Kwashiorkor and marasmus describe particular kinds of malnutrition. In the case of kwashiorkor, children experience acute protein-calorie malnutrition. In other words they are not getting enough protein in their diet which they would use to build and restore tissue in the body.
This then leads to ‘edema’ which is the accumulation of fluids in the tissue and particularly the feet (pedal edema) and legs leading to swelling in those areas. Distension of the stomach is also commonly observed. Here the children will not necessarily lose weight, because the fluid counterbalances that lost in fat and muscle tissue – they may then look fat or swollen despite their malnutrition.
In marasmus the children develop thinness but not oedema and the causes are not entirely understood. In some cases it is possible to experience elements of both (marasmic-kwashiorkor). Kwashiorkor and marasmus are both potentially life threatening conditions and require feeding programmes promptly to restore their health.
There are more differences and distinctions between kwashiorkor and marasmus. Both are caused by a lack of protein calories, but kwashiorkor will seldom appear before six months as the baby is being breastfed, while marasmus can. In kwashiorkor the hair of the child will be discolored whereas in the case of marasmus it is just dry and dull. In marasmus the skin of the child also becomes thin and wrinkled and loses elasticity, while in kwashiorkor lesions are visible. Marasmus leads to a more extensive impairment of biological functions when compared to kwashiorkor. In short a child with marasmus will look emaciated, while a child with kwashiorkor will look bloated.
Both marasmus and kwashiorkor are most commonly observed in third world countries where access to food is scarce. Most people will have seen pictures of starving individuals who will either look distended and bloated or emaciated. However marasmus is more common than kwashiorkor in dry climates as they will also usually lack fluids.
In the case of any protein calorie malnutrition the body will lack amino acids which are the carbon compounds it uses to rebuild tissue. We as humans are made from carbon and we get this from the protein in our diet – primarily in the form of meat but also to an extent in plants and vegetation. Our skin, muscle and flesh all deteriorate overtime due to use and free radicals and this is a perfectly natural occurrence. However normally the body will then be able to repair this damage by providing those parts of the body with the amino acids required to rebuild that tissue and this will enable the body to maintain itself. However where the body does not have access to these amino acids, the degeneration will not be able to be repaired and this will cause the muscles and the fat to gradually waste away without being rejuvenated. Not only will this result in the wasting of the muscles, but it will also cause the deterioration of the skin, teeth, nails and hair which become dried out and flaky.
Other problems will also occur due to the deterioration of the body as a whole and the degradation of the major organs. If the body has a lack of carbohydrates and calories in general, then the deterioration will be more rapid as the body will turn to the protein stored as muscle and organs and burn this in order to create the energy needed. Eventual other problems include infections, dehydration, circulation issues and more which are all often lethal. Once the body gets to the point where the machinery for protein synthesis has been destroyed it reaches a ‘point of no return’ where attempts to restore the body at all are futile.