Protein deficiency syndrome. Protein deficiency causes disorder throughout the body

A complete and balanced diet ensures that the body receives a number of substances that are important for its full functioning. And among them, they are in one of the first places. They are necessary for the growth and development of organs and vital systems. In addition, such substances are important for the complete restoration of cells and for maintaining all processes occurring in the body. A lack of protein in the body is considered a rather serious health problem, the symptoms, consequences and treatment of which we will now discuss.

Protein deficiency is not a very common disorder. It can be provoked by insufficient intake of proteins into the body, for example, when following a diet, or simply due to an unbalanced diet. Also, this pathological condition is caused by diseases that interfere with normal food intake, disorders of absorption and digestion of food. Sometimes a lack of protein occurs due to disturbances in neuroendocrine regulation or against the background of a large loss of protein due to active tissue breakdown or pathological excretion.

How does protein deficiency manifest itself, what symptoms indicate this?

Manifestations of protein deficiency can be completely invisible; at the initial stage, the disorder makes itself felt only by a slight decrease in body weight. Over time, pathological processes lead to pale and dry skin, which also becomes cold to the touch. There is a disruption in the functioning of the digestive tract: patients are bothered by problems that only worsen their condition.
The average degree of protein deficiency causes. In addition, libido decreases in patients of both sexes.
Patients with a lack of protein are characterized by irritability and apathy, their performance decreases and cognitive functions are impaired, namely memory, logical thinking, etc.

Any degree of such a disorder causes a weakening of cellular immunity and increases susceptibility to infectious lesions. Patients may experience pneumonia, gastroenteritis, genitourinary tract infections, and in particularly severe situations, sepsis. Their appetite decreases, which leads to an even greater decrease in body weight and a decrease in the amount of protein.

Also, a lack of protein leads to loss of both fat and fat. Patients' bones begin to protrude, their hair becomes thin, dries out and begins to fall out. Skin turgor decreases, poor wound healing is observed, which can lead to secondary infections. Elderly patients with protein deficiency are more likely to develop fractures and may develop bedsores and trophic ulcers.

Lack of protein negatively affects the functioning of the cardiovascular system, leading to a decrease in heart size and a drop in cardiac output. Pathological processes also cause a slow heart rate. The vital capacity of the lungs decreases, which leads to a decrease in breathing intensity. In particularly severe cases, swelling and anemia occur, and jaundice may also develop.

About how protein deficiency in the body is corrected, what treatment is effective?

Treatment for protein deficiency depends solely on what exactly caused the problem. Correction of the deficiency itself also plays an extremely important role. Patients with this problem need to increase their daily protein intake by calculating their ideal body weight and focusing on it. All patients are prescribed multivitamin medications, their water-electrolyte balance is corrected, which helps prevent deficiency of potassium, magnesium and other microelements.

If the patient can independently take and swallow food, a balanced diet helps to cope with the problem. If the patient's appetite decreases or if he cannot chew food on his own, he is prescribed liquid nutritional formulas. He can take them on his own, or such drugs can be administered through a tube an hour before meals.

If protein deficiency is complicated by diarrhea, the patient is prescribed yoghurt-based rather than milk-based nutritional formulas.

If the disease is severe, treatment is carried out in an inpatient department. The patient is prescribed a controlled diet, the disturbed water-electrolyte balance is corrected, and infectious diseases are treated. Additional nutrition is provided with mixtures. If necessary, parenteral nutrition can be provided. Vitamin therapy is carried out in a dosage twice the daily needs of a healthy person.

Patients with anorexia may be prescribed medications that increase appetite. Anabolic steroids can also be used to increase body weight.

Treatment of elderly patients is especially difficult. They need not only to organize proper nutrition, but also to provide treatment for depressive conditions, ailments of the digestive system, as well as medications that stimulate appetite. Many elderly patients need to be fed. Some of them are allowed to give up therapeutic diets for a while, for example, for diabetes or hypercholesterolemia, etc.

How does a lack of protein in the body affect it, what are the consequences for health?

With timely detection and adequate treatment, protein deficiency can be successfully corrected. If such a disorder is not treated in any way, over time it can lead to the development of liver, kidney or cardiovascular failure and cause death.

Protein deficiency - treatment with folk remedies

Traditional medicine specialists do not offer any methods to directly treat protein deficiency. However, there are means to improve appetite, eliminate exhaustion resulting from such a lack, and also strengthen the body.

