┌───────────────────────┐ │ Etiology of PEM │ └───────────┬───────────┘ │ ┌────────────────────────┴────────────────────────┐ ▼ ▼ ┌─────────────────────────┐ ┌─────────────────────────┐ │ Socioeconomic │ │ Clinical/Secondary │ │ (Primary Causes) │ │ (Secondary Causes) │ └────────────┬────────────┘ └────────────┬────────────┘ ├─ Poverty & Food Insecurity ├─ Malabsorption (e.g., IBD) ├─ Over-Diluted Infant Formula ├─ Hypermetabolism (e.g., Cancer) └─ Famine & Political Instability └─ Recurrent Pediatric Infections Socioeconomic and Environmental Drivers
This is a critical slide for clinical practice. Divide into two phases:
: Restricts access to nutrient-dense foods, forcing reliance on low-protein, carbohydrate-heavy staples.
: Severe protein deficiency with relatively adequate calorie intake [15, 20].
Gradually increase calorie and protein intake.
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