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Starvation
Classification and external resources

A girl during the Nigerian-Biafran war of the late 1960s, shown suffering the effects of severe hunger and malnutrition.
ICD-10 T73.0
ICD-9 994.2
DiseasesDB 12415
MeSH D013217
World map showing percentage of population suffering from malnutrition, World Food Programme, 2006
Starved Vietnamese man, who was deprived of food in a Viet Cong prison camp.

Starvation is a severe reduction in vitamin, nutrient and energy intake. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage[citation needed] and eventually, death. The term inanition refers to the symptoms and effects of starvation.

According to the World Health Organization, hunger is the gravest single threat to the world's public health.[1] The WHO also states that malnutrition is by far the biggest contributor to child mortality, present in half of all cases.[1] According to the FAO, starvation currently affects more than one billion people, or 1 in 6 people on the planet.[2]

Contents

Common causes

The basic cause of starvation is an imbalance between energy intake and energy expenditure. In other words, the body expends more energy than it takes in as food. This imbalance can arise from one or more medical conditions and/or circumstantial situations, which can include:

Medical reasons

Circumstantial causes

Signs and symptoms

Individuals experiencing starvation lose substantial fat (adipose) and muscle mass as the body breaks down these tissues for energy. Catabolysis is the process of a body breaking down its own muscles and other tissues in order to keep vital systems such as the nervous system and heart muscle (myocardium) functioning. Vitamin deficiency is a common result of starvation, often leading to anemia, beriberi, pellagra, and scurvy. These diseases collectively can also cause diarrhea, skin rashes, edema, and heart failure. Individuals are often irritable and lethargic as a result.

Atrophy (wasting away) of the stomach weakens the perception of hunger, since the perception is controlled by the percentage of the stomach that is empty. Victims of starvation are often too weak to sense thirst, and therefore become dehydrated.

All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration. With a weakened body, diseases are commonplace. Fungi, for example, often grow under the esophagus, making swallowing unbearably painful.

The energy deficiency inherent in starvation causes fatigue and renders the victim more apathetic over time. As the starving person becomes too weak to move or even eat, his or her interaction with the surrounding world diminishes.

There is also an inability to fight diseases, and in females, irregular menstruation can occur.

Biochemistry

When food intake ceases, the body's glycogen stores are used up in about 24 hours.[citation needed] The level of insulin in circulation is low and the level of glucagon is very high. The main means of energy production is lipolysis. Gluconeogenesis converts glycerol into glucose and the Cori cycle converts lactate into usable glucose. Two systems of energy enter the gluconeogenesis, proteolysis provides alanine and lactate produced from pyruvate. Acetyl CoA produces dissolved nutrients (Ketone bodies), which can be detected in urine and are used by the brain as a source of energy.

In terms of insulin resistance, starvation conditions makes more glucose available to the brain.

Efforts

Treatment

Starving patients can be treated, but this must be done cautiously to avoid refeeding syndrome.[3]

Prevention

For the individual, prevention obviously consists of ensuring they eat plenty of food, varied enough to provide a nutritionally complete diet. Short of sitting in front of a potentially starving person and offering him or her food, to address societal mechanisms by which people are denied access to food is a more complicated matter.

Supporting farmers in areas of food insecurity through such measures as free or subsidized fertilizers and seeds increases food harvest and reduces food prices.[4]

Example of successful response in Malawi

In Malawi, almost 5 million of its 13 million people needed emergency food aid. Then, however, deep fertilizer subsidies and lesser ones for seed, abetted by good rains, helped farmers produce record-breaking corn harvests in 2006 and 2007, according to government crop estimates. The government reported that corn production rose from 1.2 million metric tons (mmt) in 2005, to 2.7 mmt in 2006 and 3.4 mmt in 2007. The harvest also helped the poor by lowering food prices and increasing wages for farm workers. Malawi became a major food exporter, selling more corn to the World Food Program and the United Nations than any other country in Southern Africa.

Over the 20 years prior to this change in policy (enacted by the World Bank), some rich nations that Malawi depended on for aid had periodically pressed it to cut back or eliminate fertilizer subsidies, in the name of free market policies. This is despite the fact that the United States and Europe extensively subsidized their own farmers. However, many, if not most, of its farmers are too poor to afford fertilizer at market prices. Proponents for helping the farmers includes the economist Jeffrey Sachs, who has championed the idea that wealthy countries should invest in fertilizer and seed for Africa’s farmers. He also conceived the Millennium Villages Project (MVP), which provides seeds and fertilizers, as well as training, to qualifying farmers. In one Kenyan village, application of this policy resulted in a tripling of its corn harvest, even though the village had previously experienced a cycle of hunger.

