The Other Side of Protein

Abstract

As outlined by McLaren (1974) and Newman (1995), kwashiorkor was first clearly recognized and formally named in the early to mid-1930s by Williams (1933, 1935), a British medical officer in the Gold Coast (now Ghana). Williams made a convincing argument that the disease occurred in young children who were weaned early and put on a maize-based diet that was deficient in protein. And time has shown her to be correct. Problems arose after World War II, however, not from questions about Cicely Williams’ original diagnosis of kwashiorkor, but from two influential reports, one by Brock and Autret (1952) published through the UN’s World Health Organization (WHO), the other by Trowell et al. (1954). In an oft-quoted statement, Brock and Autret (1952), representing the position of WHO, maintained that kwashiorkor, or protein malnutrition as it came to be called, was the principal source of childhood malnutrition throughout the world: kwashiorkor “is the most serious and widespread nutritional disorder known to medical and nutritional science” (Brock and Autret 1952; quoted in McLaren 1974:93 and Schürch 1995:2255S). Only since the 1970s has protein malnutrition come to be seen as a comparatively rare deficiency syndrome which is now subsumed under the much more inclusive rubric of “protein-calorie” or “protein-energy” malnutrition (PCM or PEM). In other words, as it turns out inadequate protein intake is seldom the root cause of childhood malnutrition. The cause is usually the result of inadequate overall food intake, compounded by pathogens and other factors often associated with poverty and unsanitary living conditions.