Kwashiorkor is a severe form of protein energy malnutrition seen in children. It typically occurs when the diet provides enough carbohydrates and fats for energy but is seriously deficient in which key nutrient?

Introduction / Context:
Kwashiorkor is a well known protein energy malnutrition disorder that affects children, especially in areas where diets are heavily based on starchy staples but low in good quality protein. It is characterized by oedema (swelling), an enlarged fatty liver, skin and hair changes, and growth failure. Understanding the dietary cause of kwashiorkor is important for public health, nutrition, and paediatrics. This question asks you to identify the specific nutritional imbalance that leads to kwashiorkor.

Given Data / Assumptions:

• The disease mentioned is kwashiorkor in children.
• We must identify which dietary pattern causes this condition.
• Options describe different combinations of sufficient or deficient carbohydrates, fats, proteins, and vitamins.
• We assume basic knowledge of macronutrients and their roles.

Concept / Approach:
Kwashiorkor occurs when a child's diet supplies adequate energy from carbohydrates and fats but lacks sufficient protein. This means that calories may be enough, so the child does not appear extremely wasted, but the body does not receive the amino acids needed for growth, tissue repair, and synthesis of important proteins like albumin. Low serum albumin leads to oedema, so kwashiorkor often presents with swelling of feet, legs, and face, giving an appearance of being “puffy” rather than thin. In contrast, marasmus occurs when there is severe deficiency of both energy and protein, resulting in extreme wasting.

Step-by-Step Solution:
Step 1: Recall that kwashiorkor is specifically associated with protein deficiency, not just general starvation. Step 2: Note that in kwashiorkor, energy from carbohydrates and fats may still be adequate or near adequate. Step 3: Look for an option that describes a diet with sufficient carbohydrates and fats but a deficiency of protein. Step 4: Compare the options and identify the one that fits this pattern exactly. Step 5: Select “enough carbohydrates and fats but deficient proteins in the diet” as the correct description.

Verification / Alternative check:
You can imagine a child whose diet consists mainly of cereal gruels or starchy roots with very little milk, pulses, or animal protein. Such a diet may supply calories, so the child is not completely starved, but there is not enough protein to maintain blood protein levels. Medical descriptions of kwashiorkor always mention oedema, fatty liver, irritability, and sometimes loss of hair pigment. These symptoms are classic for protein deficiency rather than simple calorie deficiency. This comparison confirms that the key problem is lack of dietary protein despite the presence of carbohydrates and fats.

Why Other Options Are Wrong:
Enough carbohydrates but less fats in the daily diet: A shortage of fat alone does not cause kwashiorkor. The critical deficiency is protein, not fat. Enough vitamins but deficient fats in the food intake: Again, fat deficiency and vitamin sufficiency do not describe the typical kwashiorkor situation. Enough fats but deficient vitamins in the diet: Lack of vitamins leads to specific deficiency diseases but not the classical picture of kwashiorkor. Enough proteins but deficient mineral salts in the diet: Mineral deficiencies cause other problems such as anaemia or bone disorders, but kwashiorkor is driven by lack of protein.

Common Pitfalls:
Students may confuse kwashiorkor and marasmus because both are protein energy malnutrition disorders. The key difference is that marasmus involves overall deficiency of calories and protein leading to extreme wasting, while kwashiorkor usually involves relatively adequate energy intake but severe protein deficiency leading to oedema and fatty liver. Remembering that kwashiorkor can occur even when the child receives enough carbohydrate rich food but very little protein helps to choose the correct option in exam questions.

Final Answer:
Thus, kwashiorkor disease in children is caused by Enough carbohydrates and fats but deficient proteins in the diet.