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The cardiovascular, metabolic and hormonal changes accompanying acute starvation in men and women

Published online by Cambridge University Press:  17 March 2008

J. Webber
Department of Physiology and Pharmacology, University of Nottingham Medical School, Clifton Boulevard, NottinghamNG7 2UH
I. A. Macdonald
Department of Physiology and Pharmacology, University of Nottingham Medical School, Clifton Boulevard, NottinghamNG7 2UH
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The effect of fasting for 12, 36 and 72 h was studied in twenty-nine healthy subjects (seventeen women and twelve men). Measurements were made of cardiovascular variables, metabolic rate, respiratory exchange ratio, plasma metabolites, insulin, thyroid hormones and catecholamines. During starvation there were no significant changes in blood pressure, whilst heart rate (beatslmin) increased at 36 h and remained elevated after 72 h (12 h 625 (SE 1.8), 36 h 68.0 (SE 1.9), 72 h 69 2 (SE 1.8); P< 0.001). Forearm blood flow (FBF), increased progressively from 3.32 (SE 0.20) to 6.21 (SE 0.46) m1/100 ml per min (P < 0.001). Resting metabolic rate (kJ/min) was significantly increased after 36 h of starvation (12 h 4 60 (SE 0.14), 36 h 4 88 (SE 0.13), P < 0.001), but was not significantly different from the 12 h value after 72 h (72 h 4.72 (SE 0.15) P = 0.06). The respiratory exchange ratio fell progressively from 0.80 to 076 to 0.72 (P < 0.001). Blood glucose fell, whilst plasma glycerol and β-hydroxybutyrate rose and plasma lactate did not change. Plasma insulin and free triiodothyronine fell during starvation. Plasma adrenaline and noradrenaline were unchanged at 36 h, but were significantly increased after 72 h. Both sexes showed a similar pattern of response to starvation, although absolute values of blood pressure, forearm blood flow, metabolic rate and plasma catecholamines were higher in men than women. Acute starvation produces profound cardiovascular and metabolic changes which are not explained by the accompanying hormonal changes.