So, to restore appetite, you need to prepare a medicine based on ordinary radish. Grate it and eat a couple of tablespoons three times a day, wash it down with a few sips of water. At the same time, it is recommended to take mustard seeds - twenty to thirty grains once a day. They should also be washed down with water. The duration of such therapy is twenty days.

You can also prepare a medicine from sunflower to treat anorexia caused by a lack of protein. Collect the outer flowers of annual sunflowers. Brew a tablespoon of crushed raw materials with a glass of boiling water. After cooling, strain the infusion and take half a glass half an hour before your meal.

A medicine based on walnuts will help cope with the lack of protein. Crush five hundred grams of this raw material, mix with juice squeezed from four lemons, three hundred grams of honey and one hundred milliliters of aloe juice. Mix well. Take the finished product one teaspoon approximately half an hour before meals. This medicine has a wonderful general strengthening effect, improves appetite and helps correct exhaustion.

Also, to improve appetite if there is a lack of protein, you can prepare a medicine based on pine needles. Rinse a couple of tablespoons of this raw material and brew with half a liter of boiling water. Boil the product over low heat in an enamel container for twenty minutes. Infuse the prepared broth for an hour, then strain. Take the medicine half a glass twice a day, sweeten with honey.

You can improve the functioning of the digestive tract, strengthen and heal the body, and also increase appetite with the help of a medicine based on plantain leaves. Grind such plant materials. Brew a tablespoon of the resulting mixture with a glass of boiling water and leave for twenty minutes to infuse. Drink the medicine strained in three to four doses.

To achieve a general strengthening effect, traditional medicine experts advise using an infusion based on. Brew a tablespoon of crushed raw materials with half a liter of boiling water. Infuse this medicine under the lid for one hour, then strain through gauze and squeeze. The finished infusion can be sweetened with sugar. Take half a glass twice a day shortly before meals.

To strengthen the body, you can also prepare a medicine based on walnuts. Crush three hundred grams of this raw material, also steam one hundred grams of garlic and mash thoroughly. Grind another fifty grams in a coffee grinder. Mix all the prepared ingredients and mix with a kilogram of honey. Take the prepared mixture one tablespoon two hours after a meal.

Protein deficiency can be successfully corrected if diagnosed in a timely manner. The advisability of using traditional medicine should be discussed with your doctor.

Ekaterina, www.site
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Proteins are of utmost importance for the human body, as they are the material for the construction of cells, organs, tissues, for the synthesis of hemoglobin, peptide hormones, and enzymes. Basic regulatory and metabolic functions also depend on proteins.

Lack of protein in the body leads to dysfunction of the small intestine, pancreas, liver, endocrine and nervous systems. In addition, with protein deficiency, there is a disturbance in the metabolism of vitamins and fats, hematopoiesis, the activity of the endocrine glands, the absorption of nutrients, changes in hormonal levels, the development of muscle atrophy, problems with the heart muscle appear, performance decreases, memory deteriorates, and the body’s resistance to various infections decreases.

Protein deficiency has a particularly adverse effect on a growing body: body weight decreases, growth slows, mental development is delayed, and bone formation is impaired.

Causes of protein deficiency

Protein deficiency usually occurs due to a qualitative or quantitative mismatch between nutrition and age. For example, a child’s diet primarily consists of foods that are low in protein or have low biological value.

Protein deficiency can develop as a result of congenital disorders of intestinal absorption of proteins, amino acid metabolism, protein synthesis, and increased loss of protein in the urine. Protein deficiency often occurs with severe burns, bleeding and infectious diseases.

Protein deficiency is often combined with a lack of microelements, vitamins and energy. In children, this leads to a disease called kwashiorkor. This disease is characterized by impaired child development and dystrophic changes in tissues and organs.

In adults, protein deficiency occurs due to excessive enthusiasm for different diets or inattention to the diet.

Symptoms of kwashiorkor disease

At the earliest stage, a sick child experiences irritability or apathy and lethargy. Subsequently, hypotension and muscle dystrophy, growth retardation, and decreased tissue turgor are noted. Hidden and then obvious swelling appears, masking the decrease in body weight. Hyperpigmentation of the skin occurs, and layered peeling occurs in places where the skin rubs against clothing the most. In addition, after desquamation or in areas of previous darkening, depigmentation appears, sometimes taking a generalized form. Hair loses elasticity, thins, and may turn gray, red-orange, or red with streaks of color.

