Appropriate to this thread, and fittingly titled, Fuel Metabolism in Starvation
By George Cahill, and it says right upfront that it’s “partly biographical and partly scientific.” But there’s lots of good information. It starts getting really sciency on page 6. My own paraphrasing of some of it:
When fasting, nitrogen excretion goes way down (in obese people, anyway), meaning not much lean tissue is being consumed. The brain switches over to using mostly ketones for fuel, rather than glucose. This means that much less glucose is needed, and hence, much less lean tissue (muscle, etc.) breakdown.
a normal adult human could survive two months of starvation; an obese person could survive
much longer.
When fasting, ~40% of fatty acid metabolism in the whole body is from the liver making ketones.
After 2 or 3 days of fasting, the liver pretty much stops making glucose from glycogen. During longer fasts, the total glucose production - from any and all abdominal organs - is about 80 grams per day.
During longer fasts, the kidneys make ~40% of the glucose we use, the liver makes ~60%.
The increased fat breakdown during fasting releases fatty acids and glycerol - the liver uses glycerol to make glucose.
Higher ketone levels eventually slow down the release of fatty acids from our fat tissue - a counter-regulating effect. (This would probably be a ‘self-limiting’ factor that would apply to how much fat we can access per day, etc.) “but insulin is necessary for this effect.” I presume once again that this is an example of “lower insulin” being better for fat loss and energy production.
Ketones as a good fuel source - a working rat’s heart shows higher work output and lower oxygen consumption when it’s running on a mix of ketones and glucose, versus glucose alone. This is observed in other entities as well. Ketones are ‘ancient’ molecules that have been around and in use for billions of years. They’re a more efficient fuel than glucose.
Newborn humans are in ketosis. At birth, blood glucose levels go way down, and ketone concentrations rise, with the brain accounting for 60% to 70% of total metabolism - and almost half the brain’s energy is coming from ketones. Mother’s milk starts out with lots of triglycerides (fat) and protein, but not much sugar at all. Keto diet! This changes in the first few days, the lactose concentration increasing and the baby leaving ketosis.