1. “Protein Deficiency and Excess”
Results of too little, too much

2. PEM
“Most widespread form of malnutrition: PEM”
“Protein-Energy Malnutrition”
Over 500 million children currently suffer
Most of 33,000 children who die each day are malnourished

3. Where is it prevalent?
Africa, Central America, South America, Middle East, East and Southeast Asia
Can occur here too!

4. What happens when we don’t get enough protein?
“Inadequate protein intake leads to:”
“poor growth”
“weight loss”
“wasting”
(consumption of muscle)
Stunted growth is easy to overlook!

5. Old-School Thought
Used to think small stature in poor countries was an adaptation to limited food
We now know it’s a failure of growth due to lack of food in growing years

6. Sometimes patients show signs of both.
“Two Forms of PEM”
Marasmus
Shriveled all over
Kwashiorkor
Swollen belly
Sometimes patients show signs of both.

7. “1. Marasmus”
“Most common in 6-18 month old children”
The most available food in city slums in a weak cereal drink with little energy or protein
“Child is skin and bones”

8. “Muscles incl. heart weaken”
“Brain development stunts”
“Body temp is subnormal” (because of slow metabolism)
Little or no fat insulation; patients need to be wrapped in blankets
Often also starved of parental attention and need love from hospital staff

9. What happens when your body has little energy?
Body cuts nonvital activities
“Child will not even cry for food; energy is spent on vital organs”
Skin loses moisture and cracks; sores don’t heal

10. Disease Conditions
“Body stops producing blood proteins and antibodies”
So child is anemic and susceptible to infection

11. “Dysentery: infection of digestive tract, causes chronic diarrhea”
What is the major problem with diarrhea?
Deprives body of water and nutrients, causes electrolyte imbalances
Infections responsible for two-thirds of deaths

12. “Preventing Death”
“Reverse with careful nutrition therapy”
Fluid balances are delicate, and electrolytes must be restored
Then fat-free milk
Then fat
Deficits in thinking occur for years

13. “2. Kwashiorkor”
“Ghanian for ‘the evil spirit that infects the first child when the second is born.’”
There is a good reason why they believe this!

14. In these countries…
Babies are born frequently
As soon as second is born, first is weaned from breast milk
Older baby receives watery cereal instead
First baby suffers

15. Why the swollen belly?
“Proteins that maintained fluid balance are gone”
“Fluid leaks out of blood, accumulates in belly and legs (edema)”

16. “Proteins stop taking fat from liver; liver swells”
Protein loss also deprives skin and hair of melanin
Skin is patchy and scaly

18. “PEM in the U.S.” Most common among:
The poor in Native American reservations
Inner cities
Rural areas
Elderly and uncared for
Hungry and homeless children
Patients suffering from anorexia

19. “Occasionally caused by replacing milk or formula with unenriched health-food soy or rice drinks”
Also sufferers of AIDS, cancer
Drug or alcohol addicts
“PEM and other disorders worsen each other.”
Causing a downward spiral.

20. Poverty in America
Tens of millions of Americans can’t afford a steady supply of nutritious food
“14 million U.S. children are hungry.”
What impacts does this have?

21. Hungry Children:
Do not learn as well
Are less competitive
Are ill more often
Have higher absentee rates
Cannot concentrate when they are in school

22. What about “Too Much Protein”?
“No benefits, health risks for weakened kidneys”
Consumption of protein crowds out room in the diet for fruits, veggies, and whole grains!

23. Heart Disease
“Foods rich in protein can also be rich in saturated fats”
Especially red meat and dairy: greater risk of heart disease

24. Substituting vegetable protein for animal protein does lower the risk of heart disease!
“Current study: link between protein, homocysteine aa, and heart disease”
Unknown whether heart disease causes homocysteine to rise or vice versa.

25. Kidney Disease
In animals, raising protein in diet can cause enlarged kidneys or livers
“In humans, high-protein doesn’t seem to damage kidneys, but can speed decline”

26. Adult Bone Loss
“Give patient increased dose of purified protein, they spill more calcium out of body”
This means that high-protein may cause or worsen osteoporosis!
“May not be true of whole food protein.”

27. Cancer
“Red meats and processed meats increase risk for colon and rectal cancer”
Plus, hot dogs, sausages, deli meat, and bacon contain high amounts of saturated fat and salt.