PROTEIN ENERGY MALNUTRITION University of 蛋白质能量营养不良大学.pptVIP

PROTEIN ENERGY MALNUTRITION Abdelaziz Elamin MD, PhD, FRCPCH Professor of Child Health College of Medicine Sultan Qaboos University Muscat, Oman azizmin@ HUMAN NUTRITION Nutrients are substances that are crucial for human life, growth well-being. Macronutrients (carbohydrates, lipids, proteins water) are needed for energy and cell multiplication repair. Micronutrients are trace elements vitamins, which are essential for metabolic processes. HUMAN NUTRITION/2 Obesity under-nutrition are the 2 ends of the spectrum of malnutrition. A healthy diet provides a balanced nutrients that satisfy the metabolic needs of the body without excess or shortage. Dietary requirements of children vary according to age, sex development. Assessment of Nutr status Direct Clinical Anthropometric Dietary Laboratory Indirect Health statistics Ecological variables Clinical Assessment Useful in severe forms of PEM Based on thorough physical examination for features of PEM vitamin deficiencies. Focuses on skin, eye, hair, mouth bones. Chronic illnesses goiter to be excluded Clinical Assessment/2 ADVANTAGES Fast Easy to perform Inexpensive Non-invasive LIMITATIONS Did not detect early cases Trained staff needed ANTHROPOMETRY Objective with high specificity sensitivity Measuring Ht, Wt, MAC, HC, skin fold thickness, waist hip ratio BMI Reading are numerical gradable on standard growth charts Non-expensive need minimal training ANTHROPOMETRY/2 LIMITATIONS Inter-observers’ errors in measurement Limited nutritional diagnosis Problems with reference standards Arbitrary statistical cut-off levels for abnormality LAB ASSESSMENT Biochemical Serum proteins, creatinine/hydroxyproline Hematological CBC, iron, vitamin levels Microbiology Parasites/infection DIETARY ASSESSMENT Breast complementary feeding details 24 hr dietary recall Home visits Calculation of protein Calorie content of children foods. Feeding technique food habits OVERVIEW OF PEM The majority of world’s children live i