Period Of Undernutrition Research Articles

Refeeding Syndrome in a Woman with Colorectal Cancer: A Case Report

In digestive surgery, nutritional management of an undernourished patient is nowadays systematic and well codified, and must be part of the initial management measures. However, it is not always risk-free, as inadequately managed renutrition of a patient during a period of undernutrition, or during the post-operative period, can have deleterious clinic-biological manifestations, all too often ignored by practitioners, which we group together under the name of refeeding syndrome. Refeeding syndrome reflecting the transition from catabolic to anabolic metabolism usually occurs within five days of refeeding in patients who have undergone prolonged fasting or in a postoperative context including digestive cancer surgery. Patients may present with water-electrolyte disorders, in particular hypophosphatemia and/or hypokalemia and/or hypomagnesemia, thiamine deficiency, as well as neurological, pulmonary, cardiac, neuromuscular and hematological complications, which can lead to the patient's death. Here we present the case of a patient who underwent surgery in the General Surgery Department at Mohamed 6 University Hospital in Tangier for colorectal cancer. The patient subsequently developed an inappropriate refeeding syndrome accompanied by shock and altered consciousness in the postoperative period. Unfortunately, the patient passed away within a few hours following these complications. This is a cause of mortality that can occur without any surgical complications but remains underdiagnosed in daily practice. The management of this syndrome involves first of all the identification of patients at risk and the prevention of it by careful clinic-biological monitoring, including special hydro electrolyte monitoring, as well as the development of feeding reintroduction protocols tailored to each patient's needs.

Evaluation of spontaneous regional brain activity in weight-recovered anorexia nervosa

Whereas research using structural magnetic resonance imaging (sMRI) reports sizable grey matter reductions in patients suffering from acute anorexia nervosa (AN) to be largely reversible already after short-term weight gain, many task-based and resting-state functional connectivity (RSFC) studies suggest persistent brain alterations even after long-term weight rehabilitation. First investigations into spontaneous regional brain activity using voxel-wise resting-state measures found widespread abnormalities in acute AN, but no studies have compared intrinsic brain activity properties in weight-recovered individuals with a history of AN (recAN) with healthy controls (HCs). SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HC. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFFs), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HCs. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFF), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. Abnormal regional homogeneity found in acute AN seems to normalize in recAN, supporting assumptions of a state rather than a trait marker. Aberrant fALFF values in the cerebellum and the infertior temporal gyrus could possibly hint towards trait factors or a scar (the latter, e.g., from prolonged periods of undernutrition), warranting further longitudinal research.

Paternal under-nutrition programs metabolic syndrome in offspring which can be reversed by antioxidant/vitamin food fortification in fathers.

There is an ever increasing body of evidence that demonstrates that paternal over-nutrition prior to conception programs impaired metabolic health in offspring. Here we examined whether paternal under-nutrition can also program impaired health in offspring and if any detrimental health outcomes in offspring could be prevented by micronutrient supplementation (vitamins and antioxidants). We discovered that restricting the food intake of male rodents reduced their body weight, fertility, increased sperm oxidative DNA lesions and reduced global sperm methylation. Under-nourished males then sired offspring with reduced postnatal weight and growth but somewhat paradoxically increased adiposity and dyslipidaemia, despite being fed standard chow. Paternal vitamin/antioxidant food fortification during under-nutrition not only normalised founder oxidative sperm DNA lesions but also prevented early growth restriction, fat accumulation and dyslipidaemia in offspring. This demonstrates that paternal under-nutrition reduces postnatal growth but increases the risk of obesity and metabolic disease in the next generation and that micronutrient supplementation during this period of under-nutrition is capable of restoring offspring metabolic health.

The importance and elements of healthy nutrition

ABSTRACTNutritional compromise and altered eating behaviour are key characteristics of eating disorders. Body image distortion, excessive fear of fatness, restricted dietary intake, binge eating or purging may occur. The physical and psychological features of eating disorders are profound and are associated with high morbidity and mortality. Starvation or periods of undernutrition are known consequences of eating disorders, though can also lead to many of the peculiar eating behaviours and physical and psychological changes seen in eating disorders. They starved so that others be better fed: Remembering Ancel keys and the Minnesota experiment. Journal of Nutrition, 135(6), 1347–1352]. Nutrition forms an essential component of treatment and evidence suggests also has a role in prevention of illness onset. This series of papers is designed to provide information on the importance of adequate nutrition and the key nutritional concepts relevant to eating disorders. The first paper in this series provides info...

