Starvation
What Is Starvation?
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?Starvation iscomplete stoppage
of eating food by a
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human body.
What Is Total Starvation?
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?Total starvation iscomplete stoppage
of Food and Water.
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Conditions Developing Starvation? Food Scarcity
(Natural Calamities , Draughts Floods and ,Famines)
? Extreme Poverty
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? Lost in Sea routes for long durations? Clinical Conditions: Major Surgeries, Severe Burns.
? Desire to loose rapid weight
? Political Issues: Hunger Strikes
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Features Of Starved Body? No entry of exogenous food constituents
? Body in starvation is deprived of:
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?Calories (Carbs and Lipids)
?Building blocks (Proteins)
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?Growth Factors(Vitamins and Minerals)?Protectors (Antioxidants)
During
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Starvationthe body
is under
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Metabolic Stress
?During Starvation the
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body is in an emergencycondition
?Starved body has to get
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adapted
?And Manage with
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Endogeneous reservestores.
Survival Period During Starvation
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? Survival period during Starvationdepends upon the:
? Reserve Fat stores in Adiposecytes.
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?More content of TAG in Adiposecytes
?More is the duration of survival in
Starvation and vice a versa.
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Length Of Survival In Starvation? Due to deprivation of only Food:
?3 to 4 Weeks
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?Longer up to 65 days
? Deprivation of water alone then
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survival is only for few days?Less than a week
Effects Of Starvation
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OR
Human Body Adaptation In
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StarvationBiochemical Alterations In
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Starvation
During Starvation
? No exogenous Food source ingested
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? Food Nutrients get deprived
? Body is in an emergency condition
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? Metabolic stress is developed? Body manages and adapts to live on
the endogenous fuel stores.
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? Alterations in metabolic/biochemical
processes
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? The biochemical alterations duringStarvation are influenced by hormonal
actions.
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? Glucagon and Epinephrine in starvation
act upon the target organs
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? Stimulate metabolic pathways whichsupply fuels and
? Improve survival phase during
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Starvation.
Different Modes
To Study Biochemical Adaptations
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During Starvation Phases
Study Of Biochemistry Of Starvation
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With Respect To?Stages
?Metabolism
?Organs
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Occurrence OfFour Stages During Starvation
OR
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Metabolic Alterations During
Starvation
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StagesMetabolic Process
First Stage
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Increased Glycogenolysis
Second Stage Increased Gluconeogenesis
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Third StageIncreased Lipolysis/Fatty
acid Beta Oxidation
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Fourth Stage
Increased Ketogenesis
Alternative Adaptations
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In Different
Metabolic Processes
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During StarvationHormonal Alterations In Starvation
? Insulin secretion
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decreased
? Glucagon and Epinephrine
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increasedHormonal Influences In Starvation
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HormoneSource
Change in
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Secretion
Norepinephrine Sympathetic
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Nervous System
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Norepinephrine Adrenal Gland
Epinephrine
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Adrenal GlandThyroid
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Thyroid GlandHormone T4
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(changes to T3
peripherally)
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? When food is in Short supply? Metabolic activity decreases
to spare fuel.
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? Conservation of energy is oneof the basic adaptive
responses to calorie reduction
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? The Hormones influencesthe utilization of
endogenous reserve stores
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and
? Supply fuels to body
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organs during starvationphase.
?Norepinephrine and T3
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participate to
?Decrease in metabolic
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activity when calorie
intake decreases.
Biochemical Adaptations Of
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Carbohydrate Metabolism
During Starvation Phase
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Carbohydrate MetabolismIn Liver During Starvation Phase
? Glycogenolysis Increased
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? Glycogenesis Decreased? Gluconeogenesis Increased
? Glycolysis Decreased
? TCA operation Decreased
? HMP Shunt Decreased
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? Blood Glucose level Decreases (later stages)? Cellular Glucose Deprivation (In Muscle Cells)
?PDH a Multi Enzyme
Complex is inhibited
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during Starvation.
Biochemical Alterations of
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Lipid Metabolism In StarvationLipid Metabolism During Starvation
? Lipolysis is Increased
? Mobilization of Free Fatty acids increased
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? Beta oxidation of Fatty acids increased? Incomplete Fatty acid Oxidation increased
? Ketogenesis Increased
? Ketolysis Decreased
? Ketosis Noted (Ketoacidosis)-Rotheras Test +ve
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? Lipogenesis is Decreased?Enzyme Acetyl Carboxylase
is inhibited during
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Starvation.
Increased Ketogenesis In Starvation
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What Happens? When Ketone body production
Exceeds than the Ketone body Utilization?
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? When?? Cellular Glucose deprivations occurs in
? Uncontrol ed Diabetes
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? Prolonged Starvation? Ketosis
? High levels of Ketone Bodies in blood and urine
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? Ketoacidosis
? Severe ketosis
? Lowered blood pH,
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? Nausea ,Acetone breath? Coma, Death
Cure For Ketosis
? Ketosis Cured by infusion of
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Glucose.
Alterations In Protein Metabolism
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During StarvationDuring Starvation
? Catabolism Of Muscle Proteins
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increased? Transdeamination reaction of
Amino acids is increased
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? To release Glucogenic amino
acids
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? Ammonia Detoxification andUrea production increased
initial y and decreased as
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Starvation phase prolongs.
? Body is in negative Nitrogen
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Balance.? Concentration of Functional
Proteins Decreases.
