Recovery of endocrine and inflammatory mediators following an extended energy deficit.

CONTEXT: Due to current operational requirements, elite soldiers deploy quickly after completing arduous training courses. Therefore, it is imperative that endocrine and inflammatory mediators have fully recovered. OBJECTIVE: Our objective was to determine whether a short-term (2-6 wk) recovery period was sufficient to restore endocrine and inflammatory homeostasis after sustained energy deficit. DESIGN: Before and immediately after the course, serum concentrations of inflammatory and endocrine markers were taken along with anthropometric measures prior to and immediately after the Army Ranger course. In addition, nine soldiers were assessed between 2 and 6 weeks after the course. SETTING: This research occurred in a field setting during an intensive 8-week military training course characterized by high-energy expenditure, energy restriction, and sleep deprivation (U.S. Army Ranger School). PARTICIPANTS: Twenty-three male soldiers (23.0 ± 2.8 y; 177.6 ± 7.9 cm; 81.0 ± 9.6 kg, 16.8 ± 3.9% body fat) participated in this study. INTERVENTIONS: There were no interventions used in this research. OUTCOME MEASURES AND RESULTS: Significant changes occurred in circulating total testosterone (-70%), brain-derived neurotrophic factor (-33%), total IGF-1 (-38.7%), free IGF-1 (-41%), IGF binding protein (IGFBP-6; -23.4%), sex-hormone binding globulin (+46%), thyroid stimulating hormone (+85%), IGFBP-1 (+534.4%), IGFBP-2 (+98.3%), IGFBP-3 (+14.7%), IL-4 (+135%), IL-6 (+217%), and IL-8 (+101%). Significant changes in body mass (-8%), bicep (-14%), forearm (-5%), thigh (-7%), and calf (-2%) circumferences, sum of skinfolds (-52%), and percentage body fat (-54%). All anthropometric, inflammatory, and hormonal values, except T3, were restored to baseline levels within 2-6 weeks after the course. CONCLUSIONS: Endocrine markers and anthropometric measures were degraded, and inflammatory mediators increased after an extended energy deficit. A short-term recovery of 2-6 weeks was sufficient to restore these mediators.

Anorexia nervosa: a rogue hibernation?

Anorexia nervosa is a puzzling and often tragic disorder which causes the individual to self starve and hyper-exercise. We present a speculative analysis of the disorder which begins by acknowledging and accepting the adaptation to flee famine theory. This theory holds that anorexia nervosa results from activation of an archaic pathway that functioned well during human's nomadic past. We advance this idea by suggesting that the faulty signal indicating there is a famine, arises from misalignment of the circadian/circannual oscillations. Entry and exit from hibernation is dependent on these cycles, and we draw an analogy between hibernation and anorexia nervosa. We offer ideas for testing the hypothesis, and targeting these faulty signals.

[Physiological basis of survival and rehabilitation of the residents of blockaded Leningrad].

The authors attribute survival of certain residents of blockaded Leningrad under conditions ofcomplete starvation to activation of natural sanologic mechanisms of the body. Physiological psychoemotional stress is supposed to contribute to the formation of prerequisites for survival during subsequent starvation. Also, the survival is believed to be related to selected activation of apoptosis of renewable cells and utilization of their constituents in endogenous nutrition. The role of priority energetic and trophic support of brain and kidneys and the contribution of the psychosomatic factor are postulated. The mechanisms of rehabilitation after upset of vital activity involve partial reversibility of atrophic and metabolic processes and neural regulation of organs and their systems. The importance of the study of activation of natural sanologic mechanisms in extreme conditions is discussed

[Evolution and follow-up of hunger strikers: experience from an interregional hospital secured unit]. / Évolution et surveillance des patients grévistes de la faim : expérience d'une unité hospitalière sécurisée interrégionale.

PURPOSE: A hunger strike is a voluntary fast, performed to protest publicly against an issue deemed unfair. In the case of French prisoners, hospitalization in an interregional hospital secured units (UHSI) may be necessary. METHODS: A retrospective epidemiological study based on one UHSI medical records was performed on the period of May, 2006 to December, 2008, and focused on symptoms, outcomes and ethical problems encountered. RESULTS: Seven men and one woman with a mean age of 32.6 years were hospitalized in an UHSI, with nine episodes of hunger strike of a median duration of 57 days. Clinical symptoms began after two weeks of voluntary deprivation in the form of dizziness, weakness, muscle pain and headache. Laboratory tests showed hypoglycemia (<0.4g/L) on admission, 16.3% decrease of albumin after 40.5 days, and dehydration in case of thirst strike. The clinical tolerance was good and no patient presented Wernicke's encephalopathy. A diabetic patient developed acidocetosis during two hunger strikes. All hunger strikes were respected by medical staff, and treatment was based upon surveillance of symptoms, vitamin B and sweetened drinks administration and explanations of the clinical hazards on a daily basis. CONCLUSION: The special problem encountered in the medical management of these strikers was to convince them to accept treatments in order to avoid a coercive life-saving treatment as requested by French law.