Often, with kwashiorkor, children experience diarrhea, vomiting, anorexia, an enlarged liver, and signs of vitamin deficiency. Immunity drops sharply, causing severe infectious diseases to occur. The function of the central nervous system is impaired; in severe cases, stupor and coma may develop, which can be fatal.

Treatment of protein deficiency

To restore the required level of protein in the body, adults should adjust their diet, which should be varied and balanced. You should include sea fish, eggs, meat, dairy products, as well as greens, fruits, vegetables, legumes and spinach in your diet.

Treatment of children with protein deficiency (kwashiorkor) is carried out in a hospital. Nutrition is adjusted according to the child’s age. The lack of protein is compensated by introducing dairy products, amino acids, and protein amino acids into the diet. The energy value of food and protein content are increased gradually. In the diet of a child with protein deficiency, preference is given to vegetable fats, since they are better absorbed than fats of animal origin. From the first days of treatment, enzyme preparations, vitamins A and B, iron, magnesium, and potassium preparations are used. If there are complications caused by a secondary infection, antibacterial drugs are prescribed. Treatment of diseases that contributed to the development of kwashiorkor is also carried out. Over the course of several weeks from the start of treatment, the child's weight may decrease due to decreased swelling.

Protein deficiency is a pathological condition that occurs as a result of a partial or complete cessation of the intake of proteins into the body. Isolated protein deficiency is rare; most often we are talking about protein-energy malnutrition (PEM), in which, in addition to protein deficiency, there is also insufficient energy supply. Unfortunately, in developing countries this pathological condition is still quite common today, and during periods of famine the prevalence of PEM can reach 25%. Typically, this pathological condition is accompanied by a deficiency of other nutrients (macronutrients), microelements and vitamins.

We are talking about primary protein-energy deficiency in cases where this pathological condition is caused by insufficient intake of animal protein into the body due to socio-economic factors. PEM occurs when there is insufficient quantity and unsatisfactory quality of food, in particular, when plant proteins with low energy value predominate in the diet. In addition, the cause of primary protein deficiency can be exhausting diets and vegetarianism.

Secondary protein-energy malnutrition can result from many factors:

insufficient intake of not only protein, but also other nutrients into the body due to external factors or diseases that prevent normal food intake (narrowing of the esophagus, etc.);
violation of food digestion and absorption of nutrients in the intestines, caused by diseases of the gastrointestinal tract (atrophy of the gastrointestinal tract, etc.);
large protein losses due to increased tissue breakdown or pathological excretion, which are not covered even by increased food intake, in cancer, severe injuries, extensive burns and other similar conditions;
disruption of neuroendocrine regulation.

In developing countries, there are two forms of PEM in children:

Marasmus is a form of protein-energy malnutrition, which is characterized by growth retardation, severe atrophy of muscles and subcutaneous fat, and edema is usually not observed.
Kwashiorkor is an isolated protein deficiency in which growth retardation, swelling, and fatty liver are observed, but the volume of subcutaneous fat is preserved.

Symptoms of protein deficiency

With protein deficiency, the patient's digestive system is disrupted, which can manifest as diarrhea.

Symptoms of mild protein deficiency may be absent or minimal for a long time, and slight weight loss occurs.

With moderate PEM, patients' skin becomes pale, dry, its elasticity decreases, and it becomes cold to the touch. The functioning of the digestive system is disrupted, which is expressed in the form of frequent diarrhea, as a result of which the condition of patients is further aggravated due to the loss of intestinal enzymes. Women experience amenorrhea, and libido decreases in both sexes. People suffering from moderate protein deficiency are irritable and apathetic, their performance is reduced, and cognitive functions (memory, attention) are impaired.

With any degree of protein deficiency, cellular immunity is weakened and susceptibility to infections increases. Patients often develop pneumonia, genitourinary tract infections, and in severe cases even sepsis. Due to the development of infectious diseases and activation of the immune system, even if weakened, appetite decreases, which in turn leads to an even greater loss of muscle mass and a decrease in protein levels in the blood.

Another common sign of PEM is a decrease in fat and muscle mass. When fasting for a month, weight loss was about 25% of the initial body weight, and in children the weight loss was faster. Cachexia is most obvious in areas where there are normally deposits of subcutaneous fat. There is a decrease in muscle mass, bones begin to protrude. Hair thins, becomes dry and falls out. Skin turgor decreases significantly, wounds heal poorly, which often results in secondary infection. Elderly patients have an increased risk of bone fractures, bedsores and trophic ulcers.

