Protein energy malnutrition: problems and priorities.

Protein energy malnutrition and infection are largely responsible for the very high postneonatal and toddler mortality ratios of developing countries. Availability of food is just one environmental factor in the aetiology of protein energy malnutrition--many others such as size at birth, infection and culture play a role. Diet needs as careful prescription as any other form of therapy, but in the severely malnourished child it is only one aspect of management; care is necessary to avoid or detect 6 complications: hypothermia, hypoglycaemia, encephalopathy, intractable diarrhoea, cardiac failure, and infection. Prevention should be incorporated within the child health services as a whole and delivered with them; however central government, and the food industry from farming to retailing, play an at least as important role as health care professionals.