two types of malnutrition associated with a lack of protein
- Recall the side-effects and risks of a high protein diet
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