Research Article
Copyright © The Nutrition Society 1994



Amiel, S. A, Maran, A, Powrie, J. K., Umpleby, A. M. & Macdonald, I. A. (1993). Gender differences in counterregulation to hypoglycaemia. Diabetologia 36, 460469.CrossRefGoogle ScholarPubMed
Andersson, B., Elam, M., Wallin, B. G., Bjorntorp, P. & Andersson, O. K. (1991). Effect of energy-restricted diet on sympathetic muscle nerve activity in obese women. Hypertension 18, 783789.CrossRefGoogle ScholarPubMed
Andersson, B., Wallin, B. G., Hedner, T., Ahlberg, A. C. & Andersson, O. K. (1988). Acute effects of short-term fasting on blood pressure, circulating noradrenaline and efferent sympathetic nerve activity. Acta Medica Scandinavica 223, 485490.CrossRefGoogle ScholarPubMed
Astrup, A., Simonsen, L., Bulow, J., Madsen, J. & Christensen, N. J. (1989). Epinephrine mediates facultative carbohydrate-induced thermogenesis in human skeletal muscle. American Journal of Physiology 257, E340E345.Google ScholarPubMed
Beer, S. F., Bircham, P. M. M., Bloom, S. R., Clark, P. M., Hales, C. N., Hughes, C. M., Jones, C. T., Marsh, D. R., Raggatt, P. R. & Findlay, A. L. R. (1989). The effect of a 72-h fast on plasma levels of pituitary, adrenal, thyroid, pancreatic and gastrointestinal hormones in healthy men and women.Journal of Endocrinology 120, 337350.CrossRefGoogle Scholar
Benedict, F. G. (1915).A Study of Prolonged Fasting. Carnegie Institute Publication no. 203, Washington, DC: Carnegie Institute.CrossRefGoogle Scholar
Bennett, T., Macdonald, I. A. & Sainsbury, R. (1984). The influence of acute starvation on the cardiovascular responses to lower body subatmospheric pressure or to standing in man. Clinical Science 66, 141146.CrossRefGoogle ScholarPubMed
Berne, C., Fagius, J. & Niklasson, F. (1989). Sympathetic response to oral carbohydrate administration. Evidence from microelectrode nerve recordings.Journal of Clinical Investigation 84, 14031409.CrossRefGoogle ScholarPubMed
Boulter, P. R., Hoffman, R. S. & Arky, R. A. (1973). Pattern of sodium excretion accompanying starvation. Metabolism 22, 675683.CrossRefGoogle ScholarPubMed
Clore, J. N., Glickman, P. S., Helm, S. T., Nestler, J. E. & Blackard, W. G. (1989). Accelerated decline in hepatic glucose production during fasting in normal women compared with men. Metabolism 38, 11031107.CrossRefGoogle ScholarPubMed
Esler, M., Jennings, G., Lambert, G., Meredith, I., Horne, M. & Eisenhofer, G. (1990). Overflow of catecholamine neurotransmitters to the circulation: source, fate and functions. Physiological Reviews 70, 963985.CrossRefGoogle Scholar
Fellows, I. W. & Macdonald, I. A. (1985). An automated method for the measurement of oxygen consumption and carbon dioxide excretion in man. Clinical Physics and Physiological Measurement 6, 349355.CrossRefGoogle ScholarPubMed
Jung, R. T., Shetty, P. S., Barrand, M., Callingham, B. A. & James, W. P. T. (1979). Role of catecholamines in hypotensive response to dieting. British Medical Journal 1, 1213.CrossRefGoogle ScholarPubMed
Landsberg, L. & Young, J. B. (1985). The influence of diet on the sympathetic nervous system. In Neuroendocrine Perspectives, vol. 4, pp. 191218. [Muller, E. E., MacLeod, R. M. and Frohman, L. A., editors]. Amsterdam: Elsevier Science Publishers.Google Scholar
Lloyd, B., Burrin, J., Smythe, P. & Alberti, K. G. M. M. (1978). Enzymic fluorimetric continuous flow assays for blood glucose, lactate, pyruvate, alanine, glycerol and 3-hydroxybutyrate. Clinical Chemistry 24, 17241729.CrossRefGoogle Scholar
Macdonald, I. A. & Lake, D. M. (1985). An improved technique for extracting catecholamines from body fluids. Journal of Neuroscience Methods 13, 239248.CrossRefGoogle ScholarPubMed
McGuire, E. A. H., Helderman, J. H., Tobin, J. D., Andres, R. & Berman, M. (1976). Effects of arterial versus venous blood sampling on analysis of glucose kinetics in man. Journal of Applied Physiology 41, 565573.CrossRefGoogle ScholarPubMed
Mansell, P. I. & Macdonald, I. A. (1990). The effect of starvation on insulin-induced glucose disposal and thermogenesis in humans. Metabolism 39, 502510.CrossRefGoogle ScholarPubMed
Mansell, P. I., Macdonald, I. A. & Fellows, I. W. (1990). 48 hours starvation enhances the thermogenic response to infused epinephrine. American Journal of Physiology 258, R87–R93.Google Scholar
Merimee, T. J. & Fineberg, S. E. (1973). Homeostasis during fasting. 11. Hormone substrate differences between men and women. Journal of Clinical Endocrinology and Metabolism 37, 698702.CrossRefGoogle Scholar
Moller, N., Jorgensen, J. O.LMoller, J. F., Bak, J. F.,Porksen, N, Alberti, K. G. M. M. & Schmitz, O. (1990). Substrate metabolism during modest hyperinsulinaemia in response to isolated hyperketonaemia in insulin-dependent diabetic subjects. Metabolism 39, 13091313.CrossRefGoogle Scholar
Neilson, S. L., Bitsch, V., Larson, O. A, Lassen, N. A. & Quaade, F. (1968). Blood flow through human adipose tissue during lipolysis. Scandinavian Journal of Clinical and Laboratory Medicine 22, 124130.Google Scholar
O'Dea, K., Esler, M., Leonard, P., Stockigt, J. R. & Nestel, P. (1982). Noradrenaline turnover during under- and over-eating in normal weight subjects.Metabolism 31, 896899.CrossRefGoogle ScholarPubMed
Palmblad, J., Levi, L., Burger, A., Melander, A, Westgren, U., von Schenck, H. & Skude, G. (1977). Effects of total energy withdrawal (fasting) on the levels of growth hormone, thyrotropin, cortisol, adrenaline, noradrenaline, T4, T3, and rT3 in healthy males. Acta Medica Scandinavica 201, 1522.CrossRefGoogle ScholarPubMed
Vernet, O., Nacht, C.-A., Christin, L., Schutz, Y., Danforth, E. Jr & Jequier, E. (1987). P-adrenergic blockade and intravenous nutrient-induced thermogenesis in lean and obese women.American Journal of Physiology 253, E65–E71.Google Scholar
Weir, J. B de V. (1949). New methods for calculating metabolic rate with specific reference to protein metabolism. Journal of Physiology 109, 19.CrossRefGoogle Scholar
Welle, S., Schwartz, R. G. & Statt, M. (1991). Reduced metabolic rate during P-adrenergic blockade in humans.Metabolism 40, 619622.CrossRefGoogle Scholar
Whitney, R. J. (1953). The measurement of volume changes in human limbs. Journal of Physiology 121, 127.CrossRefGoogle ScholarPubMed