Biological living standards in North Korea as reflected in famine to post-famine trends in birthweight, 1998-2009.

This research investigates the trend in birthweight as an indicator of living conditions in early life inside North Korea, one of the most secluded nations in the world that experienced a great famine in the 1990s. Descriptive analysis based on data taken from officially released national nutrition survey reports suggests that prevalence of low birthweight (= below 2500 g) declined from 9.0% in the famine year of 1998-5.7% in the post-famine period of 2009. Mean birthweight improved from 2800 g in 1998-2940 g in 2002, although more recent surveys await implementation. Based on raw data comprising 2495 newborns measured at birth from 2000 to 2002 from a national nutrition survey conducted in 2002, neither contingency analysis nor error bar analysis showed statistically significant improvements during the observed periods. Regression analysis indicates that there is a significant positive relation between birthweight and birthyear, but the effect is negligibly small (0.0001 g). Raw data analysis of the 2002 survey further revealed that prevalence of low birthweight hovered at around 7% from 2000 to 2002. Overall, this prevalence of low birthweight was closer to the mean percentage for industrialized nations (6%) than that of developing nations (17%), although being expectedly much higher (that is, twice the rate) compared to its "twin" in South Korea (3.5%) at that time. Some technical, biological, and socio-economic biases affecting birthweight measurements in North Korea are discussed in a latter section of this paper.

Is Exposure to Famine in Childhood and Economic Development in Adulthood Associated With Diabetes?

CONTEXT: The Chinese were afflicted by great famine between 1959 and 1962. These people then experienced rapid economic development during which the gross domestic product per capita increased from $28 in 1978 to $6807 in 2013. We hypothesize that these two events are associated with the booming rate of diabetes in China. OBJECTIVE: We aimed to explore whether exposure to famine in early life and high economic status in adulthood was associated with diabetes in later life. DESIGN AND SETTING: Our data of 6897 adults were from a cross-sectional Survey on Prevalence in East China for Metabolic Diseases and Risk Factors study in 2014. Among them, 3844 adults experienced famine during different life stages and then lived in areas with different economic statuses in adulthood. MAIN OUTCOME MEASURE: Diabetes was considered as fasting plasma glucose of 7.0 mmol/L or greater, hemoglobin A1c of 6.5% or greater, and/or a previous diagnosis by health care professionals. RESULTS: Compared with nonexposed subjects, famine exposure during the fetal period (odds ratio [OR]1.53, 95% confidence interval [CI]1.09-2.14) and childhood (OR 1.82, 95% CI 1.21-2.73) was associated with diabetes after adjusting for age and gender. Further adjustments for adiposity, height, the lipid profile, and blood pressure did not significantly attenuate this association. Subjects living in areas with high economic status had a greater diabetes risk in adulthood (OR 1.46, 95% CI 1.20-1.78). In gender-specific analyses, fetal-exposed men (OR 1.64, 95% CI, 1.04-2.59) and childhood-exposed women (OR 2.81, 95% CI, 1.59-4.97) had significantly greater risk of diabetes. CONCLUSIONS: The rapid increase in the prevalence of diabetes in middle-aged and elderly people in China is associated with the combination of exposure to famine during the fetal stage and childhood and high economic status in adulthood. Our findings may partly explain the booming diabetes phenomenon in China.

Snakes survive starvation by employing supply- and demand-side economic strategies.

Animals vary widely in their abilities to tolerate extended periods of food limitation. Although some snakes are known for their unique ability to survive periods of inanition that last up to 2 years, very little is known about the biological mechanisms that allow them to do this. Consequently, the present study examined physiological, compositional, and morphological responses to 168 days of starvation among three distantly related snake species (i.e., ball python, Python regius; ratsnake, Elaphe obsoleta; and western diamondback rattlesnake, Crotalus atrox). Results revealed that each of these species was able to successfully tolerate starvation by adaptively utilizing supply- and demand-side regulatory strategies. Effective demand-side strategies included the ability of snakes to depress their resting metabolic demands by up to 72%. Moreover, supply-side regulation of resources was evidenced by the ability of snakes to spare their structurally critical protein stores at the expense of lipid catabolism. Such physiological strategies for minimizing endogenous mass and energy flux during periods of resource limitation might help explain the evolutionary persistence of snakes over the past 100 million years, as well as the repeated radiation of snake lineages into relatively low-energy environments. The final section of this study outlines a novel modeling approach developed to characterize material and chemical flux through animals during complete inanition. This approach was used to make comparisons about the efficacy of various supply- and demand-side starvation strategies among the three species examined, but could also be used to make similar comparisons among other types of animals.

The energy metabolism of common carp (Cyprinus carpio) when exposed to salt stress: an increase in energy expenditure or effects of starvation?

