Flashcards in Starvation/Undernutrition Deck (39):
in starvation, what levels increase and what levels decrease?
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?
where are ketone bodies released from?
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?
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?
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
reduced enzyme activites
atrophy of intestine
diarrhea, skin rashes, edema, heart failuer
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
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
how do children look with marasmus?
show less than 80% of standard weight
what is marasmus associated with in adults?
+ old age...
what are anorexia affects on the body?
brain and nerves: bad memory, fatigue
heat: low BP, palpitation
Kidneys: kidney stones, kidney failure
body fluids: low minerals like potassium, mg, Na
hormones: loss of menstrual cycle
what is beri beri due to a deficiency of?
what is cheilosis due to a deficiency of?
what is pellagra due to a deficiency of?
what is scurvy due to a deficiency of?
what is microcytic anemia due to a deficiency of?
vit. B6 + iron + copper
what is macrocytic anemia due to a deficiency of?
vit. B12 + folic acid
what is reduced blood clotting due to a deficiency of?
what is reduced response to infections due to a deficiency of?
iron + selenium + zinc
what is poor wound healing due to a deficiency of?
what is night blindness due to a deficiency of?
what is rickets/osteomalacia due to a deficiency of?
vit. D, sunlight
what are foods with optimal protein scores?
mis of plant food can lead to optimal score too
what are symptoms of Kwashiorkor?
muscle wasting due to lack of aa, stunted growth
decreased blood albumin
edema in belly and legs
how can patients look with Kwashiorkor?
could look well nourished or obese becasue of edema
what does Kwashiorkor decrease the ability of the body to do?
decreased ability to make digestive enzymes and new intestinal epithelial cells