tain vitamin C, notably raw fruits and vegetables,
helps maintain adequate intake.
FOODS HIGH IN VITAMIN Cbell peppers (especially red) broccoli
brussels sprouts cabbage
cantaloupe grapefruit
kiwi lemons
limes mango
oranges spinach
strawberries sweet potatoes
watermelon
Risk Factors and Preventive Measures
Scurvy occurs only as a deficiency of vitamin C,
thus adequate vitamin C consumption prevents
scurvy. People who have increased risk for scurvy
are those who have chronic ALCOHOLISM, chronic
health conditions that interfere with the digestion
or absorption of NUTRIENTS, and the very elderly
who may not receive adequate nutrition through
diet because they cannot or do not eat properly.
Fruit and vegetable juices are easy substitutions
for whole fruits and vegetables. Many juices are
fortified with additional vitamin C and other
nutrients.
See also BERIBERI; FANCONI’S SYNDROME;LEUKO-
CYTE; MALNUTRITION; NUTRITIONAL DEFICIENCY; NUTRI-
TIONAL NEEDS; PELLAGRA; RICKETS; VITAMINS AND
HEALTH.
starvation The most severe state of MALNUTRITION
resulting from extended lack of food and nutri-
tion. An otherwise healthy adult may lose up to
50 percent of body weight before organ systems
fail and death occurs. Total starvation that persists
beyond about 10 to 12 weeks is usually fatal. In
the United States starvation most commonly
occurs as a consequence of severe illness, severe
gastrointestinal disease, prolonged COMA, and
anorexia nervosa. In parts of the world where
food supplies are limited, starvation results from
famine and causes millions of deaths every year.
The body attempts to survive starvation by dra-
matically slowing METABOLISM. HEART RATE and
BREATHINGrate slow, BLOOD PRESSUREand body tem-
perature drop, and BLOODflow to nonvital struc-
tures diminishes. The body turns to tissues such as
MUSCLEand most organs outside the CENTRAL NERV-
OUS SYSTEM, breaking them down into chemical
products that it can use as NUTRIENTS. Conse-
quently emaciation, in which the body looks
gaunt and wasted, is a key characteristic of starva-
tion.
Treatment for starvation is aggressive nutri-
tional supplementation to restore the body to a
state such that organ systems begin to function. It
can take several weeks for the gastrointestinal sys-
tem to be able to manage solid foods, during
which time PARENTERAL NUTRITIONcan provide sus-
tenance. ENTERAL NUTRITION can deliver concen-
trated nutrients to address emerging NUTRITIONAL
DEFICIENCYdisorders. Full recovery may take six
months or longer, depending on what underlying
health conditions exist.
See also EATING DISORDERS; NUTRITIONAL SUPPLE-
MENTS.triglycerides, dietary Chemical structures that
contain three fatty acids in combination with glyc-
erol. Triglycerides are the most common forms of
fat in foods and in the body. The body uses triglyc-
erides primarily for energy. Dietary triglycerides
circulate in the BLOODalong with triglycerides the
LIVERsynthesizes from carbohydrates and fats the
body does not use for immediate energy. Some
triglycerides then go to cells for use as energy and
others go to adipose (fat) cells for storage.
The liver also uses dietary triglycerides to syn-
thesize (make) lipoproteins, the carrier proteins
that transport cholesterol and fats through the
bloodstream to cells throughout the body. Low-
density lipoproteins (LDLs) and very low-density
lipoproteins (VLDLs) have higher levels of triglyc-
erides than high-density lipoproteins (HDLs). Ele-
vated levels of LDLs and VLDLs in the blood
circulation correlate to increased risk for CARDIO-
VASCULAR DISEASE(CVD), HEART ATTACK, and STROKE.
Triglycerides are present in a wide range of
foods, notably animal-based foods and oils and fats.
Reducing overall food consumption so the calories
in balance with the calories out and reducing the
amount of refined carbohydrates (sugars) in the
diet are the most effective way to reduce blood
triglyceride levels. Daily physical exercise helps the
body more efficiently metabolize nutrients and
increases the consumption of triglycerides as an
energy source. A small percentage of people have a202 Nutrition and Diet