Neuropeptide Y seems to be involved in the process by which fasting produces hunger and motivates eating. Elevating Npy increases food intake (in rats), Npy is higher in obese animals and lower in obesity-resistant animals, it's high in anorexic patients and drops after recovery
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and it causes growth of fat cells in the abdomen. Why might this be *good* for living longer & avoiding cancer & memory loss etc? Well, "anorexia of aging" is a thing and contributes to frailty, in humans and other animals; and both cancer and cognition are energy hogs.
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It makes evolutionary sense that aged organisms should eat less (more food left for their still-fertile kids!) but undereating is a serious problem for geriatric patients from our perspective, and puts them at higher risk for potentially life-threatening injuries and illnesses.
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According to this article, 15% of older persons are malnourished! https://academic.oup.com/ajcn/article/66/4/760/4655899 … Malnutrition causes cognitive problems (4x risk of delirium), greater susceptibility to infections, poorer wound healing, etc. Huge under-appreciated problem.
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It's worse for the institutionalized elderly: 37% (!) are malnourished. https://www.researchgate.net/profile/Nicholas_Hays2/publication/7014604_The_anorexia_of_aging_in_humans/links/5a0aae0eaca272d40f4144d0/The-anorexia-of-aging-in-humans.pdf …
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Some of this is due to aging itself reducing appetite, but a lot is social: poverty, lack of help buying groceries or preparing meals, social isolation, being in an institution with crappy food or staff neglect, etc.
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All the folk-hacks for getting enough nutrition are also clinically validated in the malnourished elderly: tastier & more varied foods, liquid foods, company during meals, assistance acquiring & preparing food, etc. Good news: you don't have to be a doctor to help Grandma eat.
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Anecdotal opinion: the ultimate hack for consuming enough calories while food-repulsed is the milkshake. The cold blunts nausea. Worked for my mom in chemo, worked for me in pregnancy, worked for my ED friend in recovery.
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