Protein energy malnutrition classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Protein energy malnutrition may be classified according to the 'Gomez classification' based on weight for age, or the 'Water low classification' based on stunting and wasting, or the 'Welcome classification' based on the presence or absence of edema.

Classification

Definitions of general terms that are used in the classification of protein-energy malnutrition include the following:

Terminology Meaning
Undrweight Underweight for one’s age (Weight for age )
Stunted Too short for one’s age (Height for age )
Wasted Dangerously thin (Weight for height )
Micronutrient malnutrition Deficient in vitamins and minerals (Hidden Hunger )

The three different classification schemes of protein-energy malnutrition are described below:[1][2]

Gomez classification

Grade of PEM Weigh for age (%)
Normal 90-100
Mild malnutrition, Grade I 75-89
Moderate malnutrition, Grade II 60-74
Severe malnutrition, Grade III Less than 60

Water low's classification

Grade of PEM Stunting

(low height for age)

Wasting

(low weight for height)

Normal 95 90
Mild malnutrition 87.5-95 80-90
Moderate malnutrition 80-87.5 70-80
Severe malnutrition Less than 80 Less than 70

Welcome's classification

Weight for age With edema Without edema
60-80% Kwashiorkor Undernutrition
<60% Marasmic kwashiorkor Marasmus

References

  1. Bhattacharyya AK (1986). "Protein-energy malnutrition (Kwashiorkor-Marasmus syndrome): terminology, classification and evolution". World Rev Nutr Diet. 47: 80–133. PMID 3088855.
  2. Waterlow JC (1976). "Classification and definition of protein-energy malnutrition". Monogr Ser World Health Organ (62): 530–55. PMID 824854.

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