starvation and maluntrition *clinical nutrition and health

starvation and maluntrition *clinical nutrition and health Case Study example
Case Study
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Metabolic Adaptations during Starvation The Cuban poet Pedro Luis Boitel had been on a hunger strike for 53 days. He died of starvation. When somebody is starving, several metabolic adaptations and changes occur to preserve functioning of vital organs. An understanding of various metabolic pathways related to functioning of the body during various phases of starvation is essential to understand the survival crux of the Cuban poet for 53 days.


Glycogen is mobilized mainly from liver. Other storage sites for glycogen are muscles and skin. Boitel would have initially sustained on blood glucose levels maintained through these mechanisms. Glucagon stimulates breakdown of glycogen and causes inhibition of glycogen synthesis by triggering the cascade of cyclic AMP. This ultimately leads to phosphorylation and activation of the enzyme phosphorylase. Glucagon then causes inhibition of the enzyme glycogen synthetase. This prevents synthesis of glycogen and its storage into muscle and liver. Glucagon also causes inhibition of the synthesis of fatty acids by diminishing pyruvate production and by decreasing the activity of acetyl CoA carboxylase (Berg, 2002). This, it does by keeping it in unphosphorylated state. All this is aimed to mobilize glycogen and decrease conversion of glucose in the blood to glycogen so that the glucose levels in the blood are maintained in adequate ranges for functioning of vital organs like brain and heart which, at this stage are still dependent on glucose alone for energy. Glycogen releases glucose-6-phosphate and this is hydrolyzed to release large amounts of glucose. Liver is the main source of glycogen in this context in a starvation patient like Boitel. ...
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