As a Physician on a Mission to Treat Patients in SubSaharan

As a physician on a mission to treat patients in subSaharan Africa you encounter numerous children with a common cluster of signs and symptoms. These include chronic diarrhea, dizziness, fatigue, delayed wound healing, and muscle wasting. Given the constellation of symptoms in your patients, you make a diagnosis of marasmus. Which of the following is the principal cause of the observed symptoms?

A) adequate carbohydrate and fat but lack of protein
B) adequate caloric intake but a lack of essential fatty acids
C) adequate protein but deficiency in carbohydrate and fat
D) high concentration of total protein causing kidney failure
E) total caloric intake of protein, carbohydrate, and fat far below necessary needs for growth