. |
 


|
|
Rev Hosp Clin Fac Med Sao Paulo 2000
Mar-Apr;55(2):47-54
Changes in body fluid and energy
compartments during prolonged hunger strike.
Faintuch J, Soriano FG, Ladeira JP,
Janiszewski M, Velasco IT, Gama-Rodrigues JJ
Department of Emergency Medicine,
Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo, Brazil.
Prolonged total food deprivation in
non-obese adults is rare, and few studies have documented body composition changes in this
setting. In a group of eight hunger strikers who refused alimentation for 43 days, water
and energy compartments were estimated, aiming to assess the impact of progressive
starvation. Measurements included body mass index (BMI), triceps skinfold (TSF), arm
muscle circumference (AMC), and bioimpedance (BIA) determinations of water, fat, lean body
mass (LBM), and total resistance. Indirect calorimetry was also performed in one occasion.
The age of the group was 43.3+/-6.2 years (seven males, one female). Only water,
intermittent vitamins and electrolytes were ingested, and average weight loss reached
17.9%. On the last two days of the fast (43rd-44th day) rapid intravenous fluid,
electrolyte, and vitamin replenishment were provided before proceeding with
realimentation. Body fat decreased approximately 60% (BIA and TSF), whereas BMI reduced
only 18%. Initial fat was estimated by BIA as 52.2+/-5.4% of body weight, and even on the
43rd day it was still measured as 19.7+/-3.8% of weight. TSF findings were much lower and
commensurate with other anthropometric results. Water was comparatively
low with high total resistance, and
these findings rapidly reversed upon the intravenous rapid hydration. At the end of the
starvation period, BMI (21.5+/-2.6 kg/m2) and most anthropometric determinations were
still acceptable, suggesting efficient energy and muscle conservation. Conclusions: 1) All
compartments diminished during fasting, but body fat was by far the most affected; 2)
Total water was low and total body resistance comparatively elevated, but these findings
rapidly reversed upon rehydration; 3) Exaggerated fat percentage estimates from BIA tests
and simultaneous increase in lean body mass estimates suggested that this method was
inappropriate for assessing energy compartments in the studied population; 4) Patients
were not morphologically malnourished after 43 days of fasting; however, the prognostic
impact of other impairments was not considered in this analysis.
PMID: 10959123, UI: 20416343 |
|