A Syndrome of Early Protein-Calorie Malnutrition

P ROTEIN-CALORIE malnutrition is the most common nutritional disorder of early childhood, particularly in developing areas and among deprived populations. Although many different synergistic factors may influ-ence its occurrence and manifestations, the basic problem appears to be dietary-ingestion of insufficient protein of good quality to meet requirements of growth, resistance and repair, and a low or disproportionately high intake of calories from carbohydrate 12 For many years research efforts have focused primarily on the most serious forms of protein-calorie malnutrition, particularly kwashiorkor and nutritional marasmus. Representing one end of the clinical spectrum, these advanced major syndromes with their high mortality rates have overshadowed interest in the mild forms which, by comparison, are so incon-spicuous and ill-defined that they are easily overlooked and frequently ignored. Dietary lack of protein, however, is a far greater prob-lem than prevalence figures for the full-blown syndromes suggest. Even a slight deficiency of protein intake during the first three years o life when growth demands are high may lead to precarious nutritional imbalance, and i