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]

Classification

Protein energy malnutrition (PEM) is a spectrum of conditions ranging from growth failure to overt marasmus or kwashiorkor. There are various classifications of PEM;

• Gomez classification
• IAP classification
• NCHS (WHO) classification
• Waterlow's classification
• Wellcome's classification

The wellcome's classification is described here;

• Parameter: weight for age +/- edema
• Reference standard (50th percentile)
• Grades:
  • 80-60% without edema is underweight
  • 80-60% with edema is kwashiorkor
  • <60% with edema is Marasmus-Kwashiorkor
  • <60% without edema is Marasmus