ABSTRACT
This chapter discusses the energy balance and abnormal energy states. The long-term consequences of famine, starvation-refeeding, food restriction and longevity, and the effects of trauma on energy balance, voluntary starvation, or reduced food intake and pica will also be discussed. If weight is lost, the individual is in negative energy balance, while if weight is gained, the individual is in positive energy balance. Comparing the 1971 NHANES data on food consumption to those from the 2006 survey showed an increase in total energy intake with the carbohydrate kcalories contributing more to this increase than fat or protein kcalories. Starvation is the extreme state of malnutrition that occurs when the individual is provided little or no food to nourish the body. Chronic malnutrition is characterized not only by a negative energy balance but also by deficits in the protein intake and the intake of micronutrients. Unless this additional energy and protein are provided, weight loss will occur.
