Kwashiorkor is a condition that results from the insufficient amount of proteins that the body needs for the conservation of subcutaneous fat. It occurs when there are inadequate proteins in the diet, and mainly common in children between the ages of 1-3 years. It is occasionally known as edematous malnutrition due to its association with the retention of fluid. This disease is common in the regions which experience a shortage of food supply. Children suffering from kwashiorkor typically have emaciated appearance in most of the body parts except in the feet and ankles which experience fluid accumulation.
Role of Nutrition in Preventing Kwashiorkor
Nutrition plays a vital role in the prevention of kwashiorkor among children. Usually, when an individual does not get the required nutrients in the body, malnutrition is likely to occur. Children and the infants are generally at higher risk of getting kwashiorkor because they need more energy and nutrients for their growth and development. Having a balanced diet with sufficient proteins is therefore essential for the prevention of kwashiorkor ( Parrisbalogun, 2012 ). Balanced diets and proper nutrition will always ensure that one consumes enough proteins required by the body. Proteins are a vital nutrient in the body cell and play a significant role in regulating the acid-base balance in the body. Proteins are also essential for the synthesis of the enzymes and hormones as well as in the cell formation and immune system. Nutritionists recommend that a nutritious feeding involves the consumption of between 10%-35% of the daily calories as proteins. This can always help maintain the levels of body proteins that is required or the normal functioning of the body. Anyone child who gets proper nutrition with the recommended protein levels is at no risk of getting kwashiorkor. Foods such as eggs, oatmeal, wheat, peanut butter and canned meat can always provide a right quantity of proteins for the body and help prevent the chances of a child getting kwashiorkor.
Delegate your assignment to our experts and they will do the rest.
Causes of Kwashiorkor
The first primary cause of kwashiorkor is malnutrition that results from lack of proteins or inadequate proteins in the diet. Children who do not feed on enough proteins are more likely to get kwashiorkor. Certain infections such as intestinal parasites, coughs, HIV/AIDS and measles could also increase the chances of one getting kwashiorkor. This is because these infections interfere with the appetite, digestion, absorption, and utilization of nutrients resulting in malnutrition. These infections complicate kwashiorkor and as a result, predispose it to infections. Low-income levels and poverty have been linked with kwashiorkor because of lack of money to purchase nutritious foods. Children who are born with low birth weight are more likely to get predisposed to malnutrition compared to the healthy birth weight (Lee & Yan, 2012). Inadequate of exclusive breastfeeding can also lead to kwashiorkor before a child is one year due to the disposition of the child to recurrent infections.
Children with kwashiorkor always have specific symptoms such as growth retardation, edema, muscle wasting, and changes in the skin, loss of appetite and diarrhea. Poor growth results due to lack of proteins required for metabolism. Proteins are essential for the growth and development of a child as it is useful during metabolism ( Heilskov et al., 2015). Edema results when swelling starts in the feet and moves to other parts of the body. The swelling of the body is usually due to low amount of proteins in the blood. This is known as albumin which is responsible for the normalization of the movement of fluids between the blood vessels and the surrounding body cells. When albumin gets to low levels, there is a movement of more fluids to the neighboring cells making the body to swell. Wasting the muscles also occur due to loss of appetite leading to low food intake and less energy available in the body. In an attempt to provide energy, the muscles get broken down in a process known as gluconeogenesis. This leads to a diminishing of muscles making the child weak and unable to walk. Kwashiorkor is also associated with the changes in the color of the skin to become flaky and cracked. The hair also changes to brown or red and gets soft. Children suffering from kwashiorkor also experience fatigue, weight loss, and damaged immune system.
Diagnosis and Treatment of Kwashiorkor
The diagnosis of kwashiorkor starts by the doctor conducting a physical examination to look for edema or enlarged liver. The physician can also do a blood test to ascertain the levels of proteins in the blood. A battery test can also be done to identify any type of malnutrition that may result in a severe deficiency in the proteins levels. The various tests that can be done include BUN, potassium levels, CBC, Urinalysis, creatinine and arterial blood gases. Once the physician has conducted a diagnosis, the treatment process can begin.
The best treatment for kwashiorkor especially if the disease is diagnosed at an early stage is to eat a healthy and nutritious diet. At this early stage, one can take food that has sufficient proteins and balanced diet to increase the proteins levels in the body. The initial treatment starts by giving the patient carbohydrates, sugars and fats to increase energy levels in the body. Upon the start of the production of energy, the individual is then given foods rich in proteins. This is usually done slowly and gradually as the individual might have taken longer without proper diet.
