黑色字體是原文獻(xiàn)

紅色字體是機(jī)翻

藍(lán)色字體是人肉翻，校對(duì)，講解，注釋等等

Weight loss due to fasting

Rate of weight loss with starvationWith total acaloric fasting, a certain healthy 41 yr old member of a cloistered religious community lost 0.9kg per day for the first few days of the fast, a rate which decreased to a stable 0.3kg/day towards the third week of fasting.

禁食減肥

禁食減肥率在完全非傳統(tǒng)禁食的情況下，一位41歲的健康的與世隔絕的宗教團(tuán)體成員在禁食的頭幾天每天減重0.9公斤，在禁食的第三周，這一比率降至穩(wěn)定的0.3公斤/天。

基本數(shù)據(jù)跟我差不多 ，一般前3天掉1-3kg，后面每天0.7 0.5 0.6之類浮動(dòng) 約到后面越少

This rate seems consistent among various experimentally fasted subjects. Most seem to lose about 20% of their body weight during a 30 day fast.

這一比率在各種實(shí)驗(yàn)禁食的受試者中似乎是一致的。大多數(shù)人似乎在30天的禁食中減掉了大約20%的體重。

沒試過30days+，不發(fā)言了。。

The total amount of weight lost in the course of a fasting experiment is not representative of the critical care population. Our patients are infrequently monastic ovolactovegetarians with a normal BMI. Additionally, in a critical care setting the metabochanges in the rate of urinary electrolyte loss during starvationlic demands are greatly increased. One can only estimate that the ICU patient loses weight at a much faster rate, especially if burns, trauma or sepsis are involved.

禁食實(shí)驗(yàn)過程中體重減輕的總量不能代表重癥監(jiān)護(hù)人群。我們的患者很少是體重指數(shù)正常的素食主義者。此外，在重癥監(jiān)護(hù)環(huán)境中，饑餓需求期間尿電解質(zhì)損失率的代謝變化大大增加。人們只能估計(jì)重癥監(jiān)護(hù)室患者的體重減輕速度要快得多，尤其是在涉及燒傷、創(chuàng)傷或敗血癥的情況下。

這個(gè)肯定 畢竟患者的身體比起健康人肯定有問題，尤其創(chuàng)傷燒傷類，本身還需要額外蛋白修復(fù)以及各種能量供應(yīng)，這個(gè)說得通，傻子都懂。但是患者尿電解質(zhì)損失率增加這個(gè)暫時(shí)理解不了，按理說病人體內(nèi)基礎(chǔ)代謝會(huì)更低，理論上每日代謝產(chǎn)物也會(huì)低。。怎么電解質(zhì)流逝還多呢

Electrolyte changes during prolonged starvation

The 41 yr old monk lost 0.9kg per day for the first few days of the fast. This initial rapid weight loss is not totally due to the loss of dry nutrient mass. Think about it: the burning of 0.9kg of fat protein and carbohydrate in one day day would yield 3150 kcal in total, which is insane (given that a basal metabolic rate we agreed on is 1800 kcal/day).

The extra weight loss is actually due to diuresis and natriuresis. The urinary loss of the sodium cation is obligatory loss. As ketone anions are lost in the urine, they require a cation to accompany them; initially this is sodium, and later in the fast it is ammonium.

Potassium decreases initially, and remains stable at around 3.0 mmol/L. There is a constant rate of urinary potassium loss, which is thought to be the result of lean tissue dissolving. It seems to parallel the rate of proteolysis, and it seems related to lean body mass.

Magnesium remains surprisingly stable.

Calcium remains stable

Phosphate remains stable

Uric acid levels increase, perhaps as a product of protein catabolism; not only that but urate seems to compete with ketoacids for renal tubular transport sites.

長(zhǎng)期饑餓期間電解質(zhì)的變化

這位41歲的僧人在齋戒的頭幾天每天減重0.9公斤。這種最初的快速減肥并不完全是由于干燥營(yíng)養(yǎng)物質(zhì)的損失。想想看：一天內(nèi)燃燒0.9公斤的脂肪蛋白和碳水化合物總共會(huì)產(chǎn)生3150千卡的熱量，這太瘋狂了（考慮到我們商定的基礎(chǔ)代謝率是1800千卡/天）。

額外的體重減輕實(shí)際上是由于利尿和利尿。尿中鈉離子的損失是必然的損失。由于酮陰離子在尿液中丟失，它們需要一種陽離子伴隨；一開始是鈉，后來禁食是銨。

很合理，tongniao必然帶走一部分陽離子。而且3150大卡幾乎是正常人2天的基礎(chǔ)代謝量，算算就會(huì)發(fā)現(xiàn)不對(duì)勁

鉀最初減少，并在3.0mmol/L左右保持穩(wěn)定。尿鉀的流失率是恒定的，這被認(rèn)為是瘦組織溶解的結(jié)果。它似乎與蛋白水解的速率相似，而且似乎與瘦體重有關(guān)。

受組織什么鬼，，應(yīng)該是瘦肉肌把。。這個(gè)也合理，當(dāng)瘦肉開始水解后，體內(nèi)蛋白分解會(huì)有一個(gè)拐點(diǎn)，之后曲線開始走平。。這個(gè)有空回頭把另個(gè)文獻(xiàn)講解下屆時(shí)會(huì)有圖表格的說。。

鎂保持驚人的穩(wěn)定。

鈣保持穩(wěn)定

磷酸鹽保持穩(wěn)定

尿酸水平升高，可能是蛋白質(zhì)分解代謝的產(chǎn)物；不僅如此，尿酸鹽似乎與酮酸競(jìng)爭(zhēng)腎小管轉(zhuǎn)運(yùn)位點(diǎn)。

盲猜這是因?yàn)槟I小管轉(zhuǎn)運(yùn)位點(diǎn)，這尿酸鹽 et 酮酸 ，準(zhǔn)確說是尿酸根 and 酮酸根 ，使用的系同一種同向轉(zhuǎn)運(yùn)體？