Protein energy malnutrition, BY. MR. DINABANDHU BARAD

1. PROTEIN ENERGY
MALNUTRITION
BY:
DINABANDHU BARAD
MSC TUTOR, SNC, SOA, DTU

3. PROTEIN ENERGY MALNUTRITION
• WHO defines malnutrition as the cellular imbalance between the supply
of nutrient and energy and the body’s demand for them to ensure
growth, maintenance and specific function.

4. CLASSIFICATION
• SYNDROMAL CLASSIFICATION
1. KWASHIORKOR
2. NUTRITIONAL MARASMUS
3. PREKWASHIORKOR
4. NUTRITIONAL DWARFISM

6. CLASSIFICATION
• WHO CLASSIFICATION
Who used three terms to classify PEM
1. Under weight (weight for age)
2. Stunting (height for age)
3. Wasting (weight for height)

7. WHO CLASSIFICATION
PARAMETERS ACUTE
MALNUTRITION
CHRONIC
MALNUTRITION
Weight For Age Low Low
Height for Age Normal Low
Weight For
Height
Low Normal

8. WHO CLASSIFICATION
SAM MAM
W/H <3SD 2-3 SD <1 SD
NORMAL
MUAC <11.5 CM 11.5-12.5
CM
>12.5 CM
NORMAL
BILATERAL
EDEMA
PRESENT ABSENT

9. ARNOLD CLASSIFICATION BASED
ON MUAC
• NORMAL 16 CM
• MILD PEM 13.5-16CM
• MODERATE 12.5-13.5CM
• SEVERE <12.4CM

10. CLASSIFICATION
CLASSIFICATION BY IAP
(BASED ON WEIGHT FOR AGE)
NORMAL 80%
GRADE –I 71-80%
GRADE –II 61-70%
GRADE –III 51-60%
GRADE --IV <50%

11. CLASSIFICATION
CLASSIFICATION BY JELLIFE
(BASED ON WEIGHT FOR AGE)
NORMAL 90%
GRADE –I 80-90%
GRADE –II 70-79%
GRADE –III 60-69%
GRADE --IV <60%

12. CLASSIFICATION
WATERLOW CLASSIFICATION
(BASED ON HEIGHT FOR AGE)
NORMAL 95%
FIRST DEGREE STUNTING 90-95%
SECOND DEGREE STUNTING 85-89%
THIRD DEGREE STUNTING <85%

13. CLASSIFICATION
PONDERAL INDEX
PONDERAL INDEX= WEIGHT IN GRAM/ (HEIGHT IN CM)3 * 100
NORMAL >2.5
BORDERLINE PEM 2.0-2.5
SEVERE PEM <2.0

14. WEIGHT FOR AGE

30. FLAKY PAINT DERMATOSIS

33. CHEILOSIS

62. THANK YOU