Effect of different types of dietary proteins on liver and muscle mTORC1 pathway after nutritional recovery

It is known that protein synthesis is regulated by mTORC1 (mechanistic target of rapamycin). When activated, mTORC1 promotes protein synthesis mainly by phosphorylation of S6K1 and 4E‐BP1. There is an interest to study some dietary proteins or dietary protein combinations for their possible use in the nutritional recovery. In the present work we studied the effect of different types and combination of dietary proteins on the mTORC1 pathway after a period of undernutrition. Sprague Dawley rats (n= 18 per group), were given a diet with a low concentration of casein (0.5% ) during 21 days in a restricted feeding period (9 hrs). After that period, rats were divided in 7 groups and were fed with one the following diets containing different protein sources: 1) 0.5% casein, 2) 20% casein, 3) 20% soy protein, 4) 20% black bean protein, 5) 20% corn protein, 6) 10% black bean‐10% corn proteins, 7) 10% soy protein‐10% corn proteins. Rats were fed with the corresponding diets during 1, 7, or 14 days. Our results showed that rats fed with casein, soy protein, soy protein‐corn or black bean‐corn had similar weight gain and recovery, meanwhile rats fed with 0.5% casein showed the lowest weight gain followed by 20% corn protein. The phosphorylation of liver and muscle mTORC1 was similar among the groups except for the groups 1 and 5. Rats fed with the combination of dietary proteins or 20% casein showed an increase in pS6K in comparison with rats fed 0.5% casein or 20% corn protein. Thus, the results indicate that the combination of dietary proteins with corn protein probably enhance protein synthesis in a similar extent than 20% casein due to the high leucine content in the corn protein through the activation of mTOR signaling pathway via S6K.

Growth restriction, leptin, and the programming of adult behavior in mice

Prematurity and neonatal growth restriction (GR) are risk factors for autism and attention deficit hyperactivity disorder (ADHD). Leptin production is suppressed during periods of undernutrition, and we have shown that isolated neonatal leptin deficiency leads to adult hyperactivity while neonatal leptin supplementation normalizes the brain morphology of GR mice. We hypothesized that neonatal leptin would prevent the development of GR-associated behavioral abnormalities. From postnatal day 4–14, C57BL/6 mice were randomized to daily injections of saline or leptin (80ng/g), and GR was identified by a weanling weight below the tenth percentile. The behavioral phenotypes of GR and control mice were assessed beginning at 4 months. Within the tripartite chamber, GR mice had significantly impaired social interaction. Baseline escape times from the Barnes maze were faster for GR mice (65+/−6s vs 87+/−7s for controls, p<0.05), but GR mice exhibited regression in their escape times on days 2 and 3 (56% regressed vs 22% of control saline mice, p<0.05). Compared to controls, GR mice entered the open arms of the elevated plus maze more often and stayed there longer (72+/−10s vs 36+/−5s, p<0.01). Neonatal leptin supplementation normalized the behavior of GR mice across all behavioral assays. In conclusion, GR alters the social interactions, learning and activity of mice, and supplementation with the neurotrophic hormone leptin mitigates these effects. We speculate neonatal leptin deficiency may contribute to the adverse neurodevelopmental outcomes associated with postnatal growth restriction, and postnatal leptin therapy may be protective.

Mice undernourished before, but not after, weaning perform better in motor coordination and spatial learning tasks than well-fed controls

Undernutrition of rodents has been claimed to result in long-term behavioural deficits in motor coordination and spatial learning ability, although the literature on this is somewhat conflicting. We have recently been engaged in a study of the effects of either pre- or post-weaning undernutrition on longevity in mice. As part of this ageing study, we have also assessed the effects of such nutritional regimes on motor coordination and spatial learning ability of mice. Motor coordination was tested in 21-week-old control and previously undernourished mice by assessing their ability to remain on a revolving drum. We have found that mice previously undernourished either during the pre- or post-weaning period performed better than controls during some, but not all, of the test days. Spatial learning was tested in 50–58-week-old mice using the Morris water maze. In this instance we found that mice previously undernourished during the pre-weaning period performed better at this task than either controls or mice undernourished for a period after weaning. It seems that undernutrition during the pre-weaning period may, paradoxically, improve the performance of mice in these behavioural tasks compared to controls. Undernutrition after weaning had little or no effect on these behavioural measures. The exact mechanisms involved in causing the observed long-term changes in functional capacity due to a period of undernutrition from conception until weaning age of the mice in our study remain unknown.

