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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
| | {{Starvation}} |
| Image = Starved girl.jpg |
| | '''For patient information, click [[Starvation (patient information)|here]]''' |
| Caption = A female child during the Nigerian-Biafran war of the late 1960s, shown suffering the effects of severe hunger and malnutrition. |
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| DiseasesDB = 12415 |
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| ICD10 = {{ICD10|T|73|0|t|66}} |
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| ICD9 = {{ICD9|994.2}} |
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| MeshID = D013217 |
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| {{SI}}
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| {{CMG}} | | {{CMG}} |
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| | ==[[Starvation overview|Overview]]== |
| | ==[[Starvation historical perspective|Historical Perspective]]== |
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| | ==[[Starvation pathophysiology|Pathophysiology]]== |
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| ==Overview== | | ==[[Starvation causes|Causes]]== |
| '''Starvation''' is a severe reduction in [[vitamin]], [[nutrient]], and [[energy]] intake, and is the most extreme form of [[malnutrition]]. In [[human]]s, prolonged starvation (in excess of 1-2 months) causes permanent [[organ (anatomy)|organ]] damage and, eventually, death.
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| According to the [[FAO|Food and Agriculture Organization]] of the United Nations, more than 25,000 people died of starvation every day in 2003,<ref name="BBC_water_starvation">{{cite web|last = Kirby | first = Alex| title=UN warns of future water crisis| url = http://news.bbc.co.uk/2/hi/science/nature/2818615.stm | publisher = BBC | date=2003-03-05| accessdate=2007-09-01|}}</ref> and as of 2001 to 2003, about 800 million people were chronically undernourished.<ref name="FAO_malnutrition2001">{{cite web| last =| first =| authorlink =| coauthors =| title=The spectrum of malnutrition| work =| publisher =Food and Agricultural Organization| date =2001-10-05| url=http://www.fao.org/worldfoodsummit/english/fsheets/malnutrition.pdf |format =pdf| doi =| accessdate =2007-08-03}}</ref><ref name="BBC_water_starvation"/>
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| [[Image:Percentage population undernourished world map.PNG|thumb|center|250px|World map showing percentage of population suffering from hunger, World Food Programme, 2006]]
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| == Symptoms == | | ==[[Starvation differential diagnosis|Differentiating Starvation from other Diseases]]== |
| [[Image:Starved Vietnamese man, 1966.JPEG|thumb|left|Starved Vietnamese man, who was deprived of food in a Viet Cong prison camp.]] | |
| Individuals experiencing starvation lose substantial [[fat]] and [[muscle]] mass as the body breaks down these tissues for [[energy]]. [[Catabolysis]] is the process (medical condition) of a body breaking down muscles and other tissues in order to keep vital systems -- such as the [[nervous system]] and [[heart]] muscle -- working. Catabolysis will not begin until there are no usable sources of energy coming into the body. [[Vitamin deficiency]] is also a common result of starvation, often resulting in [[anemia]], [[beriberi]], [[pellagra]], and [[scurvy]]. These diseases collectively may cause [[diarrhea]], [[skin rash]]es, [[edema]], and [[heart failure]]. Individuals are often [[irritable]], [[fatigue (physical)|fatigued]], and [[lethargy|lethargic]] as a result.
