Protein-energy malnutrition: how serious can it be?

Protein is an important component of every cell, organ, and function in the body. It is vitally important and is found in various sources in the typical diet, including foods that are not so good for the human body, such as processed or fast foods. Despite the fact that protein is found in so many different food sources, there are still many people who do not get enough calories in their diet, including protein.

Protein-energy malnutrition (PEM) is a potentially fatal body deprivation disorder that is the leading cause of death in developing countries. PEM occurs when there are not enough calories or protein to meet the body’s nutritional needs. However, it doesn’t always happen simply in the absence of protein in the diet, it can also happen when the body is unable to absorb the protein or convert it for its own use.

PEM is not a common problem in the United States; However, it statistically affects two different demographic groups: the elderly living in nursing homes or other long-term care facilities, and children from poor families. It occurs in one in two surgical patients and strikes 48% of all other admitted hospital patients (Source: FAQS.org)

There are two varieties of PEM, Primary and Secondary. Primary PEM occurs when there is a general lack of protein sources in the diet and very few calories. Secondary PEM is more common in the United States and is usually a complication that has developed from another disease, including: AIDS, cancer, chronic renal failure, inflammatory bowel disease. PEM can develop slowly during chronic illness or when the body is in a state of near starvation, but it can develop rapidly if there is an acute illness.

Protein-energy malnutrition occurs in both hospitalized patients and residents of long-term care facilities for a number of reasons. Many of them cannot chew or swallow properly, which prevents them from getting enough food into their system. Others may have sluggish or faulty digestive systems, which prevents them from processing the food they are eating and makes them uncomfortable and unwilling to eat the next meal. Many of them are also not active and may have slower or completely absent metabolisms, preventing them from feeling hungry at all. The elderly also tend to have a reduced sense of appetite to begin with, even when healthy.

In addition to the inability to eat and get enough calories in the diet, these patients may have additional nutritional losses due to bleeding, diarrhea, high blood sugar, kidney disease, malabsorption disorders. There are also other conditions that greatly increase the nutritional needs of the body, especially the need for protein. These conditions include: fever, infection, surgery, trauma, tumors, burns, and some use of some medications.

The continued inability to get enough calories or protein in the diet can lead to serious problems and can alter the shape or function of every organ in the body. The rapidity or severity of the condition will actually depend on previous health and nutritional status, the nature of the disorder, and the speed of its progression.

Protein-energy malnutrition ranges from mild to severe; however, there are no established criteria to establish the levels. Most doctors agree that a loss of ten to twenty percent of body weight constitutes moderate EMP. At this level, there is a weakened grip and the inability to perform high energy tasks.

Severe PEM involves a weight loss of more than twenty percent and is potentially fatal. At this stage of the condition, the patient will be unable to eat normal-sized meals, even if they have an appetite, the heart rate will be abnormally slow, and the blood pressure will be dangerously low. Your core body temperature will also drop below normal. The skin will appear baggy and wrinkled and the hair will be dry, thin and brittle. Constipation is very likely at this point, as is lethargy. The patient will also be more prone to pressure sores (commonly known as bed sores) and other skin lesions, as the body is unable to combat damage to the skin’s surface or underlying infectious agents.

It is very important that people most at risk of protein-energy malnutrition (children, the sick, and the elderly) receive enough calories, including all three macronutrients, to ensure their good health or help them recover from illness or trauma. The use of a protein supplement can be beneficial because it is more easily assimilated into the body. Once the condition has reached the moderate to severe stage, the likelihood of death becomes even more eminent without medical and nutritional intervention.

There are several different types of protein supplements that can be considered at this point, however they must meet the same criteria to be useful:

– They must contain high quality protein that can be assimilated by the body without extra effort. (Protein requires the most energy from the body to digest)

– They must not contain additional ingredients that can cause allergic reactions or be difficult to digest or, finally, can displace the protein.

– They must be appetizing. A protein supplement that is high in amino acids is usually very bitter and will not be easily eaten by the average person. The protein in the supplement must be broken down into smaller peptides so that it is easier to use and does not taste bitter.

– They must be adaptable, which means that the patient must be able to transition on the same protein supplement from tube feeding to consumption without the need to introduce a new source of supplement into the system, which could increase the risk of allergic reaction in some people.

– They should not cause the increase in blood sugar that can occur in the presence of added sugars.

– They should address the real problem of protein digestion or absorption if possible.

– Finally, the protein supplement should provide as many additional benefits as possible without compromising current health status or impeding healing.

There are a number of types of protein supplements, including protein powders that can be added to other food sources and protein supplement shots. Protein powders have a number of pros and cons for each of the four types.

Whey Protein Powder: Benefits

– Enhances glutathione production, an immunity booster

– Highest level of naturally occurring food-derived branched-chain amino acids that can be directly metabolized in muscle tissue

– Excellent source of the amino acid leucine which is vital for muscle growth

– Helps with the optimal intake of proteins, fats, carbohydrates and micronutrients.

– Helps preserve muscle tissue

– Maintains a healthy blood sugar level

– High calorie protein source

Whey protein: disadvantages

– Potential allergic reaction in those who are lactose intolerant

– Too much whey can damage the liver

Soy protein: advantages

– Highly digestible form of protein

– Improves the nutritional value of other foods.

– May lower cholesterol

– It is suitable for vegans

– Source of phytoestrogens that are beneficial in a number of conditions and diseases, including osteoporosis and breast health

Soy protein: disadvantages

– Potential allergen

– May not be indicated in some forms of breast cancer

Rice protein: advantages

– Hypoallergenic

– Easy to digest

– Suitable for vegans

Rice protein: disadvantages

– Can be hard to find in some areas

– May be more expensive to buy

Advantages of egg protein

– Made from egg white, considered the perfect source of protein

– Fat free

– High quality protein

– Food source higher in amino acids, alanine, argine, glycine and methione.

Disadvantages of egg protein

– Potential allergen

– May react with some medications