Maternal Undernutrition Significantly Impacts Ovarian Follicle Number and Increases Ovarian Oxidative Stress in Adult Rat Offspring

BackgroundWe have shown recently that maternal undernutrition (UN) advanced female pubertal onset in a manner that is dependent upon the timing of UN. The long-term consequence of this accelerated puberty on ovarian function is unknown. Recent findings suggest that oxidative stress may be one mechanism whereby early life events impact on later physiological functioning. Therefore, using an established rodent model of maternal UN at critical windows of development, we examined maternal UN-induced changes in offspring ovarian function and determined whether these changes were underpinned by ovarian oxidative stress.Methodology/Principal FindingsOur study is the first to show that maternal UN significantly reduced primordial and secondary follicle number in offspring in a manner that was dependent upon the timing of maternal UN. Specifically, a reduction in these early stage follicles was observed in offspring born to mothers undernourished throughout both pregnancy and lactation. Additionally, antral follicle number was reduced in offspring born to all mothers that were UN regardless of whether the period of UN was restricted to pregnancy or lactation or both. These reductions were associated with decreased mRNA levels of genes critical for follicle maturation and ovulation. Increased ovarian protein carbonyls were observed in offspring born to mothers UN during pregnancy and/or lactation and this was associated with peroxiredoxin 3 hyperoxidation and reduced mRNA levels; suggesting compromised antioxidant defence. This was not observed in offspring of mothers UN during lactation alone.ConclusionsWe propose that maternal UN, particularly at a time-point that includes pregnancy, results in reduced offspring ovarian follicle numbers and mRNA levels of regulatory genes and may be mediated by increased ovarian oxidative stress coupled with a decreased ability to repair the resultant oxidative damage. Together these data are suggestive of maternal UN potentially contributing to premature ovarian ageing in offspring.

Effects of sex, litter size and periconceptional ewe nutrition on offspring behavioural and physiological response to isolation

Maternal periconceptional undernutrition alters fetal hypothalamic–pituitary–adrenal (HPA) axis development. However, the effects of this early nutritional insult on postnatal HPA axis function and stress-related behaviours are unknown. We investigated in sheep the effects of different periods of undernutrition, and of sex and litter size, on offspring behavioural and cortisol responses to isolation stress. We studied four nutritional groups: controls well nourished throughout pregnancy ( n = 39), or ewes undernourished (UN, 10–15% body weight reduction) before mating (−60 to 0 d, n = 26), after mating (−2 to + 30 d, n = 20) or both (−60 to + 30 d, n = 36). At 4 and 18 months of age, offspring were isolated for 5 min, their behaviour video recorded, and plasma cortisol concentrations measured. Offspring of all undernourished groups demonstrated 50% fewer escape attempts than controls at 4 months of age, and offspring of UN−60 + 30 ewes had 20% lower plasma cortisol area under the curve in response to isolation at 18 months. Females had higher cortisol concentrations and vocalised more than males at 4 and 18 months, and were more active at 18 months. After isolation, UN−2 + 30 males had higher cortisol concentrations than UN−2 + 30 females whereas in all other groups males had lower concentrations than females. Singleton males made more escape attempts than females, whereas in twins females made more escape attempts than males. These findings suggest that maternal periconceptional undernutrition in sheep can suppress behavioural reactions and cortisol secretion in response to isolation stress in the offspring into adulthood, and that these effects differ between males and females.

