Starvation/Undernutrition Flashcards
in starvation, what levels increase and what levels decrease?
glucose decreases
ketone bodies and fatty acids increase
what 3 pathways happen in the liver during starvation?
- gluconeogenesis to make glucose
- synthesis of ketone bodies
- uptake of FA (HS lipase) and beta oxidation to make ATP
during starvation, the liver is frantically trying to do what
secrete glucose into the blood to match the amount being removed and used by the other cells - this ensures a constant BGL during fasting and prolonged starvation
where are free fatty acids released from?
adipocytes
where are ketone bodies released from?
liver
what is the advantage of forming 3-hydroxybutyrate in the liver?
its formed at high NADH levels - and acetoacetate uses it to make it.
then NAD+ is result which allwos more beta oxidation of FA
what do muscles perfer during fasting?
ketone bodies
no what is needed for ketone body activation?
No ATP is needed! Super efficient!
can the liver use ketone bodies?
no! because it lacks thiophorase (succinyl CoA acetoacetate CoA transferase)
during starvation, what does the brain use?
glucose and ketone bodies
important in “protein sparing effect” - the lvier can now use less aa from muscle protein degadation for gluconeogenesis - because it doens’t need to make it for the brain since it like ketone bodies too!
what happens to the urea cycle during fasting
it slows down
what are the metabolic adjustments of prolonged starvation?
use ketone bodies
reduce muscle degradation
reduce metabolic rate
reduce physical activity
kidney does gluconeogenesis with the liver
the amount of body fat will determint he ultimate survival time related to energy needs
what metabolic fuel is most abundant at the beginning of the fast?
FAT stores
what stores get depleted after one day of fasting?
liver glycogen stores
what are the deleterious effects of prolonged starvation?
loss of body fat and muscle mass vit/mineral déficiences reduced enzyme activites atrophy of intestine diarrhea, skin rashes, edema, heart failuer hypothermia
what is protein energy malnutrition (PEM)?
leads to variable clinical conditions with extreme forms, including patients with major trauma, depressed immune system, elderly and children
marasmus
Kwashiorkor
Marasmic Kwashiorkor
what is marasmus?
protein-calorie malnutrition, energy deficinecy is predominant
chronic dietary restriction of carbs, lipids, protein and others
What is Kwashiorkor?
protein malnutrition is predominant, despite of adequate intake of carbs
deficiency of protein and essential aa
what is Marasmic Kwashiorkor?
most severe form of PEM
what are symptoms of marasmus?
tissue and muscle wasting (emaciation)
dry skin, loos skin folds over butt
drastic
how do children look with marasmus?
severely starved
show less than 80% of standard weight
what is marasmus associated with in adults?
anorexia nervosa
GI cancer
chronic illness
+ old age…
what are anorexia affects on the body?
brain and nerves: bad memory, fatigue heat: low BP, palpitation Blood: anemia muscles: weak joints: swollen Kidneys: kidney stones, kidney failure body fluids: low minerals like potassium, mg, Na intestine: consipation hormones: loss of menstrual cycle
what is beri beri due to a deficiency of?
thiamine, B1
