Starvation- Wikipedia

This article is about extreme malnutrition. For other uses, see Starvation (disambiguation).

This article appears to contradict the article Malnutrition. Please see discussion on the linked talk page. Please do not remove this message until the contradictions are resolved.

Starvation
Classification and external resources
A girl during the Nigerian-Biafran war of the late 1960s, shown suffering the effects of severe hunger and malnutrition.
ICD-10	T73.0
ICD-9	994.2
DiseasesDB	12415

Starved Vietnamese man, who was deprived of food in a Viet Cong prison camp.

Starvation is a severe deficiency in caloric energy, nutrient and vitamin intake. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage^[1] and eventually, death. The term inanition refers to the symptoms and effects of starvation.

According to the World Health Organization, hunger is the single gravest threat to the world's public health.^[2] The WHO also states that malnutrition is by far the biggest contributor to child mortality, present in half of all cases.^[2] Six million children die of hunger every year.^[3]Figures on actual starvation are difficult to come by, but according to the FAO, the less severe condition of undernourishment currently affects about 925 million people, or about 14% of the world population.^[4]

The bloated stomach, as seen in the picture to the right, represents a form of malnutrition called kwashiorkor which is caused by protein deficiency combined with inadequate caloric consumption.^[5] Children are more vulnerable to kwashiorkor whose advanced symptoms include weight loss and muscle wasting.^[5] It is quite common to depict a thin child with a bloated stomach as starving, but in reality, such child is malnourished.

Contents   [hide]  1 Common causes 2 Signs and symptoms 3 Biochemistry 4 Efforts 4.1 Treatment 4.2 Prevention 4.3 Organizations 5 Starvation statistics 6 As capital punishment 7 See also 8 References 8.1 External links

[edit]Common causes

The basic cause of starvation is an imbalance between energy intake and energy expenditure. In other words, the body expends more energy than it takes in as something. This imbalance can arise from one or more medical conditions and/or circumstantial situations, which can include:

Medical reasons

• Anorexia nervosa
• Bulimia nervosa
• Coeliac Disease
• Coma
• Major depressive disorder
• Diabetes mellitus
• Digestive disease
• Constant vomiting

Circumstantial causes

• Famine – for any reason, such as political strife and war.
• Fasting – done without proper medical supervision.
• Poverty

Main causes of starvation: (i)The most common cause for starvation is economy; poor people cannot buy enough food stuffs and so, fail to fulfil the caloric demands of the body. (ii)Starvation may be due to food scarcity in the society. This causes decreased supply of food to the whole of the population, and thus mass starvation may occur. (iii)Starvation may be due to diseases that can cause rapid weight loss either due to the nature of the disease or the inability of the person to either eat or eat enough due to symptoms including by not limited to: fatigue, nausea or vomiting. The person may also be the host to a parasite such as an intestinal worm which may take a significant amount of the calories ingested by its host. This effect is exacerbated if the human host is already ingesting far less food than is required to meet their daily caloric intake needs. (iv)There are some clinical conditions such as recovering from surgery or burns etc., in which the person may be too fatigued or incapacitated to eat enough during their period of convalescence.

[edit]Signs and symptoms

Individuals experiencing starvation lose substantial fat (adipose) and muscle mass as the body breaks down these tissues for energy. Catabolysis is the process of a body breaking down its own muscles and other tissues in order to keep vital systems such as the nervous system and heart muscle (myocardium) functioning. Vitamin deficiency is a common result of starvation, often leading to anemia, beriberi, pellagra, and scurvy. These diseases collectively can also cause diarrhea, skin rashes, edema, and heart failure. Individuals are often irritable and lethargic as a result.

Early symptoms include impulsivity, irritability, hyperactivity and other symptoms. Atrophy (wasting away) of the stomach weakens the perception of hunger, since the perception is controlled by the percentage of the stomach that is empty. Victims of starvation are often too weak to sense thirst, and therefore become dehydrated.

Starving Russian girl during theRussian famine of 1921

All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration. With a weakened body, diseases are commonplace. Fungi, for example, often grow under the esophagus, making swallowing unbearably painful.

The energy deficiency inherent in starvation causes fatigue and renders the victim more apathetic over time. As the starving person becomes too weak to move or even eat, their interaction with the surrounding world diminishes.

There is also an inability to fight diseases, and in females, irregular menstruation can occur.

[edit]Biochemistry

When food intake ceases, the body enters the starvation response^{[citation needed]}. Initially, the body's glycogen stores are used up in about 24 hours.^{[citation needed]} The level of insulin in circulation is low and the level of glucagon is very high. The main means of energy production is lipolysis.Gluconeogenesis converts glycerol into glucose and the Cori cycle converts lactate into usable glucose. Two systems of energy enter the gluconeogenesis: proteolysis provides alanine and lactate produced from pyruvate, while acetyl CoA produces dissolved nutrients (Ketone bodies), which can be detected in urine and are used by the brain as a source of energy.

