Starvation .

Starvation is a severe deficiency in caloric energy  intake, below the level needed to maintain an organism's life.

1. Starvation

2. contents Introduction Kwashiorkor Causes Medical reasons Circumstantial causes The main causes of starvation Sign and symptoms Changes in carbohydrate metabolism Changes in fat metabolism Changes in protein metabolism Changes in water and mineral metabolisms Prevention Treatment Reference

3. kwashiorkor

4. Causes

5. Anorexia nervosa Bulimia nervosa Eating disorder, not otherwise specified Celiac disease Coma Major depressive disorder Diabetes mellitus Digestive disease Constant vomiting Medical reasons

6. Child/ Elder/ Dependent Abuse Famine– for any reason, such as political strife and war Excessive fasting Poverty Circumstantial causes

7. Economy Food scarcity in the society Diseases that can cause rapid weight loss The person may also be the host to a parasite such as an intestinal worm Clinical conditions, such as recovering from surgery or burns, etc The main causes of starvation

8. impulsivity Irritability Hyperactivity Atrophy (wasting away) of the stomach weakens the perception of hunger. starvation lose substantial  fat (adipose tissue) and muscle mass as the body breaks down these tissues for energy Sign and symptoms

9. Catabolysis Fatigue interaction with the surrounding world diminishes In females, menstruation ceases when the body fat percentage is too low to support a fetus. Victims of starvation are often too weak to sense thirst, and therefore become  dehydrated All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration

10. Fungi Vitamin deficiency - anemia, beriberi, pellagra, and  scurvy diarrhea, skin rashes, edema, and heart failure medical study estimates that in adults complete starvation leads to death within 8 to 12 weeks individual has lost about 30% of their normal body weight

11. Changes in carbohydrate metabolism An important function of liver is to act as a blood glucose buffering organ A couple of days of fasting rapidly uses up tissue glycogen . Hypoglycemia depress insulin secretion but enhances secretion of glucagon adrenaline and glucocorticoids key gluconeogenesis enzymes enhance gluconeogenesis and glycogenolysis and maintain the liver and muscle glycogen and the blood sugar, though at a subnormal level

12. Gluconeogenesis from proteins is considerable in the liver and kidneys in the first few weeks, but continues later at a reduced rate mainly in kidneys . Hepatic glycogenesis - consequence of hypoglycemia Lipogenesis - decline in insulin secretion These factors save some blood sugar for supply to the extrahepatic tissue.

13. Changes in fat metabolism During starvation enhanced secretions of glucocorticoids, glucagon, and adrenaline hormone sensitive lipase of the adipose tissue mobilize large amounts of fatty acids from adipose tissue to the liver for oxidation.

14. Ketosis results enhanced beta oxidation and a failure to oxidize the acetyl CoA Fatty acid synthesis is reduced elevated plasma levels of long chain fatty acids inhibit acetyl CoA carboxylase R educe the outflow of mitochondrial citrate for cytoplasmic Lipogenesis while the decline in insulin secretion prevents the induction of NADPH generating malic enzyme and glucose 6 phosphate dehydrogenase

15. Lipoprotein lipase activity declines in the adipose tissue, but rises in cardiac and skeletal muscles. Muscles start using fatty acids as their principal energy source has no stored glycogen so it uses significant amounts of ketone bodies from about the 5 th day of starvation Starvation ketosis is more pronounced in females than in males, and in children than in adults. Ketosis and ketonuria produce acidosis and enhance urinary ammonia pulmonary ventilation and CO2 elimination.

16. Changes in protein metabolism Negative N balance results from increased protein catabolism for gluconeogesis and energy production Breakdown tissue proteins lowers the body protein by more than 25% and the resulting decrease in the cell mass reduces the intracellular fluid volume Intestine, liver, spleen, heart and muscles atrophy considerably due to protein catabolism

17. . Intestinal atrophy severely restricts digestion and absorption Atrophic changes of the heart lower the cardiac output to produce hypertension and circulatory failure . Increased protein catabolism lowers the secretion of insulin, thyroxin and gonadotropins, and causes failures of reproduction and lactation. Urinary NPN and urea are reduced while neutral sulfur and uric acid are increased in urine

18. Changes in water and mineral metabolisms On prolonged starvation, extensive cellular distengration lowers the intracellular K+,total body K+ and the intracellular fluid volume . Extracellular fluid (ECF) is reduced in the first few days due to increased water loss , Low serum albumin contributes to the production of edema Glomerular filtration is reduced and metabolic water is elevated

19. prevention consists of ensuring they eat plenty of food, varied enough to provide a nutritionally complete diet The Rome Declaration on World Food Security outlines several policies aimed at increasing food security and, consequently, preventing starvation. Poverty reduction Prevention of  wars and  political instability Food aid Agricultural sustainability Reduction of economic inequality Prevention

20. Rest and warmth must be provided and maintained Small sips of water mixed with glucose should be given in regular intervals Fruit juices can also be given . food can be given gradually in small quantities Proteins may be administered intravenously to raise the level of serum proteins Treatment

21. K Vijayakumaran Nair Andp I Paul, Functional Zoology, Acadamica , Jawahar Nagar, Thiruvananthapuram Patrica Truman, Nutritional Biochemistry.M,i.J Publishers, Chennai. Debajyothi Das, Biochemistry, 13 th Edition. B Sreelakshmi Dietetics, 7 th Edition, New Age International Publishers R eference

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