Extreme form of protein-calorie undernutrition resulting from severe deficiencies in both proteins and calories/energy; in an advanced state in children there is a ravenous appetite, chronic diarrhea, failure to thrive (especially, a failure of both hyperplasia and hypertrophy of brain tissue), apathy, los of muscle tonus resulting in edema with a marked swollen appearance, and finally death. Aka marasmic kwashiorkor.