Metabolic switch,

rem darurat keganasan Covid-19

Piprim Basarah Yanuarso

Covid-19 dan badai sitokin

REM GAS

REM DARURAT
Metabolic switch (rem darurat) :

• Glycolysis --> Ketosis

• Sympathetic activities -->

Parasympathetic activities

• Weak hijacked Autophagy --> or fasting

Strong Autophagy

Ketone Concentration Brain Fuel

Energy substrates for brain during fasting

Grabacka M. Int J Mol Sci (2016) 17 : 2093

Brain substrate utilization after several weeks of starvation

Cahill, Annu Rev Nutr. (2006) 26 : 1-22
How can we “buy” KETONE ?
 Beneficial Effect of Ketone
Improvement of health outcomes by increased BHB

Glycogen sparing
↑ fat oxidation ↓ inflammatory airway ↓ oxidative stress &
Longevity/health span
disease & asthma inflammation
↑ mitochondria

Dietary manipulation or supplementation to induce BHB elevation

Milton Packer
Strong autophagy vs Hijacked autophagy

JANITOR INTRACELLULAR

pH: 4,5
 Autophagy:
the housekeeper in every cell

Pemicu Autophagy:
• Infeksi patogen
• Puasa
• Olahraga
• Obat-obatan

Fasting vs starvation vs calorie restriction

Starvation is a severe de ciency in energy intake. The

body doesn’t have access to essential nutrients and is
slowly wasting away by cannibalizing its vital organs.

It’s a gradual process of degradation that’s often

characterized by the skinny-fat look or the bloated
stomach called kwashiorkor which is caused by
insu cient protein even in the presence of su cient
caloric intake”

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 Fasting vs starvation vs calorie restriction Fasting vs starvation vs calorie restriction

Caloric Restriction reduces calorie intake without causing

malnutrition or starvation. You’re simply consuming fewer
calories needed to maintain your body’s current energy Fasting is a state of metabolic suspension in which
demands. This will make you burn your stored fat and also you’re not consuming any calories. Despite that, your
lowers the body’s overall metabolic rate, down-regulated body is still nourished and gets the energy it needs. This
reproductive hormones, thyroid functioning and promotes happens by shifting into ketosis, in which you’ll be
gluconeogenesis.
burning your body fat almost exclusively”

The di erence between caloric restriction and starvation is

that when calorically restricted, your body still gets access
to the energy it needs to maintain its daily energy demands.
It’s just that those energy demands have adapted to be
lower and more e cient in terms of energy gained per
calorie”

FASTING STARVATION

Puasa 382 hari: 207 kg —> 82 kg (- 125 kg)

Mulai Juni 1965, Angus Barbieri (1939 - 7 September 1990) berpuasa selama 382 hari. Dia hanya minum
teh, kopi, air soda dan vitamin, tinggal di rumah di Tayport, Skotlandia, dan sering mengunjungi Rumah Sakit
Mary eld untuk evaluasi medis. Dia kehilangan 276 pon (125 kg) dan mencetak rekor sebagai durasi puasa
terlama
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Terimakasih