Protein Energy Malnutrition

Department of Gastroenterology, Royal Children's Hospital, Herston Road, Brisbane, Queensland 4029, Australia.
Pediatric Clinics of North America (Impact Factor: 2.12). 10/2009; 56(5):1055-68. DOI: 10.1016/j.pcl.2009.07.001
Source: PubMed


Protein energy malnutrition (PEM) is a common problem worldwide and occurs in both developing and industrialized nations. In the developing world, it is frequently a result of socioeconomic, political, or environmental factors. In contrast, protein energy malnutrition in the developed world usually occurs in the context of chronic disease. There remains much variation in the criteria used to define malnutrition, with each method having its own limitations. Early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

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    • "Protein-energy malnutrition (PEM) is the most common type of undernutrition and is caused by deficiencies in protein or macro-and micronutrients such as vitamin A, vitamin E, vitamin B6, folate, zinc, iron, copper, and selenium [2]. Inadequate energy intake leads to various physiological deficiencies, such as growth deficiencies and loss of fat, muscle and visceral mass, and has deleterious effects on the immune system [3]. Undernutrition has been linked to many deficiencies of the innate immunity as decreased lysozyme production by monocytes and polymorphonuclear cells (PMNs), depletion of complement components, and impairment of macrophage functions [4]. "
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    ABSTRACT: Cellular immunity is critical for protection against tuberculosis, but its integrity is compromised during undernutrition. The present study was designed to evaluate if the attenuated mycobacterium BCG is a safe vaccine for undernourished individuals. An experimental model of undernutrition was established by subjecting BALB/c mice to dietary restriction. These animals received 70% of the amount of food consumed by the healthy control group and exhibited physiological alterations compatible with malnutrition, including body weight loss, reduced levels of triglycerides and glucose, and reduced lymphocyte numbers. Undernourished mice were immunized with BCG, and the mycobacterial loads in lymph nodes, spleen, liver, lungs, and thymus were determined. A much higher proportion of undernourished mice exhibited bacterial dissemination to the lymph nodes, spleen and liver. In addition, only undernourished animals had bacteria in the lungs and thymus. Concomitant with higher mycobacterial loads and more widespread BCG dissemination in undernourished mice, production of TNF-α, IFN-γ, and IL-10 was also diminished in these mice. Taken together, these results indicate that BCG infection is more severe in undernourished mice. Whether a similar phenomenon exists in undernourished children or not remains to be thoroughly investigated.
    Clinical and Developmental Immunology 04/2012; 2012(3):673186. DOI:10.1155/2012/673186 · 2.93 Impact Factor
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    • "It seems that many deaths from PEM occur as a result of outdated clinical practices, and an improving of these practices appears to be essential to reduce this rate of morbidity and mortality [5]. PEM is responsible, directly or indirectly, for 54% of the 10.8 million deaths per year in children under 5 and contributes to every second cause of death (53%) associated with infectious diseases among children under 5 years of age in developing countries [1]. However, PEM is also observed in adults. "
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    ABSTRACT: This paper reviews the scientific knowledge about protein-energy and micronutrient malnutrition in the context of Chagas disease, especially in experimental models. The search of articles was conducted using the electronic databases of SciELO (Scientific Electronic Library Online), PubMed and MEDLINE published between 1960 and March 2010. It was possible to verify that nutritional deficiencies (protein-energy malnutrition and micronutrient malnutrition) exert a direct effect on the infection by T. cruzi. However, little is known about the immunological mechanisms involved in the relationship "nutritional deficiencies and infection by T. cruzi". A hundred years after the discovery of Chagas disease many aspects of this illness still require clarification, including the effects of nutritional deficiencies on immune and pathological mechanisms of T. cruzi infection.
    Journal of Tropical Medicine 04/2011; 2011(1):981879. DOI:10.1155/2011/981879
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    • "Long chain n3 moieties are present within the terrestrial food chain at much lower levels than the n6 (n6 to n3 ratio often greater than 10–1), while a ratio of about 2–1 is also thought preferable (Sinclair and Mann 1996). At the same time, many areas of the world are protein deficient, or at least deficient in protein of good quality (Grover and Ee 2009, Akuyam et al. 2009, Jahoor et al. 2008, von Schoen-Angerer et al. 2008). While shark heart is probably not a potential human food, as it would most likely be quantitatively insufficient, the much greater amounts of shark muscle has the potential to be of use in supplementing this protein deficiency, as well as providing a significant amount of polyunsaturated fatty acids and minimal saturated fatty acids. "
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    ABSTRACT: We have assessed the fatty acid profiles of the hearts and different muscle tissues from nine large shark species (Carcharhinus limbatus (blacktip), Carcharhinus obscurus (dusky), Carcharhinus brevipinna (spinner), Carcharhinus leucas (Zambezi/bull), Galeocerdo cuvier (tiger), Sphyrna lewini (scalloped hammerhead), Sphyrna zygaena (smooth hammerhead), Carcharodon carcharias (great white) and Carcharias taurus (raggedtooth/grey nurse/sand tiger)) found off the east coast of South Africa. While there was generally little variation between the species, all species showed profiles rich in both n6 and n3 polyunsaturated fatty acids compared to terrestrial commercial meats that have low n3. Thus, utilizing skeletal muscle tissues from sharks caught as part of the bycatch when fishing for teleosts would avoid unnecessary wastage of a potentially valuable resource, with all the possible health benefits of high quality protein combined with balanced polyunsaturates, although contamination with high levels of metabolic wastes, such as urea, may be a negative consideration.
    Fish Physiology and Biochemistry 03/2011; 37(1):105-12. DOI:10.1007/s10695-010-9421-8 · 1.62 Impact Factor
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