Protein Calorie Malnutrition (PCM) or Protein Energy Malnutrition (PEM) is one of the most widespread nutritional deficiency diseases in our country and poses a health problem in children below five years of age. This paper explains the clinical features of this malnutrition including kwashiorkor, marasmus and marasmic kwashiorkor. It also describes the biochemical changes including protein, carbohydrate, fat, water and electrolyte metabolisms, hormonal changes, hematological changes, pathological changes and changes in mental development occurring during protein calorie malnutrition. It also gives an idea about the measures which could be adopted for preventing this nutritional syndrome.
PEM is exacerbated in cirrhotic patients by accompanying anorexia and malabsorption. Aggressive nutrition support is often needed to meet increased energy and protein requirements in order to attenuate catabolism and PEM.
Dietary intervention commences with appropriate assessment of the patient's muscle status and not simply body weight. The latter may be affected by ascites and/or edema, and does not differentiate between fat and muscle stores. Normal weight or obesity may mask PEM, as normal or excessive fat stores can be present in such patients. The patient's requirements will need to be calculated and met, orally, nasoenterally or intravenously. Protein-Calorie Malnutrition (PCM) refers to a nutritional status in which reduced availability of nutrients leads to changes in body composition and function . Disease-associated malnutrition is a common problem among patients with cancer, affecting more than 50% of patients with certain cancers (e.g., pancreas, esophageal, gastrointestinal, and head and neck cancers). Acute and chronic inflammation play a major role in the pathogenesis of cancer-related malnutrition. Altered nutritional status may be due to increased nutrient requirements of the tumor, changes in host metabolism induced by tumor or due to side effects of aggressive anti-cancer therapies.