ABSTRACT
Physiology of Food Restriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284 Clinical Findings Associated with Food Restriction . . . . . . . . . . . . . . . . . . 285 Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Assess for Malnutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 Treat Electrolyte and Nutritional Imbalances . . . . . . . . . . . . . . . . . . . . 289 Take Steps to Prevent Refeeding Syndrome . . . . . . . . . . . . . . . . . . . . . 290 Monitor Laboratory Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Abnormal Fluid Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 Altered Glucose Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 Vitamin B1 (Thiamine) Deficiency . . . . . . . . . . . . . . . . . . . . . . . . 292 Hypophosphatemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 Hypomagnesemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293 Hypokalemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294 Hypocalcemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294 Hepatic Steatosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Establish Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294 Treat Related Musculoskeletal Conditions . . . . . . . . . . . . . . . . . . . . . . 295
The Malnutrition-Obesity Connection . . . . . . . . . . . . . . . . . . . . . 295 Loss of Lean Tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
Life-long Osteoporosis Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296 Malnutrition Can Affect the Next Generation . . . . . . . . . . . . . . . . . . . . . . . 297 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Starvation is the result of a serious or total lack of nutrients needed for the maintenance of life.1 The physiology of starvation is the same whether the cause is anorexia nervosa, cancer, hunger strike, famine, severe gastrointestinal disease, or being a refugee. In order to combat malnutrition, the body breaks down its own fat stores and eventually its own tissue. This destructive process affects both the structure and function of the body and causes a variety of symptoms. The body adapts to starvation in an attempt to survive with a complex series of metabolic alterations to decrease metabolic rate, maintain glucose homeostasis, conserve body nitrogen, and increase the use of adipose tissue triglycerides to meet energy needs.