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Glucose Nitrogen Ratio
Increased In Starvation
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During StarvationAlterations Occur In
Water and Electrolyte
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And
Acid Base Balance
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? Reduction in Body Water? Reduction of Potassium
ions
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? Acidic blood pH due toincreased Ketone bodies
?On prolonged phase of
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Starvation there results?Severe dehydration and
Acid Base imbalance
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Alterations In BMR
?BMR is first affected in
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starvation.?In starvation BMR is
Decreased.
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Biochemical Adaptations By Organs
During Starvation
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The Fasting State:
Glucagon stimulates glucose
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production and release in liver.
Also mobilizes the fatty acids
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(sparing Glucose for the Brain)Differentiation In
Well Fed And Fasting States
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Of Human Body
WELL-FED STATE
FASTING STATE
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Hormones
Insulin
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Glucagon,Adrenaline, Cortisol
Hyperglycemia
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Hypoglycemia
Response of
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GlycogenesisLipolysis
the body
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Lipogenesis
Ketogenesis
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Protein synthesisProteolysis
WELL-FED STATE
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FASTING STATE
Source of
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from stores(Glycogen)
Glucose
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from food
Gluconeogenesis
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Fate ofGlycolysis
Glucose
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formation of Glycogen and
Glycolysis
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TAG storesWELL-FED STATE
FASTING STATE
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Source offrom food TAG
from storage TAG
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Fatty acids
-oxidation
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Fate of Fatty-oxidation
(Incomplete one)
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acids
synthesis of TAG and
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Store as Depot FatKetogenesis
WELL-FED STATE
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FASTING STATE
Source of
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Amino acidsfrom food
From muscle Proteins
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Glucogenic amino
Fate of
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Protein synthesisacids
Amino acids
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Produce Glucose via
Gluconeogenesis
Preferred fuels By Human body
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In the Well-Fed and Fasting States
Organs
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Well-FedFasting
Liver
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Glucose & Fatty
Fatty acids
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acidsResting skeletal
Glucose &
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Fatty acids & KB
Muscle
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Fatty acidsCardiac muscle
Fatty acids
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FA,AA & KB
Adipose tissue
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GlucoseFatty acids
Brain
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Glucose
Glucose ,Later KB
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RBCsGlucose
Glucose
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BIOCHEMICAL PROFILE OF EARLY FASTING STATE
Blood Glucose levels decreases
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65 mg/dlActive Glycogenolysis
Muscle and Liver
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Shift of metabolic fuel from Glucose to fatty
acidsFatty acid mobilization from adipose tissues
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GluconeogenesisGlucose Alanine cycle
BIOCHEMICAL PROFILE OF STARVED STATE
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GLUCOSE levels more decreased40 mg/dL
PROTEIN CATABOLISM increased
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Sequesters Nitrogen as urea
Excretes 20 to 30 grams daily
Gluconeogenesis taking place using precursors as
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Amino acids
Lactate
Glycerol
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KETONE BODIES increasedAcetyl CoA converted to ketone bodies via Ketogenesis
In Prolonged Starvation
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? After 3 days of Starvation -> Liver
forms large amounts of Ketone
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bodies( Due to shortage of Oxaloacetate)
? Ketone Bodies -> released into blood
? Brain and Heart start to use ketone
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bodies as fuel during phase of
Starvation.
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Starvation Of Several Weeks
? After several weeks of starvation ->
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Ketone bodies become major fuel ofBrain
? After depletion of TAG stores
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? Proteins degradation accelerates? Death due to loss of Heart, Liver,
and Kidney function.
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FUEL CHOICE DURING STARVATION1. Insulin
6. Ketone bodies
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5. Fatty acids
2.Glucagon
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nge3 .Glucose
l
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at
i
v
e
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cha
Re
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4. Glycogen24
Hours of Starvation
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Changes Of Liver Glycogen ContentDuring Starvation
? Fuel changes from Glucose to Fatty acids to
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Ketone bodies
Metabolic Response To Fasting
Fasting ? Early Stage
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Muscle
Alanine / Pyruvate
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BrainGlucose
Glutamine
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Glycerol
Gluconeogenesis
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KetogenesisKetones
Fat
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AGL
Liver
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UreagenesisKetones
Urea
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NH3
Kidney
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Fasting ? Late StageMuscle
Alanine / Pyruvate
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Brain
Glucose
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GlutamineGlycerol
Gluconeogenesis
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Fat
Ketogenesis
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KetonesAGL
Liver
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Ureagenesis
Ketones
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UreaNH3
Kidney
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Intestine
Energy Expenditure in Starvation
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12
a
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y)
n
(
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g/d
8
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Normal Rangex
c
r
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et
io
4
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Partial Starvation
N
it
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ro
g
e
n
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ETotal Starvation
0
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10
20
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3040
Days
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Long CL et al. JPEN 1979;3:452-456
Consequences Of Starvation
? Severe Malnutrition
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? Damages and affects vitality of Important Internal Organs
? Decreased BMR
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? Night blindness (Vitamin A deficiency)? Scurvy (Vitamin C deficiency)
? Irregular Menses
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? Constipation
? Low Immunity
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? Bone Loss? Anaemia (Iron and Protein deficiency)
? Fatigue
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? Dehydration
? Water Electrolyte Imbalance
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? High Blood Pressure? Brain Defects
? Death
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Questions
? Explain the different stages of
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starvation & biochemical alterationsin the body during these stages.
OR
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? Biochemical alterations/adaptations
during starvation.
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? Describe the role of followingorgans during various stages of
starvation
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? Liver
? Brain
? Muscles
? Adipose tissues
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