Undernutrition during the gestation and suckling periods does not cause any loss of pyramidal neurons in the CA2–CA3 region of the rat hippocampus

The total number of hippocampal pyramidal cells in the CA2–CA3 region are reported to be unaffected by undernutrition during the gestation period. We hypothesised that this may not be the case in animals subjected to a lengthier period of undernutrition. Wistar rats were undernourished from conception until 21 post-natal days-of-age and killed for examination at 21 and 62 days-of-age. There were between 180–212 thousand pyramidal cells in control animals at both 21 and 62 days of age. Twenty-one-day-old undernourished rats had about 152 thousand such cells and this increased to about 206 thousand by 62 days-of-age. Analysis of variance tests on these data revealed a significant main effect of age but no group or interaction effects. Our experiments, therefore, confirm that these hippocampal pyramidal neurons are relatively spared the adverse effects of undernutrition during early life, even when this is extended to include both the gestation and suckling periods.

Undernutrition during either the pre- or immediate post-weaning period does not affect longevity in Quackenbush mice

Diet restriction of rodents during a lengthy period of adult life, can lead to a marked increase in their life-span. However, undernutrition during gestation and/or the suckling period is, paradoxically, known to cause long-lasting 'deleterious' deficits in body and brain structure. It remains uncertain whether or not such undernourished rodents also have an altered life-span. We have now investigated whether a short period of undernutrition of mice either before or immediately after the weaning period could modulate their life-span. Female out-bred Quackenbush mice were undernourished for 40 days by standardised procedures either from conception until weaning or from weaning (day 19) till 60-days-of-age and compared to control mice that had been well-nourished throughout their lives. During the course of their life-span, some mice in each group became seriously ill and, because of ethical considerations, were required to be killed before their 'natural' death. The median age of mice at which they were required to be euthanized due to illness was significantly younger in the well-fed control group compared to the two previously undernourished groups. Of those mice that died of natural causes, it was found that about 90% died between about 300–700 (average, 552–570; median, 556–595) days-of-age irrespective of group. Any differences between groups were not statistically significant. There were no significant differences between groups in the numbers of mice that survived beyond the 90th percentile of maximum life-span. Our results provided no evidence that a short period of undernutrition of Quackenbush mice either before or immediately after weaning has significant effects on their life-span. However, there was some evidence that, if it occurred, serious illness happened at a younger age in the well-nourished mice than those in the two diet-restricted groups.

Effects of early-and mid-pregnancy under-nutrition on maternal and foetal plasma free amino acid concentrations in Scottish Blackface and Suffolk sheep

Nutrient intake during pregnancy affects foetal development and placental function in a range of species, often with long-term effects on offspring viability. Maternal supply and placental transport of amino acids are key to delivering amino acids for foetal metabolism. Maternal under-nutrition has been shown to reduce both maternal and foetal amino acid concentrations even after a period of re-feeding (Kwon et al. 2004). Intriguingly whether sheep have been adapted to a harsh environment or not appears to influence the extent of any reduction (Jobgen et al. 2008). The present study therefore tested whether plasma amino acid concentrations differed between Scottish Blackface (B) sheep adapted to a hill environment and a lowland breed (Suffolk, S) selected for lean tissue growth when challenged by a period of under-nutrition.

Refeeding syndrome – awareness, prevention and management

BackgroundRefeeding syndrome is an important, yet commonly overlooked condition affecting patients. It occurs when feeding is commenced after a period of starvation. Head and neck cancer patients are at particular risk owing to prolonged periods of poor nutritional intake. This may be from general effects such as cancer anorexia or from more specific problems of dysphagia associated with this group of patients. Awareness of the condition is crucial in identifying patients at risk and taking measures to prevent its occurrence.ObjectivesThe aims of this review are to:1) Highlight the condition and stress the importance of its consideration when admitting head and neck cancer patients.2) Discuss the pathophysiology behind refeeding syndrome.3) Review the literature for the best available evidence and guidelines.4) Highlight the need for further high quality research.ConclusionRefeeding syndrome is potentially fatal, yet is preventable. Awareness and identification of at-risk patients is crucial to improving management.Refeeding syndrome is caused by rapid refeeding after a period of under-nutrition, characterised by hypophosphataemia, electrolyte shifts and has metabolic and clinical complications.High risk patients include the chronically under-nourished and those with little intake for greater than 10 days. Patients with dysphagia are at particular risk.Refeeding should commence at 10 kcal/kg per day in patients at risk, and increased slowly. Thiamine, vitamin B complex and multi-vitamin supplements should be started with refeeding.New NICE guidelines state that pre-feeding correction of electrolyte and fluid deficits is unnecessary, but should be done concurrently with re-feeding.More research in this field is needed as the evidence base is lacking.

Intra-individual variation in body temperature and pectoral muscle size in nestling Alpine swifts Apus melba in response to an episode of inclement weather

The Alpine swift (Apus melba) forages on insects caught exclusively on the wing, implying that dependent nestlings face acute food shortage in periods of cold and rainy weather. Therefore, there should be strong selection on nestling swifts to evolve physiological strategies to cope with periods of undernutrition. We have investigated intra-individual changes in nestling pectoral muscle and body temperature in response to a 1-week period of inclement weather. The pectoral muscle is the largest reserves of proteins, and nestlings have to devote a large amount of energy in the maintenance of body temperature. The results show that nestling pectoral muscle size and body temperature were significantly reduced during the episode of inclement weather. Assuming that these physiological changes are adaptive, our study suggests that nestling swifts spare energy by a pronounced reduction (up to 18°C) in body temperature and use proteins from the pectoral muscle as a source of extra energy to survive prolonged periods of fasting.

Impact of Research with Cattle, Pigs, and Sheep on Nutritional Concepts: Body Composition and Growth1

Studies with pigs, cattle, and sheep have provided a wealth of information regarding growth and body composition. Most of this information has been obtained using the standard methods for measuring the body composition of meat animals, which consist of dissection and chemical analysis. These methods have been used with meat animals to validate a variety of in vivo techniques that are used in both animal and human body composition studies. Research on the growth and body composition of meat animals has provided important concepts regarding the relation between growth and composition, including chemical maturity, the effects of severe undernutrition, partitioning of nutrients under various physiological conditions, the efficiency of nutrient utilization, and compensatory growth following a period of undernutrition. In addition, several genetic and physiological conditions affecting growth and body composition have been identified in meat animals that serve as important models for both animal and human growth.

Fetal exposure to excess glucocorticoid is unlikely to explain the effects of periconceptional undernutrition in sheep

Periconceptional undernutrition alters fetal growth, metabolism and endocrinology in late gestation. The underlying mechanisms remain uncertain, but fetal exposure to excess maternal glucocorticoids has been hypothesized. We investigated the effects of periconceptional undernutrition on maternal hypothalamic-pituitary-adrenal axis function and placental 11beta-hydroxysteroid dehydrogenase type 2 (11betaHSD2) activity. Ewes received maintenance feed (N, n= 20) or decreased feed from -60 to +30 days from mating to achieve 15% weight loss after an initial 2-day fast (UN, n= 21). Baseline plasma samples and arginine vasopressin (AVP)-corticotrophin-releasing hormone (CRH) challenges were performed on days -61, -57, -29, -1, +29, 33, and 49 from mating (day 0). Maternal adrenal and placental tissue was collected at 50 days. Baseline plasma levels of adrenocorticotrophic hormone (ACTH) and cortisol decreased in the UN group (P < 0.0001). ACTH response to AVP-CRH was greater in UN ewes during undernutrition (P= 0.03) returning to normal levels after refeeding. Cortisol response to AVP-CRH was greater in UN ewes after the initial 2-day fast, but thereafter decreased and was lower in UN ewes from mating until the end of the experiment (P= 0.007). ACTH receptor, StAR and p450c17 mRNA levels were down-regulated in adrenal tissue from UN ewes. Placental 11betaHSD2 activity was lower in UN than N ewes at 50 days (P= 0.014). Moderate periconceptional undernutrition results in decreased maternal plasma cortisol concentrations during undernutrition and after refeeding, and adrenal resistance to ACTH for at least 20 days after refeeding. Fetal exposure to excess maternal cortisol is unlikely during the period of undernutrition, but could occur later in gestation if maternal plasma cortisol levels return to normal while placental 11betaHSD2 activity remains low.

