Definition PEM is manifested primarily by inadequate dietary intakes of protein and energy. PEM is almost always accompanied by deficiencies of other nutrient PEM can be divided as primary pem and secondary pEMDefinition ➢ PEM is manifested primarily by inadequate dietary intakes of protein and energy. ➢ PEM is almost always accompanied by deficiencies of other nutrient. ➢ PEM can be divided as primary PEM and secondary PEM