Starvation sequence

In this post I'd like to describe the sequence of total stopping of any food intake, providing the water is still available, even if in minimal amounts. To understand the progression, it would be the best to name all the types of nutrients at the beginning, so the further explanation then makes perfect sense.  Three types of nutrients/energy are:

1. carbohydrates (or carbs)

2. fats (or lipids)

3. proteins

Because I couldn't find any flow diagram (anywhere), which would show this sequence of starvation, I was forced to improvise a little. So don't be discouraged by overt simplicity of this flow diagram. Still, (just in case) I want to clarify that symbols between the lines ( | and V ) are supposed to represent the down-pointing arrows. So let's get to it ! 

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Fed state, or so-called postabsorptive state, meaning that
all three energy sources are available for usage
 |
V
after 4 hours - carbs are spent from liver and digestive tract, while
fats and proteins levels are still intact
 |
V
12 - 24 hours - carbs spent from whole body, with
slight increase in usage of fats and proteins
 |
V
2 - 4 days - using fats after converting them into ketone bodies (<100 times of normal level), plus
using proteins in the rate of 90g a day
 |
V
4 - 40 days - further using ketone bodies from fat (100-300 times more then in fed state), plus
decreasing usage of protein each day
 |
V
40 days - 2 months - maximum usage of ketone bodies ( >300 times comparing to normal level), with
usage of proteins in the rate of 20g a day
 |
V
2 - 3 months - Body still have some fat, and ketone bodies for energy, but once the body protein level drops to about half of normal level, the physical death will occur through the infection, because the immune system will fail to work efficiently.

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Now, let's get through the whole process in slowly in the text format. After your meal, the body will be absorbing all nutrients, which is called the absorptive state. Once all the nutrients are absorbed, the next state is called post-absorptive state, signifying that the absorption is finished, and there is nothing else to digest.

Normally, those two state rotate, as with every other meal you get back into the absorptive state, and so on. But in the case, you stop eating and prolong the post-absorptive state, the first stage is called fasting. This is relatively still healthy state as you force your body to use all available (plus all excess) nutrients that are possibly accumulated in your digestive system.

Fasting changes into starvation roughly around 1-2 days after not eating any food. As I mentioned at the beginning, the water intake needs to be still available, otherwise without water, only 2-3 days will lead to dehydration, decrease of sodium levels, muscular spasm, and physical death. But that's the different story, so let's get back to our starvation sequence.

Roughly 4 hours after the end of the absorptive state and basically the beginning of post-absorptive state, all glucose in the form of glycogen in the liver is gone. That would represent about 25% of glycogen reserve in the body. The resting 75% in the skeletal muscles is then gone within 12-24 hours. This range differs with the amount of activity or rest. But basically after about 2 days of not eating, all the glycogen, and therefore the glucose in the body is gone/used.

To maintain the stable level of glucose in the blood, which is crucial for normal working of nervous system, the body converts fats into the middle-man called ketone bodies. This middle-man looks half the glucose and half amino acid, from which all the proteins are created. Glucose then feed the brain and nervous system, and amino acids are spent for protein synthesis, to save the built-in protein as much as possible.

In this state, the rate of protein usage is about 90g a day, plus with every other day after 2 days, this rate keep decreasing, finally stabilizing at the level of 20g a day in about 40 days. Meanwhile, the level of ketone bodies in the body increase about 100-300 fold. The state called the ketosis is a heavy burden for the organism, especially for the liver and kidneys, which have to take care of it.

Because ketone bodies are slightly toxic substances, they need to be eliminated from the system straight away after they are being used, and therefore, they can't be reused. Because the proteins in the blood, mainly in form of white blood cells incapacitate the toxins in ketone bodies, their level needs to be constantly updated, which is another load for protein usage.

Once the whole body protein level drops to about half, there will not be enough white blood cells for eliminating ketone bodies quickly enough. And at some point, (somewhere between 2 to 3 months), those ketones will overwhelm the immune system, and the result will the that the body will fall prey to the first virus, bacteria, or toxin which will attack the body, and will collapse.

Ironically, even in the time of death, the level of fats will be still at sufficient level to provide more ketone bodies, therefore the energy. But because of the lack of proteins, the immune system will be very frail and inefficient. So technically, the body will never run out of fat, or the energy until the end. It's the infection that will fire that fatal blow, which will result in physical death.

So I hope that this was simple and clear enough to understand the whole sequence. Of course, if at any point the new food intake is provided, the whole process will be postponed, and the cycle will start from beginning. Mainly if all three types of energy are present in fair amount of that particular meal.