The treatment of kwashiorkor usually involves both medical treatment and dietary therapy. The treatment of kwashiorkor is usually done in three phases which must be followed strictly. The first phase is the stabilization phase. This is often the initial phase which takes place within the first one week of diagnosis. It primarily involves treatment of the life-threatening infections and conditions dehydration and hypoglycemia ( Eruva, 2017 ). The low glucose levels in the blood can always cause death if not corrected immediately. Hypothermia is also a condition that can be life-threatening to the children with kwashiorkor and must, therefore, be corrected within a few hours of diagnosis. Upon the completion and elimination of all the life-threatening conditions, the treatment then moves to the rehabilitation phase. This phase involves continued treatment by taking a detailed medical history of the disease and thorough examination to identify the exact cause. It also includes continued treatment of the related conditions and infections such as anemia, dermatosis and xeropthalmia. These associated conditions can always be life-risking if not treated early. The final stage of the treatment is the follow up phase ( Coulthard, 2015 ). This phase involves a follow up on the patient to ensure appropriate weight is gained and no further infections exist. Follow up is also accompanied by a dietary therapy where the right diet is recommended for the patient so that the right and nutritious meal is taken.
Recommended Diet for Kwashiorkor Patients
Due to that fact that people with kwashiorkor have for a long time been deprived of nutritionally adequate diet, a nutritionist must plan and monitor the diet of the kwashiorkor patients. The diet should start by a gradual introduction of carbohydrates such as vegetables, fruits, bread, and cereals to provide calories and energy in the body ( Kismul, Van & Lunde, 2014 ). This is then followed by the consumption of foods containing proteins. Examples of foods rich in proteins include meat, fish, eggs, soybeans, and legumes. The dairy products such as milk, yoghurt, and cheese are also rich in proteins and can be recommended for the kwashiorkor patients. A proper diet should be followed strictly to ensure one recover entirely from the disease. Healthy and nutritious diet can always be helpful in bringing one to normal after suffering from kwashiorkor, especially if the diagnosis takes place at early stages.
Nutritional assessment is usually an essential role of the nurses in the healthcare sector. Nutritional assessment is useful in the evaluation of the nutritional status of an individual suffering from kwashiorkor and determines the necessary support to provide. Nurses must understand the needs of the kwashiorkor patients by following clinical guidelines to gain an understanding of the primary cause of the disease. The nurses also play a role in the dietary instructions to the patients by ensuring that the right diet is instructed. Nurses take a series of clinical tests before arriving at the final intervention to use in the treatment of the patient. The tests also involve identification of the presence of associated infections which could be life-threatening to the patients.
The strategies that can be used to enhance adherence to the dietary instructions include providing nutritional therapy to the patient and the family members so that they understand the need to stick to the instructed diet for the better health outcome of the patient. When both the patient and the family members understand the importance of dietary adherence, the chances of compliance is increased. A follow up on the patients’ progress after a given time interval is also essential in ascertaining that there is adherence to the dietary instructions. Follow up can involve taking the weight of the patient after some time interval to see if they have added any weight.
References
Coulthard, M. G. (2015). Letter to the Editor. Paediatrics and International Child Health, 35 (2), 164-164. doi:10.1179/2046904715z.000000000250
Eruva, V. (2017). An Early Diagnosis of Kwashiorkor and Its Successful Treatment in Urban Ludhiana - A Case Report Effective Dietary Counseling Saved Life. Journal of Medical Science and Clinical Research, 05 (04), 21040-21041. doi:10.18535/jmscr/v5i4.204
Heilskov, S., Vestergaard, C., Babirekere, E., Ritz, C., Namusoke, H., Rytter, M., & Deleuran, M. (2015). Characterization and scoring of skin changes in severe acute malnutrition in children between 6 months and 5 years of age. Journal of the European Academy of Dermatology and Venereology , 29 (12), 2463-2469.
Kismul, H., Van den Broeck, J., & Lunde, T. M. (2014). Diet and kwashiorkor: a prospective study from rural DR Congo. PeerJ , 2 , e350.
Lee, L. W., & Yan, A. C. (2012). Skin manifestations of nutritional deficiency disease in children: modern day contexts. International journal of dermatology , 51 (12), 1407-1418.
Parrisbalogun, S. (2012). Kwashiorkor. In Encyclopedia of Immigrant Health (pp. 983-985). Springer New York.
