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

1. •Ashwathi Govind

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

4. 
kwashiorkor

5. 
poverty.
imbalance between energy
intake and energy expenditure
Causes

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

7. 
 Child/ Elder/ Dependent Abuse
 Famine– for any reason, such as political strife and
war
 Excessive fasting
 Poverty
Circumstantial causes

8. 
 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

9. 
 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

10.  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

11.  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

12. 
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

13. 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.

14. 
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.

15.  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
 Reduce 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

16.  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 5th 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.

17. 
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

18.  . 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

19. 
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

20.  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

21. 
 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

22. 
 K Vijayakumaran Nair Andp I Paul, Functional
Zoology, Acadamica, Jawahar Nagar,
Thiruvananthapuram
 Patrica Truman, Nutritional Biochemistry.M,i.J
Publishers, Chennai.
 Debajyothi Das, Biochemistry, 13th Edition.
 B Sreelakshmi Dietetics, 7th Edition, New Age
International Publishers
Reference