Organizations

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 more macro-scale policies that will reduce famine and provide aid.

Hunger statistics

In 2007, 923 million people were reported as being undernourished, an increase of 80 million since 1990-92.[5] It has also been recorded that the world already produces enough food to support the world's population — 6 billion people — and could support double — 12 billion people.[6]

Year 1970 1980 1990 2005 2007
Share of hungry people in the developing world[7][8] 37 % 28 % 20 % 16 % 17 %

Hunger mortality statistics

  • On the average, 1 person dies every second as a result, either directly or indirectly, of hunger - 4000 every hour - 100 000 each day - 36 million each year - 58 % of all deaths (2001-2004 estimates).[9][10][11]
  • On the average, 1 child dies every 5 seconds as a result, either directly or indirectly, of hunger - 700 every hour - 16 000 each day - 6 million each year - 60% of all child deaths (2002-2008 estimates).[12][13][14][15][16]

As capital punishment

The starving Livilla refusing food.
From a drawing by André Castagne

Historically, starvation has been used as a death sentence. From the beginning of civilization to the Middle Ages, people were immured, or walled in, and would die for want of food.

In ancient Greco-Roman societies, starvation was sometimes used to dispose of guilty upper class citizens, especially erring female members of patrician families. For instance, in the year 31, Livilla, the niece and daughter-in-law of Tiberius, was discreetly starved to death by her mother for her adulterous relationship with Sejanus and for her complicity in the murder of her own husband, Drusus the Younger.

Another daughter-in-law of Tiberius, named Agrippina the Elder (a granddaughter of Augustus and the mother of Caligula), also died of starvation, in 33 AD. (However, it is not clear whether her starvation was self inflicted.)

A son and daughter of Agrippina were also executed by starvation for political reasons; Drusus Caesar, her second son, was put in prison in 33 AD, and starved to death by orders of Tiberius (he managed to stay alive for nine days by chewing the stuffing of his bed); Agrippina's youngest daughter, Julia Livilla, was exiled on an island in 41 by her uncle, Emperor Claudius, and not much later, her death by starvation was arranged by the empress Messalina.

It is also possible that Vestal Virgins were starved when found guilty of breaking their vows of celibacy.

Maximilian Kolbe, a Polish friar, offered his life to save another inmate sentenced to death in the Auschwitz concentration camp. He was starved, along with another nine inmates. After two weeks of starvation, only Kolbe and three other inmates were still alive, and were executed with phenol injection.

Ugolino della Gherardesca, his sons and other members of his family were immured in the Muda, a tower of Pisa, and starved to death in the thirteenth century. Dante, his contemporary, wrote about Gherardesca in his masterpiece The Divine Comedy.

In Sweden in 1317, King Birger of Sweden imprisoned his two brothers for a coup they had staged several years earlier (Nyköping Banquet). A few weeks later, they died of starvation.

In Cornwall in 1671, John Trehenban from St Columb Major was condemned to be starved to death in a cage at Castle An Dinas for the murder of two girls.

