Category Archives: Nutrition


Deficiencies due to inadequate intake are commonly seen in the developing countries accompanying PEM. This is not, however, invariable, e.g. vitamin A deficiency is never seen in Jamaica, but is common in PEM in Hyderabad. In the Western World, deficiency of vitamins is rare except in the specific groups shown. The widespread use of vitamins as ‘tonics’ is unnecessary and should be discouraged. T


This is not always practicable. ANAEMIA due to folate, iron and copper deficiency is often present, but the haematocrit may be high owing to dehydration. ELECTROLYTE DISTURBANCES are common. BLOOD should be examined for malarial parasites and the stools for pathogens. CHEST X-RAY. Tuberculosis is common and is easily missed if a chest X-ray is not performed. TREATMENT Treatment must involve the provISIon of pro


In many areas of the world, many people border on malnutrition. In addition, if events such as drought, war or changes in political climate occur, millions suffer from starvation. Although the basic condition of PEM is the same in all parts of the world from whatever cause, malnutrition due to long periods of near-total starvation produces unique clinical appearances in children virtually never seen in the W

Dietary requirements

ENERGY Food is necessary to provide the body with energy. The oxidation of carbohydrate, fat and protein  eventually leads to the generation of high energy bonds in AIP, which is then used for all energy requirements. In addition to providing energy, some of these oxidative products are utilized to generate the carbohydrates, fats and proteins of which the body is composed. Energy balance Energy balance is th

Water and electrolyte balance

Water and electrolyte balance is dealt with fully in Chapter 10. Approximately 1 litre of water per day is required in the diet to balance insensible losses, but much more is usually drunk, the kidneys being able to excrete large quantities. The daily RNI for sodium is 70 mmol (1.6 g) but daily sodium intake varies in the range of 90- 440 mmol (2-10 g). These are needlessly high intakes which are thought by


Introduction  In developed countries, excess food is available and the commonest nutritional problem is obesity. In the developing countries, lack of food and poor usage of the available food results in protein–energy malnutrition (PEM). Diet and disease are interrelated in many ways. Exces senergy intake, particularly when high in animal (saturated) fat content, is thought to be responsible for a numb