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The severe forms of infantile undernutrition common in much of the world appear only seldom in the United States. Two clinical forms may be distinguished. The first involves a general deprivation of energy (calories), which results in general growth failure and a wasting of muscle, skin, and subcutaneous tissues, and is called "marasmus." The second occurs at varying levels of caloric intake when protein intake is relatively deficient and is now called "kwashiorkor." In uncomplicated situations of deficiency, this means that net protein intake falls below about 7% or 8% of ingested (and absorbed) calories. Classically, this condition develops when an infant comes off of breast feeding (often because of the birth of a sibling) and goes on a diet adequate in calories mostly from a cereal food (corn or rice) and starches. Sometimes an infant converts his protein-calorie deficiency from marasmus to kwashiorkor because the catabolic effects of a
FINBERG L. Kwashiorkor. Am J Dis Child. 1975;129(6):665. doi:10.1001/archpedi.1975.02120430005002