The cardiovascular system also suffers, the size of the heart decreases (the heart muscle decreases in volume), cardiac output decreases, as a result of which blood pressure decreases and the pulse slows down. The vital capacity of the lungs decreases, which reduces the intensity of breathing. In severe cases, edema, anemia, and jaundice develop, and the patient may die from liver or cardiovascular failure.

Signs of protein-energy malnutrition in children are similar to those in adults.

With marasmus, children constantly experience a feeling of hunger; first, weight gain stops, then weight loss begins, and growth retardation occurs. The skin becomes flabby, hangs in folds, and bones protrude from under it. There is no swelling.

With kwashiorkor, peripheral edema develops, the abdomen is significantly enlarged in volume, but there is no ascites. The skin of sick children becomes dry, thin, wrinkled, cracks and becomes atrophic. Hair becomes thinner, turns brown or gray, falls out easily and becomes sparse. Sick children are apathetic, but when trying to rouse them, they become irritable and aggressive. Psychomotor development also suffers.

Treatment of protein deficiency

With mild to moderate degrees of protein-energy malnutrition, it is necessary to first eliminate the cause of the development of this condition. Daily protein intake is increased in accordance with ideal body weight, all patients are prescribed multivitamin complexes, and water and electrolyte balance is corrected in order to prevent a lack of potassium and other microelements.

If the patient retains the ability to take and swallow food, then self-feeding is sufficient. If appetite decreases or it is impossible to chew food normally, liquid nutritional mixtures are additionally prescribed for feeding on your own or through a tube. Nutrient mixtures are taken or administered through a tube 1 hour before meals so that the amount of solid food taken is not reduced.

If protein deficiency was complicated by diarrhea and it persists, then it is preferable for patients to be given yogurt-based mixtures rather than milk-based ones, since the body is not yet able to properly process milk proteins.

Severe PEM is treated in hospitals. Patients are prescribed a controlled diet, correction of water-electrolyte imbalances is carried out using infusion therapy, and treatment of infectious diseases. Additional nutrition with mixtures with a high content of nutrients is carried out orally or through a tube. In cases of severe malabsorption (impaired absorption of nutrients in the intestine), patients are prescribed parenteral nutrition. Vitamin therapy is carried out in doses that are 2 times higher than the daily requirement of a healthy person, until recovery.

Medicines that increase appetite are prescribed only to patients with anorexia in cases where the cause of the disease cannot be established. To increase muscle mass, which will help improve the patient’s physical condition, it is possible to use anabolic steroids.

A separate problem is the treatment of elderly patients, especially those living in nursing homes. Such facilities typically contain a large number of patients suffering from mild to moderate protein-energy malnutrition. This is due to the presence of mental disorders in older people, as well as diseases and conditions that interfere with the normal intake and absorption of food. It is necessary to treat depression, diseases of the digestive system, and prescribe appetite stimulants. Some patients require assistance with feeding. In consultation with the doctor, it is possible to temporarily abandon unpalatable therapeutic diets for hypercholesterolemia, etc.

Which doctor should I contact?

Persons with PEM are prescribed multivitamin-mineral complexes.

If there are signs of protein deficiency in the body or a decrease in its content in the blood, you should consult a physician or gastroenterologist. A nutritionist will provide additional assistance. In addition, it is necessary to consult with an endocrinologist and find out if there is a malfunction of the thyroid and pancreas.

Protein is an essential part of any diet, as it helps restore strength after exercise or hard physical work. Foods rich in proteins fill the stomach more quickly, so the feeling of hunger goes away faster. They also play an important role in the restoration, growth and maintenance of muscles in tone. This nutrient is essential for athletes.

Protein is one of the most important components of any healthy diet. This is why adequate protein intake is of great importance - it is considered the key to a healthy and balanced diet. Luckily, this element can be found in a variety of foods we eat every day. The largest amount is found in fish and meat dishes, in fermented milk and legume products, in plant seeds and plants (for example, quinoa), fruits, grains, vegetables and various protein supplements.

The amount of protein the body needs daily is determined by a person's age, activity (lifestyle) and weight. The average norm is 100 grams per day.

Despite the fact that protein is found in many foods, its deficiency is most often observed among older and older people, athletes or those who frequently diet. People who are constantly under stress or recovering from injuries and illnesses will also have a lack of protein.

