Asia, Developing motor skills in preschool age America, the Near East and Africa. Energy deficiency is the major cause.
Failure to grow adequately is the first and most important manifestation of PEM. It often results from consuming too little food, especially energy, and is frequently aggravated by infections. A child who manifests growth failure may be shorter in length or height or lighter in weight than expected for a child of his or her age, or may be thinner than expected for height. If any one of these is absent, PEM is a likely outcome. The term protein-energy malnutrition entered the medical literature fairly recently, but the condition has been known for many years. The term PEM is used to describe a broad array of clinical conditions ranging from the mild to the serious. It has been known for centuries that grossly inadequate food intake during famine and food shortages leads to weight loss and wasting and eventually to death from starvation.