With the hostages now safely in Israel’s care, one of the primary objectives is to avert critical health issues such as salt imbalances and the dangerous effects of refeeding syndrome. To achieve this, the process of reintroducing nutrition will be carried out with extreme care and precision, addressing deficiencies methodically and at a measured pace.
In the first few days following their release, the medical focus will center on their physical health, particularly the possibility that they endured significant periods without proper nourishment. Experts in clinical nutrition will carefully supervise their recovery, following a strict and structured plan designed to restore their health.
As part of their initial care upon arrival at an IDF facility, the hostages were offered a small meal consisting of tea sweetened with a teaspoon of sugar, three biscuits, and a serving of applesauce. Additionally, they were administered 100 mg of thiamine, an essential vitamin (B1) that supports critical metabolic functions in the body.
Thiamine deficiency can have serious neurological consequences, including the development of Wernicke-Korsakoff syndrome. This condition manifests as confusion, impaired eye movement, and other severe symptoms that may lead to irreversible brain damage if left untreated.
When the body begins metabolizing carbohydrates after a prolonged period of fasting, the need for thiamine rises significantly. Early intervention with thiamine supplementation is crucial in preventing refeeding syndrome, a potentially fatal condition characterized by significant metabolic disruptions.
This syndrome can cause drastic drops in potassium, phosphorus, and magnesium levels, coupled with an increased demand for thiamine, which can lead to dangerous cardiac and neurological complications.
Thiamine plays a vital role in supporting the proper function of the heart and other critical systems, as well as aiding the body in recovering cellular energy following prolonged starvation.
If left untreated, a lack of thiamine can result in symptoms such as fatigue, weakness, lactic acidosis, and impaired functioning of the central nervous system. Administering thiamine is therefore a key step in ensuring a safe recovery for individuals suffering from malnutrition or starvation.
Health Ministry protocols include the following: During the initial 24 hours of refeeding, each hostage will have their vital signs—such as heart rate, blood pressure, and oxygen saturation—monitored every four hours. Comprehensive blood work will also be conducted to identify and address any imbalances or deficiencies, with adjustments made gradually based on the individual’s BMI (body mass index), calculated as weight divided by height squared.
The Health Ministry’s guidelines classify hostages into categories based on their BMI. Those with a BMI between 16 and 18.5 (below the normal range of at least 20) are deemed at moderate risk, while a BMI under 16 indicates severe starvation and places the individual in the high-risk category.
Depending on their nutritional status, hostages will receive daily multivitamin supplements for a minimum of 30 days. Additional supplements, such as vitamin D (due to prolonged periods spent in darkness) and vitamin B12, will also be provided as needed.
For those at moderate to high risk, fluid intake and caloric nutrition will be carefully calculated based on their body weight. Some may also require glucose infusions to address specific deficiencies. Progress will be closely monitored, with caloric intake increased by 33% of the target amount every one to two days. The ultimate aim is to meet the full nutritional requirements within five to ten days.
Each individual will also receive an informational handout, which states: “After a long period of limited eating, it is very important to return to regular eating gradually and moderately to prevent potentially life-threatening complications that may result from rapid exposure to food and drink following a prolonged period of significantly reduced food intake.
To help prevent nutritional and health deterioration in the near term, it is recommended to eat gradually and cautiously until you return to the amounts you were accustomed to.
The dietitian at the medical center will accompany you through the process and assist in selecting and adjusting the types and amounts of food and drink daily, based in part on the results of various medical assessments.
This support will continue even after discharge from the medical center until nutritional rehabilitation is complete. Recording the types and quantities of food and drink consumed each day can assist in providing accurate guidance.”
{Matzav.com Israel}