Breastfeeding duration, weaning practices, and daily caloric intake.

Skeletal muscle is broken down to provide amino acids for gluconeogenesis and hepatic protein synthesis.

Reflects chronic malnutrition and long-term growth retardation.

This system integrates the presence or absence of nutritional edema: Weight-for-Age (%) With Edema Without Edema Kwashiorkor Undernutrition < 60% Marasmic-Kwashiorkor WHO Classification (Z-Scores)

The prevention of PEM is critical, particularly in areas where the condition is common. Some of the prevention strategies for PEM include:

Edema (swelling, particularly in the belly and legs), sparse hair, skin lesions, and a fatty liver.