By Jyothis James

When you wake up your body is in a postabsorptive or fasting state. This means you have absorbed all nutrients from the last meal and your body is tabbing into your reserves. This scenario will examine the postabsorptive state where homeostasis has to be reestablished during a fasting state.

The scenario: It is the 10th day of Ramadan (30 days of fasting from sun up to sun down). Last night you did not eat or drink anything.

The Absorptive State

What happens? Glucose is oxidized by cells to produce ATP The Liver converts glucose to glycogen and triglycerides Fatty acids, lipoproteins circulated by the liver, are stored in adipose tissue (body fat) Many amino acids are converted by liver to keto acids (for use in Krebs cycle ATP or glucose and fatty acid synthesis). Blood glucose is easily maintained

Postabsorptive State
Blood glucose level begins dropping from the normal 90 100 g/mL after 4 hours. The bodys aim is to maintain blood sugar thus maintaining ATP production. When no food source is available, the body starts generating ATP from other bodily sources.

Glucose Production
The ways its done: The breakdown of glycogen from the liver. This is a major source of glucose for the body, and can be supplied for up to four hours. The breakdown of glycerol stored in adipose tissue (fat tissue) in a process called lipolysis. The breakdown of lactic acid, produced by muscles during anaerobic exercise, through gluconeogenesis in the liver. The breakdown of amino acids, derived from skeletal muscle and other cells, through gluconeogenesis in the liver.

Hormones that regulate fasting

Insulin production drops while hormones that raise blood sugar and counter insulin start to increase. The main hormones include: Glucagon, which stimulates glycogen breakdown to glucose in hepatocytes and muscle fibers, as well as stimulating gluconeogenesis (the synthesis of glucose from non-carbohydrate precursors) in hepatocytes and kidney cortex, cells.

Hormones that regulate fasting continued

Epinephrine which stimulates glycogenolysis in hepatocytes and muscle fibers, and stimulates the breakdown of fatty acids (lipolysis) in adipose cells. Cortisol which stimulates the breakdown of proteins to amino acids in most body cells, stimulating gluconeogenesis in hepatocytes and the kidney cortex cells, as well as promoting lipolysis. Others: norepinephrine, human growth hormone, thyroid hormones

ATP production without glucose

ATP production without glucose Lipolysis which releases fatty acids and glycerol. The fatty acids, unlike the glycerol, cannot be used to produce glucose but most cells can oxidise them, feed them into the Krebs cycle as acetyl CoA, and produce ATP. Cardiac muscles can produce ATP in the presence of oxygen from lactic acid. Liver cells are able to oxidise amino acids to produce ATP. Fatty acids are converted to ketone bodies by the liver; these can be used by the heart, kidneys and other tissues to produce ATP. The nervous system is also able to oxidise ketone bodies to produce ATP if fasting lasts for more than a day. Glycogen can be broken down by skeletal muscle cells to glucose 6phosphate, which can, through the process of glycolysis, be used to produce ATP.

If someone is fasting, the body can start breaking down fatty acids. However the nervous system still depends on glucose. Thus as long as there is continuous water regulation, and blood glucose does not dip under 25% of normal range one can fast for lengthened periods.

Stress Related Hormones

Conclusion
When one is fasting, the body reduces the use of glucose, and instead uses other sourced to produce ATP. The nervous system is dependent on maintained blood glucose levels, though it can use ketone bodies. Fasting can thus be maintained when blood sugar levels do not fall 25% normal range, and the person remains hydrated.