See also

References

  1. ^ a b Malnutrition The Starvelings
  2. ^ FAO stating starvation figures are 1 billion people
  3. ^ Mehanna HM, Moledina J, Travis J (June 2008). "Refeeding syndrome: what it is, and how to prevent and treat it". BMJ 336 (7659): 1495–8. doi:10.1136/bmj.a301. PMID 18583681. PMC 2440847. http://bmj.com/cgi/pmidlookup?view=long&pmid=18583681. 
  4. ^ Ending Famine, Simply by Ignoring the Experts
  5. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 2. “FAO’s most recent estimates put the number of hungry people at 923 million in 2007, an increase of more than 80 million since the 1990–92 base period.”.
  6. ^ Jean Ziegler. “Promotion And Protection Of All Human Rights, Civil, Political, Economic, Social And Cultural Rights, Including The Right To Development: Report of the Special Rapporteur on the right to food, Jean Ziegler”. Human Rights Council of the United Nations, January 10, 2008.“According to the Food and Agriculture Organization of the United Nations (FAO), the world already produces enough food to feed every child, woman and man and could feed 12 billion people, or double the current world population.”
  7. ^ Food and Agriculture Organization Agricultural and Development Economics Division. “The State of Food Insecurity in the World, 2006 : Eradicating world hunger – taking stock ten years after the World Food Summit”. Food and Agriculture Organization of the United Nations, 2006, p. 8. “Because of population growth, the very small decrease in the number of hungry people has nevertheless resulted in a reduction in the proportion of undernourished people in the developing countries by 3 percentage points – from 20 percent in 1990–92 to 17 percent in 2001–03. (…) the prevalence of undernourishment declined by 9 percent (from 37 percent to 28 percent) between 1969–71 and 1979–81 and by a further 8 percentage points (to 20 percent) between 1979–81 and 1990–92.”.
  8. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 6. “Good progress in reducing the share of hungry people in the developing world had been achieved – down from almost 20 percent in 1990–92 to less than 18 percent in 1995–97 and just above 16 percent in 2003–05. The estimates show that rising food prices have thrown that progress into reverse, with the proportion of undernourished people worldwide moving back towards 17 percent.”.
  9. ^ Jean Ziegler. “The Right to Food: Report by the Special Rapporteur on the Right to Food, Mr. Jean Ziegler, Submitted in Accordance with Commission on Human Rights Resolution 2000/10”. United Nations, February 7, 2001, p. 5. “On average, 62 million people die each year, of whom probably 36 million (58 per cent) directly or indirectly as a result of nutritional deficiencies, infections, epidemics or diseases which attack the body when its resistance and immunity have been weakened by undernourishment and hunger.”.
  10. ^ Commission on Human Rights. “The right to food : Commission on Human Rights resolution 2002/25”. Office Of The High Commissioner For Human Rights, United Nations, April 22, 2002, p. 2. “every year 36 million people die, directly or indirectly, as a result of hunger and nutritional deficiencies, most of them women and children, particularly in developing countries, in a world that already produces enough food to feed the whole global population”.
  11. ^ United Nations Information Service. “Independent Expert On Effects Of Structural Adjustment, Special Rapporteur On Right To Food Present Reports: Commission Continues General Debate On Economic, Social And Cultural Rights”. United Nations, March 29, 2004, p. 6. “Around 36 million people died from hunger directly or indirectly every year.”.
  12. ^ Food and Agriculture Organization Staff. “The State of Food Insecurity in the World, 2002: Food Insecurity : when People Live with Hunger and Fear Starvation”. Food and Agriculture Organization of the United Nations, 2002, p. 6. “6 million children under the age of five, die each year as a result of hunger.”
  13. ^ Food and Agriculture Organization of the United Nations Economic and Social Dept. “The State of Food Insecurity in the World 2004: Monitoring Progress Towards the World Food Summit and Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2004, p. 8. “Undernourishment and deficiencies in essential vitamins and minerals cost more than 5 million children their lives every year”.
  14. ^ Jacques Diouf. “The State of Food Insecurity in the World 2004: Monitoring Progress Towards the World Food Summit and Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2004, p. 4. “one child dies every five seconds as a result of hunger and malnutrition”.
  15. ^ Food and Agriculture Organization, Economic and Social Dept. “The State of Food Insecurity in the World 2005: Eradicating World Hunger - Key to Achieving the Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2005, p. 18. “Hunger and malnutrition are the underlying cause of more than half of all child deaths, killing nearly 6 million children each year – a figure that is roughly equivalent to the entire preschool population of Japan. Relatively few of these children die of starvation. The vast majority are killed by neonatal disorders and a handful of treatable infectious diseases, including diarrhoea, pneumonia, malaria and measles. Most would not die if their bodies and immune systems had not been weakened by hunger and malnutrition moderately to severely underweight, the risk of death is five to eight times higher.”.
  16. ^ Human Rights Council. “Resolution 7/14. The right to food”. United Nations, March 27, 2008, p. 3. “6 million children still die every year from hunger-related illness before their fifth birthday”.

External links


1911 encyclopedia

Up to date as of January 14, 2010
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Simple English

Starvation is when a person or animal has not eaten food for such a time that they are unable to do things in a normal way.

After the stomach has been left empty for so long the body starts to give up.

The effects of starvation can include:

  • Tiredness,
  • a swollen stomach,
  • loss of weight,
  • weakness and not being able to stand

Consistently not being able to eat enough, will lead to permanent damage to the organs. This is the case for humans when they do not eat enough for about 1-2 months. A process called Catabolysis will break down usable resources, to keep vital functions (the nervous system and the heart working. It will first turn to muscles before it turns to fat).

Starvation was also used as a form of sentencing people to death.

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