The Feeding Fasting Cycle Energy Requirements
Beta Switch Program
Energy is essential for many important body functions, including the maintenance of cellular integrity and function, new tissue synthesis, thermoregulation, and
Table 1 Metabolic features and laboratory parameters of starvation and fasting
Uncomplicated protein energy malnutrition (Marasmus)
Hypoalbuminemic malnutrition (Kwashiorkor)
Stressed malnutrition (mixed)
Etiology
Metabolic adaptation
Weight loss
Resting energy expenditure Nitrogen loss Water, sodium Hormonal
Laboratory parameters
Albumin Transferrin Total lymphocyte count Skin hypersensitivity
Decreased energy intake
Slow (months to years)
Decreased
Minimal Initial loss
Early small increase in catecholamines, glucagon, cortisol, growth hormone; then slow decrease Decrease in insulin, leptin
Normal-slowly decreased Normal-slowly decreased Normal-slowly decreased
Decreased
Decreased protein intake associated with catabolic stress
Intermediate (weeks to months)
Decreased or increased
Increased
Retention
Increase in catecholamines, glucagon, cortisol, growth hormone
Decrease in insulin, leptin
Decreased
Decreased
Decreased
Decreased
Decreased energy and protein intakes associated with catabolic stress
Rapid (weeks)
Increased
Increased
Retention
Increase in catecholamines, glucagon, cortisol, growth hormone
Decrease in insulin, leptin
Decreased
Decreased
Decreased
Decreased physical activity. The energy requirements of an individual vary with age, sex, body composition, physical activity, and stress. In the normal adult at basal state, approximately 75% of energy requirements reflect the energy needs of major organs (brain, ^20%; skeletal muscle, 18-22%; abdominal muscles, ^25%; and heart, ~11%). However, during normal daily activity the total energy requirement and the proportion of energy needed by different tissues may vary considerably. For example, with exercise the energy requirement of skeletal muscles increases, and during a meal the abdominal organs require more energy for the process of digestion and absorption. Children require additional energy for growth.
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