If you are on a diet or exercise, you need to ensure that the amount of protein consumed per day is normal. But how do you know?

Here are just a few signs indicating protein deficiency in our body:

1. Feeling weak

Weakness and decrepit muscles are the first sign of protein deficiency in the body. When a person does not consume it in the required quantity, the body begins to take protein directly from the muscles: it uses it as fuel and energy. Decreased muscle mass can also slow down your metabolism.

2. The person does not lose weight

Reducing your calorie or protein intake in an attempt to lose weight can have the opposite effect. A slow metabolism caused by a decrease in muscle mass will cause extra pounds.
If a person is trying to lose weight, he should consume more protein. Foods that are less high in calories, but richer in protein, allow you to not feel hungry for a long time. In addition, weight will be lost along with fat, and not due to muscle mass.

3. Frequent illnesses

Protein is an integral part of normal immunity. When a person does not consume enough protein, the body begins to eat stem cells (germ cells), but they help fight infectious or colds. This is what causes frequent illnesses. In such people, even the most ordinary cuts, wounds, and abrasions will take much longer to heal than in people with normal immunity.

4. Hair loss

Protein is an essential component that helps build, repair, or build muscle mass. It is one of the building blocks that make up a cell of a living organism, for example, a cell of hair, nails, skin, muscles, etc. With protein deficiency, the body begins to save energy and protein, and therefore enters a phase of stupor (rest). And this means: slowing down or stopping hair growth. New hair no longer appears in place of lost hair, so it will become sparse and ugly.

5. Aging, peeling skin

Phenomena such as flaking skin or brittle nails are also signs of protein deficiency. Most often, peeling appears on the sides of the thighs and on the butt. And it is caused by a weakening of skin tone, so it becomes more susceptible to allergens.

6. Swelling

When a person does not consume enough protein, he may experience swelling in the lower extremities. This swelling is caused by fluid in the blood vessels.
Lack of protein stimulates the removal of fluid from blood vessels into tissues. If, after pressing on the swelling, the fingerprint remains in the form of a dent, this will be a sign of protein deficiency.

7. Feeling hungry

Naturally, there are many reasons that can explain the constant feeling of hunger, for example, dehydration. But this could also be a sign of protein deficiency. If a person realizes that he is constantly hungry or constantly snacks between main meals, this is a signal from the body about a lack of protein. This means that your diet urgently needs to be replenished with this element. Protein will help restore sugar levels and also increase satiety.

8. Unexplained cravings for sweets

If a person feels hungry and has an irrepressible craving for sweets, he needs to consume more protein-enriched foods. Since protein helps regulate glucose and sugar levels, a lack of it can lead to overeating on sweets. When there is a sufficient amount of protein in dishes, our body stops demanding dessert.

9. Fatigue

If a person constantly does not get enough sleep, is overexerted at work, at home or in the gym, the feeling of fatigue sets in very quickly. However, when fatigue is already felt in the middle, or even at the beginning of the day, a decrease in sugar or protein levels may be to blame. Instead of taking a nap (for many, this option is simply unacceptable), you need to have a snack. Find food enriched with protein - this is what will increase your energy level and relieve fatigue.

10. Absent-mindedness

People who are deficient in protein often suffer from absent-mindedness. Protein does not reach our brain in sufficient quantities, which prevents it from focusing. You should not rely on carbohydrates found in sweets. It's better to add protein to your diet - it will help keep your brain in a good and clear state.

If someone is experiencing these symptoms, they may be due to protein deficiency. Its level can be increased in two ways:
- include foods that contain a lot of protein in your diet;
- drink protein shakes.

To keep your body functioning optimally, make sure it gets the right amount of protein.

Which doctors should you contact if you have protein-energy deficiency?

What is Protein-energy malnutrition?

With insufficient protein and energy intake, lean body mass and the amount of adipose tissue decrease, and one of these changes may be more pronounced.

Protein deficiency is a pathological condition that develops as a result of a reduction or cessation of protein intake into the body. It can also be caused by increased protein breakdown in the body, for example, in case of burn disease, severe trauma, purulent-septic disease.

In developing countries, protein-energy malnutrition is common; during periods of famine its prevalence can reach 25%.

Primary protein-energy malnutrition occurs in cases where socio-economic factors do not allow for sufficient quantity and quality of food - in particular, if mainly plant proteins with low biological value are consumed. The high prevalence of infections also plays a role.