In terms of insulin resistance, starvation conditions make more glucose available to the brain.

[edit]Efforts

[edit]Treatment

Starving patients can be treated, but this must be done cautiously to avoid refeeding syndrome.^[6] 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. Later, food can be given gradually in small quantities. The quantity of food can be increased overtime. Proteins may be administered intravenously to raise the level of serum proteins.^[7]

[edit]Prevention

See also: Food security

For the individual, prevention consists of ensuring they eat plenty of food, varied enough to provide a nutritionally complete diet. Short of sitting in front of a potentially starving person and offering him or her food, addressing societal mechanisms by which people are denied access to food is a more complicated matter.

Supporting farmers in areas of food insecurity through such measures as free or subsidized fertilizers and seeds increases food harvest and reduces food prices.^[8]

[edit]Organizations

Main article: Famine relief

Many organizations have been highly effective at reducing starvation in different regions. Aid agencies give direct assistance to individuals, while political organizations pressure political leaders to enact more macro-scale policies that will reduce famine and provide aid.

[edit]Starvation statistics

Main articles: Malnutrition and Hunger

According to estimates by the FAO there were 925 million under- or malnourished people in the world in 2010.^[9] This was a decrease from an estimate of 1023 million malnourished people in 2009.^[10] In 2007, 923 million people were reported as being undernourished, an increase of 80 million since 1990-92.^[11] It has also been recorded that the world already produces enough food to support the world's population.

As the definitions of starving and malnourished people are different, the number of starving people is different from that of malnourished. Generally, much fewer people are starving, than are malnourished. The numbers here may provide some indication, but should not be quoted as a number of starving people.

The share of malnourished and of starving people in the world has been more or less continually decreasing for at least several centuries.^[12] This is due to an increasing supply of foodand to overall gains in economic efficiency. In 40 years, the share of malnourished people in the developing world has been more than halved. The share of starving people has decreased even faster. This improvement is expected to continue in the future.

Year	1970	1980	1990	2005	2007	2009
Share of undernourished people in the developing world[10][13][14]	37 %	28 %	20 %	16 %	17 %	16 %

[edit]

See also

2007-2008 world food price crisis Anorexia mirabilis Anorexia nervosa Norman Borlaug Celiac Disease Cachexia Dehydration Global Hunger Index Famine

Famine response Famine scales Fasting Food security Hunger Hunger strike Kwashiorkor List of famines

List of people who died of starvation Malnutrition Marasmus Muselmann Overpopulation Poverty Refeeding syndrome Santhara

[edit]References

1. ^ Disease-Related Malnutrition: An Evidence-Based Approach to Treatment "When [food] intake is poor or absent for a long time (weeks), weight loss is associated with organ failure and death."
2. ^ ^a b Malnutrition The Starvelings
3. ^ "U.N. chief: Hunger kills 17,000 kids daily". CNN. 17 November 2009.
4. ^ FAO: The State of Food Insecurity in the World
5. ^ ^a b http://www.bettermedicine.com/article/kwashiorkor
6. ^ Mehanna HM, Moledina J, Travis J (June 2008)."Refeeding syndrome: what it is, and how to prevent and treat it". BMJ 336 (7659): 1495–8.doi:10.1136/bmj.a301. PMC 2440847.PMID 18583681.
7. ^ "The Physiology and Treatment of Starvation". US national library of medicine. Retrieved 17 August 2012.
8. ^ Ending Famine, Simply by Ignoring the Experts
9. ^ FAO:Hunger
10. ^ ^a b The State of Food Insecurity in the World, 2010: Addressing Food Insecurity in Protracted Crises
11. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 2. “FAO’s most recent estimates put the number of hungry people at 923 million in 2007, an increase of more than 80 million since the 1990–92 base period.”.
12. ^ Fogel, RW (2004). The escape from hunger and premature death, 1700-2100: Europe, America, and the Third World. Cambridge: Cambridge University Press.
13. ^ Food and Agriculture Organization Agricultural and Development Economics Division. “The State of Food Insecurity in the World, 2006 : Eradicating world hunger – taking stock ten years after the World Food Summit”.Food and Agriculture Organization of the United Nations, 2006, p. 8. “Because of population growth, the very small decrease in the number of hungry people has nevertheless resulted in a reduction in the proportion of undernourished people in the developing countries by 3 percentage points – from 20 percent in 1990–92 to 17 percent in 2001–03. (…) the prevalence of undernourishment declined by 9 percent (from 37 percent to 28 percent) between 1969–71 and 1979–81 and by a further 8 percentage points (to 20 percent) between 1979–81 and 1990–92.”.
14. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 6. “Good progress in reducing the share of hungry people in the developing world had been achieved – down from almost 20 percent in 1990–92 to less than 18 percent in 1995–97 and just above 16 percent in 2003–05. The estimates show that rising food prices have thrown that progress into reverse, with the proportion of undernourished people worldwide moving back towards 17 percent.”.