Kwashiorkor, a form of malnutrition, is caused by the deficiency of

The correct answer is D, Proteins. Kwashiorkor is caused by a severe lack of protein in the diet, even when the child gets some calories from starchy food. It usually strikes children aged one to five after they stop breastfeeding and are fed mostly rice, maize or cassava. The tell-tale signs are a swollen belly and puffy legs due to fluid retention (oedema), a moon face, peeling skin, thin reddish hair and poor growth. The word comes from Ghana and is often explained as the sickness of the older child pushed off the breast when a new baby arrives. Its cousin marasmus comes from a lack of both protein and calories and leaves the child wasted, with no swelling. A is wrong, because mineral shortages cause other diseases, such as anaemia from lack of iron and goitre from lack of iodine. B is wrong, because vitamin deficiencies cause scurvy, rickets and night blindness, not kwashiorkor. C is wrong, because a lack of fat is not what causes kwashiorkor. Exam tip: kwashiorkor, protein only, swollen belly; marasmus, protein and calories, wasting.