Protein deficiency is aggravated by insufficient energy intake, since in this case the amino acids in food are not used for protein synthesis, but are oxidized to produce energy.

In developing countries, 2 forms of protein-energy malnutrition occur in children - marasmus and kwashiorkor.

Marasmus is characterized by growth retardation, muscle atrophy (due to protein utilization) and subcutaneous tissue; there is no swelling. The disease is caused by insufficient intake of both proteins and energy.

With kwashiorkor (isolated protein deficiency), growth retardation, edema, hypoalbuminemia, and fatty liver are observed. Subcutaneous tissue is preserved.

Mixed forms can occur in both adults and children; the differences between protein-energy malnutrition and isolated protein malnutrition are of little clinical significance.

In developed countries, secondary protein-energy deficiency is most often observed, developing against the background of acute or chronic diseases. The reasons are decreased appetite, increased basal metabolism, malabsorption, alcoholism and drug addiction; in the elderly - depression, loneliness, poverty. In half of hospitalized elderly, exhaustion is already present at the time of admission to the hospital or develops during hospitalization.

Primary and secondary protein-energy malnutrition can be combined. Thus, with insufficient nutrition, the increase in basal metabolism and decrease in appetite characteristic of infections lead to the appearance of clinical signs of exhaustion more quickly than with normal nutritional status.

Isolated protein-energy malnutrition is rare. It is usually accompanied by a deficiency of other food components - folic acid, vitamin B1, vitamin B2 and vitamin B6, nicotinic acid, vitamin A. With protein-energy deficiency in children, vitamin A deficiency is especially dangerous. With the progression of the disease and the utilization of cellular proteins, a loss of intracellular potassium occurs, phosphorus and magnesium, and this loss is proportional to the excretion of nitrogen. Therefore, against the background of restoration of nutritional status, symptoms of deficiency of these substances may appear.

Pathogenesis (what happens?) during Protein-energy malnutrition

The body's adaptation to energy deficiency, in which the calorie intake does not meet the minimum energy requirement, involves hormonal changes. These changes promote the mobilization of free fatty acids from adipose tissue and amino acids from muscle. Gluconeogenesis and amino acid oxidation provide the energy needed for other organs, especially the brain. As a result, protein synthesis decreases, metabolism slows down, lean body mass decreases, and the amount of adipose tissue decreases. In the first week of fasting, weight loss is 4-5 kg (25% is fat tissue, 35% is extracellular fluid, 40% is proteins). Subsequently, weight loss slows down. Different components of the body are utilized at different rates: skeletal muscles - faster than the heart muscle, gastrointestinal organs and the liver - faster than the kidneys. Skeletal muscle proteins are used to synthesize albumin, so hypoalbuminemia develops later.

When eating mainly plant proteins with low biological value, as well as in cases where only glucose solution is used for parenteral nutrition, protein deficiency may develop. At the same time, insulin secretion increases, which inhibits lipolysis and mobilization of skeletal muscle proteins. The level of amino acids in the blood drops, and the synthesis of albumin and other proteins decreases. As a result, hypoalbuminemia, edema and fatty liver disease, characteristic of kwashiorkor, develop.

Mineral deficiency is due in part to weight loss and loss of extracellular fluid. Losses of potassium and magnesium may be disproportionately high due to the mobilization of intracellular stores of these substances. The deficiency is aggravated by insufficient consumption of minerals (for example, parenteral nutrition using only glucose as an energy source) and an increase in their losses (increased diuresis, diarrhea, fistula).

Starvation usually does not lead to rapid death. The body's adaptation to energy deficiency includes meeting the energy needs of the central nervous system through the oxidation of fatty acids and ketone bodies, and slowing down metabolism, which helps preserve protein reserves. Fasting is more dangerous in acute or chronic diseases. They help increase basal metabolism, accelerate weight loss, as well as the loss of nitrogen and essential food components. Whether this effect is due to the immediate metabolic consequences of inflammation, infection, fever and wound healing or is mediated by the action of inflammatory mediators such as FO alpha, IL-2 and IL-6 is not entirely clear.

Thus, severe protein-energy malnutrition develops with insufficient nutrition against the background of acute or chronic diseases. Thus, it is often observed in AIDS (probably due to decreased appetite, fever and diarrhea).

