Identifying starvation episodes using stable isotopes in hair Forensic approach on serial hair analysis

Background. Determination of the duration of malnutrition episodes in children or adults, especially to distinguish between acute and chronic malnutrition, is an important part of criminal law assessment. In a previous study a method to reliably detect starvation episodes by serial analysis of stable nitrogen and carbon isotopes in hair samples which can be non-invasively sampled was developed Sequential analysis of isotopic ratios of hair strands of all patients could be related to the respective body mass index (BMI) of each patient. Materials and Methods. In this follow-up study a further seven patients and one control subject were recruited to validate this method. Results. The hypothesis concerning a diachronic change in delta(15)N and delta(13)C during therapy was verified in this study. Conclusion. In this study the application of stable isotopes with serial hair analysis in forensic studies with regard to malnutrition or starvation cases of children and adults has been verified. An unbiased biomarker to reliably determine the onset and duration of chronic or acute starvation in order to set a timeframe for each individual malnutrition neglect case has been established which is independent of age, race, geographical location and individual metabolism.