Bibliographical note on behavioral aspects: on the margin of the 50th anniversary of the Minnesota Starvation-Nutritional Rehabilitation experiment.

The principal technical aim of this note is to bring together bibliographic information on the papers dealing with the behavioral aspects of the study and published both before and, in particular, after the appearance in print of the two-volume treatise on The Biology of Human Starvation by Keys, et al. in 1950, which provides a systematic, comprehensive account. The communications fall into three categories: methods, results, and overviews. The section on results is concerned primarily with the effects on personality.

Malnutrition and mortality during recent famines in Ethiopia: implications for food aid and rehabilitation.

The 1972-73 and 1984-85 famines varied significantly among different populations within famine areas at the regional, community and household levels. Political and social factors were crucial in this pattern. Evidence from both pastoral and farming areas indicates that the development of community-based resources may be less disruptive socially and economically and result in less morbidity and mortality than dependence on relief shelters. Areas needing further study are identified.

Starvation in the modern world.

PIP: Nutritionists, including those involved in famine relief, have learned in the last 25 years that certain deficiency diseases arise from the high protein foods used to rehabilitate starving populations. Other, sometimes inappropriate relief foods starving populations. Other, sometimes inappropriate relief foods include unprocessed or inappropriate grains and unfortified dry skimmed milk. Yet, relief workers do not always receive the most appropriate food for distribution to certain populations. Millions of dollars are appropriated to protect relief supplies for starving people in Somalia, but money is not spent to develop and evaluate simple foods that might save the lives of starving people. There are several items relief agencies and governments should consider when deciding on the most appropriate foods to prevent starvation in famine situations. During kwashiorkor, intestinal mucous produce grossly defective cells, resulting in considerable lactose malabsorption. Thus, using milk to rehabilitate people, especially children, poses a considerable hazard. High carbohydrate diets to rehabilitate starving people can cause gross edema and fatal congestive heart failure. Generally, clinically apparent vitamin or mineral deficiencies do not occur during famines, because the amount of vitamins or minerals needed to small to maintain a very shrunken body. Yet, when the body demand increases as a result of a rehabilitation diet poor in vitamins and minerals but high in protein or calories, clinical deficiency symptoms emerge, e.g., pellagra in Mozambique. Common food combinations used in relief situations consists of corn, soy, and milk fortified with vitamins and minerals (Bal'ahar mixture, India). Both mixtures require the addition of vegetable oils to make it easier for infants and small children to digest the mixtures.^ieng

[Intracellular regeneration of neurons in the rat lateral hypothalamic area of the brain after resumption of food intake]. / Vnutrikletochnaia regeneratsiia v neironakh lateral'noi gipotalamicheskoi oblasti mozga krys posle vozobnovleniia priema pishchi.

Electron microscopy was used to explore changes in intracellular regeneration processes in neurons of the anterior, medial and posterior parts of the lateral hypothalamus area (LHA) of rats at various time (10, 20, 30, 50 and 70 days) after resumption of food perception. Ultrastructural changes observed during 7 days of food deprivation in intact neurons were of a reversible character. Recovery processes initially appeared and finished earlier in the neurons of medial (day 30) and anterior (day 50) parts of the LHA, in the posterior part of LHA the normalization of the neuronal structure was slower and was over only by the 70th day after the resumption of food reception. The above data are both of theoretical and practical importance, serving as a base for the study of directed treatment of diseases caused by hunger.

[Metabolism and nutritional status in plane crash situations without food reserves or with low-calorie rations]. / Obmen veshchestv i pishchevoi status pri nakhozhdenii v avariinykh usloviiakh bez zapasov pishchi ili s malokaloriinym ratsionom.

The comparative study of the metabolism and nutritional status of test subjects who 3-5 days were in a contingency situation with no or low-caloric (300 g chocolate) food available demonstrated the advantage of even this inadequate diet as compared to no food.