Anna Hazare’s urine shown presence of acetone which means that his fat is now becoming the source of energy, said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health mela. As long as fat content in the body remains more than 10% the body can tolerate fasting. Anna being 70 kg can afford to lose 10 kg weight.
The fall of upper BP by 30 and rise of pulse by 10 means dehydration and need for more fluids.
1. Ketonuria is a medical condition in which ketone bodies are present in the urine. Medically it is presence of acetone in the urine.
2. It is seen in conditions in which the body produces excess ketones as an alternative source of energy. It is seen during starvation or in diabetes. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy.
3. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids.
4. In prolonged fasting insulin deficiency increases fat lysis and increased free fatty acid delivery to the liver. Glucagon excess promotes conversion of free fatty acids into ketoacids in the liver.
5. Ketone bodies that appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced. Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading.
6. The body continues to use fat for as long as there is fat to consume. The body will generally indicate to the faster when fat levels are running extremely low (less than 7% and 10% of body weight for males and females, respectively) with an increased urge for food. Fasts are usually broken long before this point. If the fast is not broken, starvation begins to occur, as the body begins to use protein for fuel. Health complications associated with fast-induced starvation include electrolyte imbalances, thinning hair, lanugo, cardiac arrhythmia and renal failure. Death can occur if fasting is pursued to the point of complete starvation.
7. While fasting one should not take paracetamol as it can case fatal liver damage.
8. Acetone can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetone. A small amount of acetone is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. In prolonged fasting the Ketoacid levels do not exceed 10meq/L and plasma bicarbonate concentration is typically above 14meq/L. The limitation in the degree of ketone formation with fasting in part reflects the ability of ketonemia to promote insulin secretion, thereby limiting the availability of free fatty acids. There is also increased ketoacid uptake by the brain as it switches from glucose to ketones as a source of fuel.
9. Fasting ketoacidosis is treated by administration of dextrose and saline solutions. The dextrose will increase insulin and reduce glucagon secretion, while the saline will repair any fluid deficit.
10. The plasma phosphate concentration may fall to low levels with therapy as insulin drives phosphate into the cells. When present, severe hypophosphatemia may be associated with marked and possibly life-threatening complications in these patients, including heart attack.
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