Stenohaline common carp (Cyprinus carpio) were chronically exposed to the two main osmoregulatory ions, Na+ and Cl-, at levels close to their isoosmotic value for 28 d (171 mM NaCl; 324 mosm kg-1; 10 per thousand). The aim of this study was to assess whether or not the disturbed ion and osmoregulation affected the energy demand and the energy stores of the exposed fish. Salt exposure reduced food intake by 70% and had adverse effects on growth and survival. Although food consumption decreased and growth was seriously affected, routine oxygen consumption of the exposed fish did not drop, indicating a reallocation of energy expenditure from growth toward other processes. A stress-induced increase in plasma glucose was observed. As a result of low food intake, lower levels of protein were used for fuel. Protein use itself was probably replaced by the use of carbohydrates. These effects were confirmed by the depletion of both muscle and liver glycogen stores during the experimental period. We conclude that, besides the effects of reduced feeding, stress induced extra energy requirements leading to the depletion of energy stores.

[Advance in studies on compensatory growth of aquatic animals after starvation or undernutrition].

This paper reviewed the studies on the compensatory growth of aquatic animals after starvation or undernourisment. The extent of compensatory growth, its affecting factors, physiological mechanisms, changes in chemical composition and dynamics of growth rate were discussed. The experimental design problems and the application prospects of related studied were also analyzed.

Nutritional assessment and skeletal muscle function.

The validity of skeletal muscle function as a functional measure of nutritional state was determined by stimulating the ulnar nerve at the wrist and measuring the force of isometric contractions of the adductor pollicis muscle. Nutritional state was evaluated by measuring body composition, by multiple-isotope dilution, in 21 malnourished and 44 normally nourished patients. No significant correlation between body composition and muscle function was found. In eight normally nourished volunteers, muscle function was determined before, after 24 and 48 h of complete starvation, and 6, 24, and 48 h following resumption of normal diet. Muscle function became abnormal after 24 h of starvation and deteriorated further after 48 h. Six hours following a single normal meal, muscle function returned to normal. Experimental data indicate that the response of the adductor pollicis muscle to ulnar nerve stimulation is not an accurate measure of nutritional state.

Starvation-induced changes in metabolic rate, blood flow, and regional energy expenditure in rats.

Starvation results in an energy-conserving reduction in metabolic rate that has features of an adaptive response. Tissue and organ sites of this response were investigated by examining the effects of starvation for 5 d on tissue blood flow (microsphere method) and regional arteriovenous O2 differences ((a-v)O2) in conscious rats resting quietly at 28 degrees C. Comparison was with fed and overnight-fasted animals. Whole body resting metabolic rates (MR), colonic temperatures (Tc), and tissue weights were also determined. Quantitative changes in energy expenditure (as O2 consumption) were obtained for two regions: the portal-drained viscera (PDV) and the hindquarters (HQ). Fasting overnight resulted in increased blood flow to white adipose tissue (WAT) and decreased flow to the brain, PDV, testes, and skin; however, MR, Tc, the two regional ((a-v)O2, and the weights of most tissues were not significantly altered. In comparison with overnight fasting, starvation for 5 d resulted in a 13% reduction in body weight, weight loss in many tissues and organs, a 26% reduction in MR, a decline of 0.5 degree C in Tc, decreased (a-v)O2 across both the PDV and HQ, reduced cardiac output, and decreased blood flow to the heart, PDV, skin, WAT, leg muscle, HQ, and the musculoskeletal body as a whole. Utilization of O2 by the PDV and HQ (flow X (a-v)O2) declined by amounts that accounted for 22 and 18%, respectively, of the reduction in MR. The reductions in cardiac output (18%) and heart blood flow (36%) indicate that the heart also made a contribution to energy conservation (roughly estimated as 5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Importance of nutritional assessment and support in surgical and cancer patients.

Malnutrition has been reported to have an impact upon the prognosis of patients with cancer as well as those undergoing surgery for other diseases. It is important for practicing gynecologists to familiarize themselves with the methods of nutritional assessment and of nutritional replacement.

Voluntary total fasting: a challenge for the medical community.

A movement opposing the nuclear arms race asked for medical surveillance of four people intending to go without food for an unlimited period. The course of fasting was uneventful until day 28-35, when weight loss reached 18%. In one subject fasting was ended on day 38 owing to development of Wernicke's encephalopathy; the others agreed to suspend their fast by day 40. The presence of physicians, offered under defined conditions, may have contributed to the timely cessation of this protest.

KIE: Medical attendance on fasting members of a French anti-nuclear group, part of the international Fast for Life movement, is described. Four physicians agreed to authenticate the fast, release health bulletins, provide medical surveillance, advise on lifestyle and hygiene, and warn of impending permanent damage. Conditions set by the doctors for their involvement included arrangements for proxy decision making, awareness of risks on the part of the fasters, daily medical examinations, and withdrawal of surveillance if medical decisions were not implemented. The circumstances and course of the 40-day fast are related, and the role of the physicians in this episode is discussed.

[Quantitative assessment of the viability of renal tissue when the donor's body is treated differently]. / Kolichestvennaia otsenka zhiznesposobnosti pochechnoi tkani pri razlichnykh vozdeistviiakh na organizm donora

It was shown that the vital capacity of the mouse kidney tissues quantitatively estimated by the in vitro growth in a plasma-free medium depended upon the condition of the donor organism. Depression of the culture growth was noted after the general X-irradiation of the animals, as well as following prolonged starvation and chloric cadmium poisoning. An increased growth of the kidney tissues was observed both in compensatory hypertrophy caused by unilateral nephrectomy and in subcutaneous inflammation.