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| == Psychological effects of starvation == | | ==[[Starvation epidemiology and demographics|Epidemiology and Demographics]]== |
| [[Image:Holodomor.jpg|thumb|left|220px|Child victim of the Holodomor.]] | |
| Through several reports and studies, scientists have discovered that starvation has many psychological effects on a person, in addition to its physiological effects.<ref name="Brozek">Brozek, Josef. "Psychology of Human Starvation and Nutritional Rehabilitation." ''The Scientific Monthly'' 70 (1950): 270-274. </ref> The most extensive and informative study on starvation's psychological effects is called The Minnesota Starvation-Rehabilitation Experiment, which was carried out from 1944-1946. The subjects of this experiment were thirty-two healthy conscientious objectors, ages twenty to thirty-three.<ref name="Brozek"/> Subjects experienced three phases of the experiment: twelve weeks of control period, twenty four weeks of semistarvation, and then twelve weeks of rehabilitation. During the control experiments, subjects were given 3,492 calories, during the period of semistarvation, calories were decreased to 1,570, and during the period of rehabilitation, they were re-increased to normal levels. During the period of semistarvation, subjects were fed foods most likely consumed in European famine areas.<ref name="Brozek"/> The results of the starvation experiment were tested in many ways. According to Josef Brozek, author of ''Psychology of Human Starvation and Nutritional Rehabilitation'', studies "ranged from intelligence and personality tests through ratings to purely descriptive material, provided by the experimenters' notes and diaries kept by the subjects".<ref name="Brozek"/> According to subjects of the semistarvation experiment, tiredness was the worst effect of the low calorie intake, followed by appetite, muscle soreness, irritability, apathy, sensitivity to noise, and hunger pain.<ref name="Brozek"/> Standard personality tests revealed that the starving individuals experienced a large rise in the "neurotic triad" -- hypochondriasis, depression, and hysteria. Also, the subjects of the experiment noticed a marked decrease in the drive for activity, and a remarkable decrease in sex drive.<ref name="Brozek"/> In peer evaluations, other experiment subjects noted great changes in subjects' personalities during the period of semistarvation. In interviews years later, subjects reported that they felt that they had not returned to normal by the end of the three month recovery period.<ref name="Kalm">Kalm LM, Semba RD (2005), [http://jn.nutrition.org/cgi/content/full/135/6/1347 They starved so that others be better fed: remembering Ancel Keys and the Minnesota experiment]. ''Journal of Nutrition'', Volume 135, Issue 6, Pages 1347-1352. Retrieved on September 13, 2007.</ref> Subjects' own estimates of the time it took for recovery ranged from two months to two years.<ref name="Kalm"/> Many subjects reported that they grossly overate and put on fat after the experiment due to the urge to eat.<ref name="Kalm"/>
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| == Organizations Working to End Starvation == | | ==[[Starvation risk factors|Risk Factors]]== |
| Many organizations have been highly effective at reducing starvation in different regions. Aid agencies give direct assistance to individuals, while political organizations pressure political leaders to enact policies that will reduce famine and provide aid.
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| ==Common causes of starvation== | | ==[[Starvation natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *[[Anorexia nervosa]]
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| *[[Bulimia nervosa]]
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| *[[Clinical Depression]]
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| *[[Coma]]
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| *[[Crash diet]]ing
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| *[[Diabetes mellitus]] (untreated)
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| *[[Digestive disease]]
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| *[[Famine]]
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| *[[Fasting]]
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| *[[Malnutrition]]
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| *[[Overpopulation]]
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| *[[Poverty]]
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| == See also == | | ==Diagnosis== |
| | [[Starvation history and symptoms|History and Symptoms]] | [[Starvation physical examination|Physical Examination]] | [[Starvation laboratory findings|Laboratory Findings]] | [[Starvation electrocardiogram|Electrocardiogram]] | [[Starvation other imaging findings|Other Imaging Findings]] | [[Starvation other diagnostic studies|Other Diagnostic Studies]] |
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| * [[Refeeding syndrome]]
| | ==Treatment== |
| * [[Anorexia (symptom)|Anorexia]]
| | [[Starvation medical therapy|Medical Therapy]] | [[Starvation primary prevention|Primary Prevention]] | [[Starvation secondary prevention|Secondary Prevention]] | [[Starvation cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Starvation future or investigational therapies|Future or Investigational Therapies]] |
| * [[Anorexia nervosa]]
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| * [[Cachexia]]
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| * [[Dehydration]]
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| * [[Famine]]
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| * [[Famine response]]
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| * [[Famine scales]]
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| * [[Fasting]]
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| * [[Hunger]]
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| * [[Malnutrition]]
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| * [[Kwashiorkor]]
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| * [[Marasmus]]
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| * Muselmann
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| * [[Overpopulation]]
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| * [[Hunger strike]]
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| * List of famines
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| * [[List of countries by fertility rate]]
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| == References == | | == Case Studies == |
| <references/>
| | [[Starvation case study one|Case #1]] |
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| {{Consequences of external causes}} | | {{Consequences of external causes}} |
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| [[Category:Humanitarian aid]]
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| [[Category:Malnutrition]] | | [[Category:Malnutrition]] |
| [[Category:Poverty]] | | [[Category:Poverty]] |
| [[Category:Execution methods]]
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| [[Category:Causes of death]] | | [[Category:Causes of death]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |