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AFAIK people that suffer from severe starvation (e.g., prisoners liberated from concentration camps in the end of WW2) can die if you allow them to eat "at will". There is documented evidence that eating too much after prolonged starvation can make you physically ill immediately, as well as refeeding syndrome which occurs because the body doesn't have the materials necessary to sustain digestion (And can be fatal).

If you don't have access to medical equipment, such as drips and some kind of nutrient solution, but just more common food of the type you have with you when camping or at home - how do you feed someone suffering from starvation in a safe way?

  • You can buy metabolic salt packs which are made for starvation, they are a powder which is mixed with water and drank at a rate which won't shock the cells. Other than intravenous, they do nasal-stomach tubes if the person is comatose. – aliential Apr 1 '19 at 10:02
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    @com.prehensible But that is not really anything you have in your pantry? – d-b Apr 1 '19 at 14:51
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    mashed potatoes and fruit are what the red cross used in ww2 so that should be available. A potato is high in potassium, magnesium, iron, copper and manganese. It also contains vitamin C and most B vitamins. – aliential Apr 1 '19 at 18:03
  • This is an interesting question but unfortunately it doesn't meet MedSci.SE requirements and shouldn't have been migrated. Instead of rejecting the migration, could you please do some basic research on this and add what you find to your question? A reference to a credible source that says feeding a starving person can kill them would be sufficient. – Carey Gregory May 1 '19 at 20:34
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    @d-b - I edited the question to bring some evidence in and skew it a little more towards a medical type question. If you disagree with the edits, you are free to roll it back. – JohnP May 1 '19 at 21:10
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DISCLAIMER: This answer is only about "how to break fast" and prevent refeeding syndrome in otherwise healthy adults, not in those who suffer from chronic alcoholism, eating disorders, cancer or other conditions.

Refeeding syndrome can occur within few days of rapid feeding that follows prolonged starvation lasting for more than 5 days. Symptoms can include weakness, muscle cramps, tingling, seizures and, possibly, death.

Refeeding syndrome occurs due to glucose that quickly enters the cells and drags phosphate, potassium, magnesium and vitamin B1 with it, resulting in hypophosphatemia and, less commonly, hypokalemia, hypomagnesemia and vitamin B1 deficiency. Sodium and water retention resulting in edema can also occur.

Prevention of refeeding syndrome:

  • Slow feeding in the first week:
    • after 5-10 day fasting: 20 Kcal/kg body weight/day
    • after >10 day fasting: 10 Kcal/kg body weight/day
  • Taking multivitamin supplements, including vitamin B1, daily for at least 10 days
  • Eating usual foods, but taking care to get enough phosphates (meat, canned fish with bones, cheese, eggs) and potassium (potatoes, bananas)
  • Avoiding foods high in sugars and other quickly-absorbable carbohydrates (fruit juice, soda, sweets, white bread, pasta cookies or rice) to prevent quick blood glucose shifts
  • Drinking only as much water as necessary to maintain normal skin turgor and excretion of clear or straw-yellow urine, and avoiding excessive salt intake to prevent water retention (swollen ankles)

Sources:

  1. Refeeding syndrome: what it is, and how to prevent and treat it (PubMed, 2008)
  2. The Importance of the Refeeding Syndrome (Hopkins Medicine, 2001)
  3. Refeeding syndrome – awareness, prevention and management (PubMed, 2009)
  4. Refeeding Syndrome: Recognition Is the Key to Prevention and Management (Journal of American Dietetic Association, 2008)
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