Inadequate intake of nutrients and energy with food (partial or complete starvation) leads to the development of a pathological condition of the body, which is designated in the International Classification of Diseases and Causes of Death of the 10th revision (ICD-10) as protein-energy malnutrition (PEM).

In the medical literature, there are other terms in relation to this disease: alimentary dystrophy, malnutrition, substrate-energy deficiency, cachexia.

The term PEU does not quite accurately reflect the essence of the problem, since along with protein and energy deficiencies, as a rule, there is a lack of other nutrients (vitamins, minerals, fats, carbohydrates).

However, other terms cannot be considered successful either: the concept of "

Causes of protein-energy malnutrition.

Both past and present, malnutrition in most cases has social causes. These include extreme conditions (a striking example is the blockade of Leningrad), protest forms of starvation, poverty. A number of diseases also contribute to the development of PEU..

The main causes of protein-energy malnutrition:.

Inadequate intake of nutrients:.

a) socio-economic, religious and other reasons;

b) iatrogenic causes (hospitalization, starvation due to examinations, hospital diets, dietary restrictions for various diseases, irrational artificial nutrition);

c) psychoneuroendocrine disorders with suppression of appetite and perversion of eating behavior (anorexia nervosa, psychoses);

d) mechanical disorders of oral food intake: gastrointestinal obstruction, dental disorders, dysphagia;

Digestion and/or absorption disorders of nutrients: maldigestion and malabsorption syndromes.

Hypercatabolic states:.

a) conditions in which cytokines are released that accelerate catabolism, oncological diseases, fever, infections;

b) endocrine diseases with impaired anabolism and accelerated catabolism (hyperthyroidism, diabetes mellitus).

Increased nutrient loss (disorders associated with the loss of protein and other nutrients) nephrotic syndrome, chronic obstructive pulmonary disease, intestinal fistulas, exudative enteropathy, plasmorrhea in burn disease, desquamative dermatitis.

Increased need for nutrients:.

a) physiological conditions (pregnancy, lactation, childhood and adolescence);

b) pathological conditions (period of convalescence after injuries and acute infectious diseases, postoperative period).

Ingestion of nutrient antagonists: alcoholism, poisoning with vitamin antagonists and drugs.

Prevalence of protein-energy malnutrition.

According to FAO/WHO estimates, at least 400 million children and 0.5 billion adults were starving on the planet at the end of the 20th century.. Their number has increased by a quarter in 15 years, and the proportion of undernourished children in the world has increased in the late 90s.

Fish consumption in Russia for the period from 1987 to 1998. decreased by 2/3; meat, poultry and sugar - by 1/2; sausages, margarine and butter - 1/3.

Selective studies of the nutrition of the Russian population have shown that about 25% of the surveyed are malnourished, and 80% have a deficiency of vitamins and microelements..

PEU is one of the main problems of patients in therapeutic and surgical hospitals. Numerous studies have shown that more than 50% of patients admitted for treatment suffer from protein-energy deficiency and severe hypovitaminosis (especially deficiency of folic acid, vitamins B2 and C).

medbe. en.