What Is Kwashiorkor or Protein Malnutrition? | Nutrition

Kwashiorkor or Protein Malnutrition

Understanding kwashiorkor

Kwashiorkor, also known as “edematous malnutrition” because of its association with edema (fluid retention), is a nutritional disorder most often seen in regions experiencing famine. It is a form of malnutrition caused by a lack of protein in the diet. People who have kwashiorkor typically have an extremely emaciated appearance in all body parts except their ankles, feet, and belly, which swell with fluid.

Most people who are affected by kwashiorkor recover fully if they are treated early. Treatment involves introducing extra calories and protein into the diet. Children who develop kwashiorkor may not grow or develop properly and may remain stunted for the rest of their lives. There can be serious complications when treatment is delayed, including coma, shock, and permanent mental and physical disabilities. Kwashiorkor can be life-threatening if it’s left untreated. It can cause major organ failure and eventually death.

Causes of kwashiorkor

Kwashiorkor is caused by a lack of protein in the diet. Every cell in your body contains protein. You need protein in your diet for your body to repair cells and make new cells. A healthy human body regenerates cells in this way constantly. Protein is also especially important for growth during childhood and pregnancy. If the body lacks protein, growth and normal body functions will begin to shut down, and kwashiorkor may develop.

Kwashiorkor is most common in countries where there is a limited supply or lack of food. It is mostly found in children and infants in sub-Saharan Africa, Southeast Asia, and Central America. A limited supply or lack of food is common in these countries during times of famine caused by natural disasters such as droughts or floods or political unrest. A lack of nutritional knowledge and regional dependence on low-protein diets, such as the maize-based diets of many South American countries, can also cause people to develop this condition.

This condition is rare in countries where most people have access to enough food and can eat adequate amounts of protein. If kwashiorkor does occur in the United States, it can be a sign of abuse, neglect, or fad diets, and it’s found mostly in children or older adults. It can also be a sign of an underlying condition, such as HIV.

Symptoms of kwashiorkor

The symptoms of kwashiorkor include:

  • Change in skin and hair colour (to a rust colour) and texture
  • Fatigue
  • Diarrhoea
  • Loss of muscle mass
  • Failure to grow or gain weight
  • Edema (swelling) of the ankles, feet, and belly
  • The damaged immune system, which can lead to more frequent and severe infections
  • Irritability
  • Flaky rash
  • Shock

Diagnosis of kwashiorkor

If kwashiorkor is suspected, your doctor will first examine you to check for an enlarged liver (hepatomegaly) and swelling. Next, blood and urine tests may be ordered to measure the level of protein and sugar in your blood.

Other tests may be performed on your blood and urine to measure signs of malnutrition and lack of protein. These tests may look for muscle breakdown and assess kidney function, overall health, and growth. These tests include:

  • Arterial blood gas
  • Blood urea nitrogen
  • Blood levels of creatinine
  • Blood levels of potassium
  • Urinalysis
  • Complete blood count

Treatment for kwashiorkor

Kwashiorkor can be corrected by eating more protein and more calories overall, especially if treatment is started early.

You may first be given more calories in the form of carbohydrates, sugars, and fats. Once these calories provide energy, you will be given foods with proteins. Foods must be introduced and calories should be increased slowly because you have been without proper nutrition for a long period. Your body may need to adjust to the increased intake. Your doctor will also recommend long-term vitamin and mineral supplementation to your diet.


Even with treatment, children who have had kwashiorkor may never reach their full growth and height potential. If treatment comes too late, a child may have permanent physical and mental disabilities. If left untreated, the condition can lead to coma, shock, or death.

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