I am flying solo over the snow covered Alps. I crash my plane into a mountainside. My legs are mangled in the wreck and I am losing blood. I perform a double amputation just above the knees and do an expert job of trussing my stumps.
Lets say that I would normally die of starvation in 10 weeks (my Merck Manual gives the time of 8-12 weeks before death from total starvation.) The question would be what is my dietary need to stave off starvation? I have two legs worth of flesh keeping fresh in the snow. My caloric needs will increase because of the trauma but will decrease because two legs no longer need to be physiologically supported. If my condition stabilizes before I consume all of the leg flesh then auto-ingestion makes sense for survival.
If a leg remains attached the body will use those calories but the calories will be used in large part to maintain the living leg. The leg will not be available to the rest of the body but will consume itself partly in cellular autophagy in order to support itelf. So an attached leg is not the same source of nutrition as a detached leg.
If the caloric value of my amputated legs exceeds the calories spent healing, then I will have a net gain of calories and I will extend my life.
It would be interesting to see the curve of caloric requirement over the days after the amputations. It would be fairly easy for the doctors in the forum to find out what dietary adjustments are made for amputees.
You don’t. There is a lot of fat in the marrow for example that is still there even in animals that have starved to death. There is protein in the muscle itself that never vanishes. The nerves contain a lot of ft that is never mobilised. I don’t know what percentage of the energy is not available, but an educated guess from observations of animals that have starved to death suggests that 10% of the energy is never recoverable.
Whether you have access to the energy is irrelevant to exmachina’s point, as I suspected. What is being discussed is whether the energy used to heal an amputation is greater or less than the energy required to maintain that limb. Obviously if a fast continues long enough it will be energetically beneficial to amputate a leg. The only question is whether the fast needs to last 1 week or 1 year to reach the break-even point. I suspect it would be closer to one year, but I have no figures to back that up, and neither does anyone else. Until someone presents some figures the OP can not be answered. We have no idea.
Ex Machina - in your latest scenario, it would seem to make sense (at least in terms of calorie intake) to eat the legs, but this is hardly comparable to the initial scenario, where amputating them was an additional risk.
I do believe the credentials of Qadgop even exceed those of Ex Machina. Qadgop casts a long shadow in these parts.
Anyway, I don’t think autophagy would extend your life. Malnutrition comes from either inadequate protein or calories, and the body would try to compensate for these by auto-digestion of muscles, etc. Eating your leg would waste energy for several reasons: heat losses due to stomach acid, energy involved in mastication and rebreaking down proteins and fat, blood loss, and the increased energy needed to repair damaged tissues – even if you could get these with magically minimal trauma. During malnutrition, the body would preferentially sent blood to the most important organs anyway through vasodilation, so the energy changes through less volume would not be proportional to the loss of volume.
The biggest loss of volume you could survive would surely come from the legs. I think any self-filleting would be a poor survival strategy, but at least your morale would plummet and you would be less able to catch more viable food. I have very few rib eye steaks on my body AFAIK.
Blake makes a good point about the stuff (marrow, etc.) that the body doesn’t use to stave off starvation. And the body goes after the organs pretty early on. That’s one of the dangers of the Atkins diet, or so I’ve read.
What did King have to say about it in the book?
Sure, 10% of the leg may still be usable energy after the person starves to death. That doesnt mean that the digestive system could have done better than that had the leg been eaten initially. The digestive track isnt 100% efficient and surely not even close to that in times of stress. I guess you`d be lucky to get 85% efficiency out of the leg through digestion. That leaves you with a -5% loss.
“Records claimed without unremitting medical surveillance are inadmissable. The longest period for which anyone has gone without solid food is 382 days by Angus Barbieri (b 1940) of Tayport, Fife, Scotland, who lived on tea, coffee, water, soda water and vitamins from June 1965 to July 1966 in Maryfield Hospital, Dundee, Angus, Scotland. His weight declined from 472 lb to 178 lb.”
Guinness Book Of World Records, 1986, p41 (Sorry, it’s the most recent copy I have onhand).
From the same page, the absolute record for a complete fast (we’re talking nothing at all, no food, no water, zilch) was 18 days by a guy who was put into a holding cell and forgotten about by the local PD in Austria. He was near death.
For non-forcefed hunger strikes, they list one of “…94 days by 9 men in Cork Prison, Ireland, from Aug 11 to Nov 12, 1920. These 9 survivors owed their lives to expert medical attention and an appeal by the nationalist leader, Arthur Griffith.”
That may well be the case. However that must still be less than the figures being assumed by those who were stating that the body can use all the energy stored in a limb.
The point being that this is a very compex issue. It’s not just a case of saying that amputations need energy to heal and that autophagy is more efficent than digestion. While those two staments are true those who claim no benefit seem to be ignoring that autophagy is only more efficient for those nutrients it can mobilise at all and that maintaining a limb over a certain time period will be more energy expensive than amputation.
