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Fuel metabolism in starvation.

George F Cahill1

  • 1Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA. gcahill1@cheshire.net

Annual Review of Nutrition
|July 20, 2006
PubMed
Summary

This article explores human fuel metabolism, highlighting how D-beta-hydroxybutyric acid aids survival during starvation. This ketone body also shows therapeutic potential for various ischemic conditions.

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Area of Science:

  • Biochemistry
  • Metabolic Research
  • Academic Medicine

Background:

  • Early understanding of human fuel metabolism was limited in 1953.
  • Key metabolic components like free fatty acids and insulin were not well-understood or measurable.
  • Beta-hydroxybutyric acid was controversially viewed as a metabolic toxin.

Purpose of the Study:

  • To characterize the metabolism of key fuel substrates during prolonged starvation.
  • To investigate the role of insulin and various metabolites in human fuel metabolism.
  • To explore the therapeutic potential of D-beta-hydroxybutyric acid.

Main Methods:

  • Indirect calorimetry.
  • Characterization of metabolic states during prolonged starvation.
  • Review of clinical and biochemical data from academic medicine practice.

Main Results:

  • D-beta-hydroxybutyric acid is utilized by the brain, enabling survival during prolonged starvation.
  • Characterization of the metabolism of free fatty acids, glycerol, glucose, lactate, and pyruvate was advanced.
  • D-beta-hydroxybutyric acid demonstrates potential for therapeutic use in ischemic conditions.

Conclusions:

  • D-beta-hydroxybutyric acid plays a crucial role in starvation adaptation.
  • This ketone body offers potential therapeutic benefits in conditions like stroke and myocardial insufficiency.
  • Further research into ketone metabolism may yield novel treatments for metabolic and ischemic disorders.

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