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Physiology of starvation
Definition
Causes of starvation
Effects of complete starvation
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Physiology of starvation
Definition of starvation:
It is complete absence of food intake ,
except for water.
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Physiology of starvation
Causes of starvation
1- Decreased availability of food as in famines
and poverty.
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Physiology of starvation
Causes of starvation
2- Refusal of food intake either due to
psychological causes as anorexia nervosa orvoluntary starvation.
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Physiology of starvation
Causes of starvation
3- Gastrointestinal causes as malabsorption
syndrome and cancer esophagus.
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Physiology of starvationEffects of complete starvation
1- Depletion of food stores in the body tissues.
0.1 Kg glycogen
0.4 Kg glycogen
12 Kg fat
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Effects of complete starvation
When fat stores are used up, tissue proteinsbecome the only
remaining source of energy and are rapidly catabolized.
During the first day of starvation, glycogen stores in the liver andmuscles are totally consumed
After glycogen depletion, fat & easily mobilizable proteins are used
for energy production. (gluconeogenesis, maintained blood glucose)
After all the easily mobilizable proteins are used, neutral fatbecomes
the only source of energy. (Ketosis, decreased blood glucose)
DEATH
50% tissue proteins
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Effects of complete starvation
1- Depletion of food stores in the body tissues.
Weeks of starvation
protein
fat
carbohydrate
Q
uantitiesoffoo
dstuffs(Kg)
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Effects of complete starvation
2- Vitamin deficiency
After a week, mild vitamin deficiencies usually begin
especially the water soluble vitamins (vit B and C)
After several weeks, severe deficiencies can occurwhich add to the debility leading to death.
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Effects of complete starvation
3- Gradual weight loss
The individual loses about 1 Kg/day for the first 10
days, then, 0.3 Kg /day afterwards.
Body organs also decrease in size ; the liver, the
kidneys, the heart and the gastrointestinal tract,except for thebrain ,which is spared.
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Effects of complete starvation
4- Decreased activity of both endocrine and exocrine
glands
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Effects of complete starvation
5- Decreased BMR and body temperature.
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Effects of complete starvation
6- Depressed cardiovascular functions
bradycardia,
decreased cardiac output,
lowered arterial blood pressure and postural
hypotension.
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Effects of complete starvation
7- CNS manifestations
Depressed mental functions
Increased sleeping hours.
Psychological disturbances
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Effects of complete starvation
8- GIT manifestations
Hunger pains occur but disappear after 2-3
days
Atrophy of the intestine and decreased
digestive secretions
Diarrhea.
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Effects of complete starvation
9- Blood changes
Blood glucose concentration is kept near the fastinglevel by gluconeogenesis
Decreased RBC count, hemoglobin content and
packed cell volume
Hypoproteinemia, which causes edema.
Starvation lipaemia due to fat mobilization.
Ketosis
Decreased alkali reserve as it is used to buffer the
ketoacids.
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Effects of complete starvation
The urine volume and specific gravity depend on the amount ofwater intake.
Ketinuria which lowers the pH of urine.
Decreased urea and uric acid excretion.
10- Urinary changes
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Effects of complete starvation
11- Edema
Due to:
hypoproteinemia.
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Effects of complete starvation
12- Death
usually occurs about 60 days from thestart of starvation.
The terminal event isintractable diarrhea.
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1. The starving person is given frequent small feeds ofskimmed milkor yogurt. Then, moderate amounts offats, vitamins and semisolid foods are gradually added.
2. In severely ill patients who refuse to eat, nasogastric orparentral feeding may be considered.
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QUESTIONSQUESTIONS
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11-- If a normal person is completelyIf a normal person is completely
deprived of food, the followingdeprived of food, the following
effects will resulteffects will result EXCEPTEXCEPT::
a)a) Ketosis andKetosis and ketonuriaketonuria
b)b) Increased secretion of epinephrine andIncreased secretion of epinephrine andnorepinephrinenorepinephrine
c)c) hypoproteinemiahypoproteinemia
d)d)vitamin deficiencies especially vitaminvitamin deficiencies especially vitaminB and C.B and C.
