I like the idea. It reminds me of some survival mods for skyrim. They make normal gameplay a lot harder to pull off by making diseases very deadly and you actually have to eat, sleep, and stay warm to survive. I even heard of one where torches burn out and all the dungeons are pitch black. These mods together could cause a normal dungeon to take a long time to complete and also prepare for so it was sort of neat in its own way - preventing you from going through many dungeons in a single sitting.
Anyway, I think, since you don't have the whole world of skyrim to live in (unless you really do build a large world map), you should focus on the gameplay elements that this theme entails. That means hard combat that focuses on basics like you mention - not taking damage, conserving supplies, etc. No room for things like becoming a god due to items you obtain.
I would focus on making interesting enemies (dodge-able abilities and attacks, exploitable weaknesses) and interesting items (mostly consumable that get depleted in some way).