Then he didn’t go more than a year without food. He simply stopped eating solid food and switched to liquid. Here was a man living on strong glucose solutions, milk, vitamins and a few other things for twelve months. Big deal, many babies go for that long on just the milk. While it would take some willpower I can’t see any reason why a person couldn’t live on such a diet indefinitely. It doesn’t seem to be lacking in any nutrients at all and certainly not calories. This tells us nothing at all about how long a person can go without food.
The 94 day period for non-force-fed hunger strikers is a better approximation. After 3 months they were clearly on there last legs. Howveer I would need to find out what non-force-fed means before I could evelaute the figure. Most hunger strikers volountarily takes glucaose solutions without being force fed, so even they are ingesting food.
Thanks for the references though Valgard. At least now we know the approximate timeframe is somewhere about 3 months.
I doubt this. Skeletal trauma alone could easily multiply energy needs by 1.3, skeletal trauma with sepsis (and how are you going to prevent infection) could multiply it by 1.6
Tea, coffee, soda water and vitamin pills have no real caloric value by themselves. It wouldn’t surprise me to learn that he had some cream & sugar in there but if he was having mugs of cream with spoonfulls of sugar and a drop of tea the sentence would likely read that he survived on milk, sugar, etc. I think we’re still talking very minimal calories each day.
IIRC a pound of fat is about 3500 calories. That guy’s weight loss works out to a deficit of 2700 calories per day (weight loss divided by 382 days, multiplied by 3500 cal/lb. Assuming that he’s just losing body fat). A normal person needs about 2500 cal/day, so if Mr. Barbieri was eating a little more than normal before and then taken down to near-zero caloric intake each day and kept under close medical watch (not exerting himself a lot, etc) then the calorie deficit would account for the weight loss, right? I don’t have any special medical knowledge but if he had calories to burn (body fat) and kept his fluids and vitamin levels in check this would be possible, wouldn’t it?
You can’t do this indefinitely, and it won’t work for somebody of “normal size” for long - a 200 pound person burning 5-10 pounds per week (depending on whether it’s fat or lean being broken down) on a zero-calorie diet can’t go long before important body parts are being “eaten”. Mr. Barbieri had 300 pounds of stored fat (over 1 million calories) in reserve to start with.
Regardless of how the math works out (3 months or 13 months), we agree that a person can go an astoundingly long time without food under the right conditions.
I’m quite sure that the body doesn’t wait 'till the fat is all gone before it goes after lean and organ calories. I read about this awhile back when reading about Cesar Chavez.
If a person starves slowly, while taking in some food, they do indeed lose pretty much all body fat before they die. But If someone suddenly just stops eating they die much faster, and can starve with some fat still on the body.
Some of the “weaker” people in the death camps in Germany died while they still had some flesh on their bodies. The so-called ‘doctors’ even tried to figure out why. They wanted to find a way to further cut rations to the soldiers, I expect.
The man was Scottish. He would have had sugar and milk in his tea because no True Scotsman would drink tea without milk or sugar.
Seriously though, tea in the UK usually means white with 2 so the tea and coffee do have caloric values. I never suggested that he was obtaining all his requirements this way, all I said was that he could. There are no major nutrients lacking at all from a diet of milk and vitamin tablets. Depending on how much tea he was drinking he could have been getting quite a bit of food. The point is that it isn’t an example of person going without food. Not that he wasn’t losing weight.
As I said, I’d have to know whether not being force-fed also equates with not drinking glucose solution and eating barley sugar volountarily. Most hunger strikers I have heard of do just that to prolong the strike. We can agree that a human can for over a month without food and remain conscious without suffering serious problems. Anywhere beyond that is debatable at present.
You can’t really can’t doubt it without invoking magic. A leg will consume claries for as long as it is on. An amputation will only consume calories until it heals. Or to put it more simply an amputation has a finite energy cost while keeping the limb is an infinite energy cost. Unless you want to explain it by magic you really have to accept that maintaining a limb over a certain time period will be more energy expensive than amputation. The limb might have to be maintained for 20 years before it exceeds the energy cost of an amputation, but it must exceed it at some point, eventually. The only question is whether that time period will expire before or after the patient.
Blake, the body will expend a ton of energy getting around on just one leg. Most people never overcome the ongoing deficit from losing, then not having a leg with savings from not having to maintain it.
So, you’d just have to amputate at least 25 - 40% of your body to come out ahead. So much for just a calf. Better amputate both legs @ the hip. :rolleyes:
Ex Machina, you haven’t even broken a hundred posts. An apology to QtM seems to be in order.
Around these parts, we may wage mighty war but at least we show due respect to our opponents. He is exactly whom he says he is, and dodging around it up there with basically saying, " Sure you can say you’re an M.D. if you wanna, but I don’t care " was cheap.
And yes, this is the Atkins Diet. They SAY he died from a head injury secondary to a fall. Heh. Heh. Munch. Munch.
No, that would only be the figure if the duration of starvation were less than the dration of recovery. Once the fast period exceeeds that the figures start to converge and eventually the balance comes back into the positive.