Effect of Refeeding on Growth, Development, and Behavior of Undernourished Bank Swallow (Riparia Riparia) Nestlings

AbstractNestlings of aerial insectivores adjust their energetics, behavior, and development of internal organs in response to food shortages and subsequent improvements in feeding conditions. Here, we present results of laboratory refeeding of Bank Swallow (Riparia riparia) nestlings, which were undernourished between 4 and 7 days of age. During a subsequent three-day-long refeeding, their body mass did not catch up with that of individuals continuously fed ad libitum. However, refed young managed to compensate for delayed growth of pectoral muscles, small intestines, and fully restored fat reserves. Their resting metabolic rates and body temperatures increased to values similar to those of nestlings fed ad libitum. In contrast, digestive activity of their guts (quantified as carrier-mediated intestinal brushborder uptake rate of L-proline) was reduced, as compared with the period of undernutrition. Likewise, high locomotor activity observed during food shortage was significantly reduced upon refeeding. Furthermore, differences in body mass between nest mates, which had earlier modulated both locomotor activity and physiological responses to food shortage, had no effect on mobility and physiology of refed nestlings. Our results indicate that even a short, three-day period of refeeding triggered conspicuous acceleration of growth and development of vital internal organs in previously undernourished nestlings. However, that was not accompanied by significant compensatory whole-body growth (defined as a period of above-normal rapid growth, relative to age).

Metabolic physiology

Body mass (weight) and changes in body mass are the parameters used most frequently to assess the adequacy of an individuals nutrient intake with respect to their nutritional requirements. The precise relationship between the two components is complex and affected by a variety of factors such as activity and disease, but essentially, in health, adipose tissue depots enlarge when energy intake exceeds expenditure and they function as an energy reserve in times of energy restriction. While the immediate determinants of a patient's ability to withstand surgery and illness are principally cardiovascular and respiratory, the ability of these systems to withstand the demands made on them by a prolonged period of illness, often accompanied by a period of undernutrition, and the onset of complications—sepsis, organ failure, etc.—are heavily influenced by metabolic and nutritional factors. Indeed nutritional status is a major factor in the occurrence of postoperative complications. This article will review the methods available to assess protein and energy requirements and nutritional status.

Metabolic physiology

Body mass (weight) and changes in body mass are the parameters used most frequently to assess the adequacy of an individuals nutrient intake with respect to their nutritional requirements. The precise relationship between the two components is complex and affected by a variety of factors such as activity and disease, but essentially, in health, adipose tissue depots enlarge when energy intake exceeds expenditure and they function as an energy reserve in times of energy restriction. While the immediate determinants of a patient's ability to withstand surgery and illness are principally cardiovascular and respiratory, the ability of these systems to withstand the demands made on them by a prolonged period of illness, often accompanied by a period of undernutrition, and the onset of complications—sepsis, organ failure, etc.—are heavily influenced by metabolic and nutritional factors. Indeed nutritional status is a major factor in the occurrence of postoperative complications. This article will review the methods available to assess protein and energy requirements and nutritional status.

EFFECT OF REFEEDING ON GROWTH, DEVELOPMENT, AND BEHAVIOR OF UNDERNOURISHED BANK SWALLOW (RIPARIA RIPARIA) NESTLINGS

Nestlings of aerial insectivores adjust their energetics, behavior, and development of internal organs in response to food shortages and subsequent improvements in feeding conditions. Here, we present results of laboratory refeeding of Bank Swallow (Riparia riparia) nestlings, which were undernourished between 4 and 7 days of age. During a subsequent three-day-long refeeding, their body mass did not catch up with that of individuals continuously fed ad libitum. However, refed young managed to compensate for delayed growth of pectoral muscles, small intestines, and fully restored fat reserves. Their resting metabolic rates and body temperatures increased to values similar to those of nestlings fed ad libitum. In contrast, digestive activity of their guts (quantified as carrier-mediated intestinal brushborder uptake rate of L-proline) was reduced, as compared with the period of undernutrition. Likewise, high locomotor activity observed during food shortage was significantly reduced upon refeeding. Furthermore, differences in body mass between nest mates, which had earlier modulated both locomotor activity and physiological responses to food shortage, had no effect on mobility and physiology of refed nestlings. Our results indicate that even a short, three-day period of refeeding triggered conspicuous acceleration of growth and development of vital internal organs in previously undernourished nestlings. However, that was not accompanied by significant compensatory whole-body growth (defined as a period of above-normal rapid growth, relative to age).