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22-- As starvation progresses all of theAs starvation progresses all of the
following is truefollowing is true EXCEPTEXCEPT::
a)a) Edema may occur.Edema may occur.
b)b) Signs of vitamins B and C deficiencySigns of vitamins B and C deficiencyappear.appear.
c)c) The amount of alkali reserve isThe amount of alkali reserve is
increased.increased.d)d)The hemoglobin content and packedThe hemoglobin content and packed
cell volume are decreasedcell volume are decreased
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33-- If a normal person is completelyIf a normal person is completely
deprived of food, glycogen stores willdeprived of food, glycogen stores will
be depleted afterbe depleted after
a)a) 1212 hourshours
b)b) One dayOne dayc)c) One weekOne week
d)d) One monthOne month
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44-- The most abundant amount ofThe most abundant amount of
glycogen is stored in the :glycogen is stored in the :
a)a) HeartHeart
b)b) LiverLiverc)c) Skeletal musclesSkeletal muscles
d)d) BrainBrain
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55-- AfterAfter 33 days of completedays of complete
starvation, blood sugar level isstarvation, blood sugar level is
maintained near fasting values by:maintained near fasting values by:
a)a) Catabolism of muscle and liver glycogenCatabolism of muscle and liver glycogen
into glu
cos
einto glu
cos
eb)b) Synthesis of glucose from easilySynthesis of glucose from easily
mobilizablamobilizabla proteins byproteins by gluconeogenesisgluconeogenesis
c)c) Oxidation of neutral fat stores in adiposeOxidation of neutral fat stores in adiposetissuetissue
d)d) Catabolism of tissue proteinsCatabolism of tissue proteins
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66--Tissue proteins areTissue proteins are catabolisedcatabolised andand
used as a source of energy only if:used as a source of energy only if:
a)a) All muscle glycogen is depletedAll muscle glycogen is depleted
b)b)All liver glycogen is depletedAll liver glycogen is depletedc)c) All easilyAll easily mobilizablemobilizable proteins andproteins and
neutral fat are depletedneutral fat are depleted
d)d) Blood glucose level is decreased.Blood glucose level is decreased.
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77-- During complete starvation,During complete starvation,
cardiovascular changes include thecardiovascular changes include the
following:following:
a)a) Postural hypotensionPostural hypotension
b)b) BradycardiaBradycardia..c)c) Decreased cardiac outputDecreased cardiac output
d)d)All of the aboveAll of the above
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88-- If a normal person is completelyIf a normal person is completely
deprived of food for one week, he willdeprived of food for one week, he will
suffer from:suffer from:
a)a) Severe constipation.Severe constipation.
b)b) Decreased sleeping hours.Decreased sleeping hours.c)c) Decreased basal metabolic rate.Decreased basal metabolic rate.
d)d)Weight loss by aboutWeight loss by about 00..11Kg/dayKg/day
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99-- During complete starvation forDuring complete starvation for
one week, the following change inone week, the following change in
the blood will result :the blood will result :
a)a) alkalosisalkalosis
b)b) Increased RBCs countIncreased RBCs countc)c) HyperproteinemiaHyperproteinemia
d)d) HyperlipidemiaHyperlipidemia
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1010-- The following conditions mayThe following conditions may
cause starvation EXCEPT:cause starvation EXCEPT:
a)a) FaminesFamines
b)b)Anorexia nervosa.Anorexia nervosa.c)c) MalabsorptionMalabsorption syndromesyndrome
d)d) Cancer colon.Cancer colon.
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Put true or false:Put true or false:
11-- during complete starvation, weight ofduring complete starvation, weight of
the brain tissu
e iskept relativelythe brain ti
ssue i
skept relativelyconstant.constant.
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Put true or false:Put true or false:
22--The easilyThe easily mobilizablemobilizable proteins areproteins are
depleted veryslowlydepleted very
slowly
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Put true or false:Put true or false:
33--The brain tissue cant utilizeThe brain tissue cant utilize ketoneketone
bodies
as
asource of energy.bodie
sas
asource of energy.
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Put true or false:Put true or false:
44-- Hunger painsusually disappear afterHunger painsusually disappear after 22--33
days
ofstarvation.day
sof
starvation.
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Put true or false:Put true or false:
55-- Severe diarrhea is a common cause ofSevere diarrhea is a common cause of
death in cases
of completestarvation.death in ca
ses
of completestarvation.
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Put true or false:Put true or false:
66-- Duringstarvation, weight loss is initiallyDuringstarvation, weight loss is initiallyslow, then increa
ses
afterwards.
slow, then increa
ses
afterwards.
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DOAA SAMY
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