Symptoms of Protein-Energy Malnutrition

Mild to moderate protein-energy malnutrition. Children do not gain weight or height. In adults, weight loss is observed, although with edema or obesity it may not be as noticeable. The thickness of the skin fold over the triceps brachii muscle and the muscle mass in the shoulder area decrease.

In the absence of kidney disease, the ratio of daily creatinine excretion to height (measured weekly) is a sensitive indicator of protein deficiency. The levels of albumin, transferrin and transthyretin (prealbumin) in the blood decrease. T3 levels decrease and reverse T3 levels increase. Metabolism slows down. Lymphopenia and impaired glucose tolerance are possible. The size of the heart is reduced.

Severe protein-energy malnutrition. Severe protein-energy malnutrition is accompanied by more pronounced changes in clinical and laboratory parameters. Physical examination reveals retraction of the intercostal spaces, atrophy of the temporal muscles and atrophy of the muscles of the limbs. Subcutaneous tissue is atrophied or absent. Characterized by apathy, fatigue, feeling of cold, skin depigmentation and hair depigmentation, sharpened facial features; the skin is dry, covered with cracks. In advanced cases, bedsores form and the skin ulcerates. Blood pressure is reduced, as is body temperature, and the pulse is weakened. The functions of all organs and systems are impaired.

Cardiovascular system, respiratory system and kidneys. The ventilatory response to hypoxia is weakened. Heart and kidney mass decreases in accordance with the decrease in lean body mass and slower metabolism, and therefore cardiac output and GFR, although decreased, are still in line with the body's needs. However, with infection, stress, as well as with rapid restoration of blood volume and nutritional status, heart failure is possible.

Blood. BCC, hematocrit, albumin and transferrin levels, as well as the number of lymphocytes in the blood are reduced. Normocytic normochromic anemia develops, usually due to a decrease in erythropoiesis caused by a decrease in protein synthesis. Anemia is aggravated by a deficiency of iron, folic acid and vitamin B6.

Metabolism. Basal metabolism and body temperature are reduced, apparently due to a drop in T3 levels and the loss of the heat-insulating function of the subcutaneous tissue. In the terminal stage, hypoglycemia develops.

Gastrointestinal tract and pancreas. Atrophy of intestinal villi and increased growth of microflora in the small intestine are observed; the exocrine and endocrine functions of the pancreas are disrupted. Malabsorption and lactose intolerance occur. These symptoms may be caused not by fasting itself, but by atrophy of the gastrointestinal tract from inactivity, since similar changes are observed with total parenteral nutrition.

The immune system. Humoral immunity is usually preserved; laboratory tests reveal a violation of cellular immunity. Pneumonia and other infections, including opportunistic ones, often develop.

Wound healing. The healing of wounds (including surgical wounds) is slowed down. The edges of the wound often separate.

Reproductive system. Implantation of the egg, growth and development of the fetus are disrupted. Childbirth occurs with complications, lactation decreases. The newborn has growth retardation; Children who survive may experience cognitive impairment in the future.

Treatment of protein-energy malnutrition

In case of mild to moderate protein-energy deficiency, the possible causes of this condition should be eliminated. The daily intake of proteins and energy is increased (in accordance with the ideal weight) to eliminate their deficiency. All patients are prescribed multivitamins. They also treat and prevent mineral deficiency (including microelements) to prevent life-threatening hypokalemia, hypomagnesemia, hypophosphatemia, etc. If the patient is able to eat and swallow, independent nutrition is sufficient. If there is a decrease in appetite or in the absence of teeth, liquid nutritional mixtures are additionally prescribed for self-feeding or tube feeding.

Severe protein-energy malnutrition requires more urgent intervention. Treatment of such patients is difficult for several reasons:

Diseases that cause protein-energy deficiency are severe and more difficult to treat. Sometimes nitrogen balance can be restored only after the infection has been cured and the fever has resolved.
Protein-energy malnutrition itself can interfere with the cure of the serious disease that caused it. In such cases, it is necessary to start tube or parenteral nutrition as early as possible.
The intake of food through the gastrointestinal tract contributes to diarrhea due to atrophy of the mucous membrane and deficiency of intestinal and pancreatic enzymes. In this case, total parenteral nutrition may be indicated.
The concomitant deficiency of other food components (vitamins, essential minerals, microelements) should be eliminated.

In adults, restoration of nutritional status occurs slowly and not always completely; in children, recovery occurs within 3-4 months. In all cases, educational and rehabilitation programs, as well as psychological and social support measures, are necessary.