JOURNAL
OF
VOLUME
5
THE
1, NUMBER
CLINICAL
JULY-AUGUST,
Treatment
of OBESITY
Calorically
UNRESTRICTED
I
well
IS
T
quires
to
known
that
weight
a limitation
a level
penditure.
by
conscious
of
below
This
that
limitation
restraint
of
there
that
it
logical
upon
forces
which,
being
the appetite,
regulate
is
lost
the
In
appetite
appears
mechanisms;
and
obese,
higher
level
to
in
cessive
fat
storage,
caloric
intake
stance
that
more
for
the
operate
It
at
seems
the
the oxidative
a factor
which,
disturbs
This
decrease.
on
the expernnents
Keeton
and
as
the
inhibiting
influence
on the
oxidation
of fat,
with
a
of
Co.,
Wilmington,
I.
du
Pont
work
of
a plan
of
restricted,
decline
a
is to
be expected.
OF
THE
OIwsE
DIETS
been
reviewed
by
who i’efer to the
Evans
Rynearwork
of
by
acid,
obese
finds
the
reports
of this
sub-
that
insufficient
the
result
h)CFSOUS
erage
(IP Nemours
among
Del.
:343
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by Washington University, Law School Library user
on 21 May 2018
and
(lecline
eight
Strang.#{176} Moller.7
Rony9
as showing
conclusions
were
based
Strang
and
of Evans
an(1
Bone.’#{176} Rynearson
question
rate
in
the
and
Rony’s
that
the
metabolic
permit
elusion.
Brown
and
Topper,8
diet
Re-
is believed,
of pyruvic
such
Erown
and Ohlson4
and of Strang
and Evans
as showing
a (leerease
in basal
caloric
expenditure
of the
obese
on low calorie
diets,
and to
such
rest nc-
is
CALORIE
subject
has
(;astinetti,3
be-
and
E.
and!
the
suggested
of
EXPENDITURE
Low
and
been
Division,
CAroRIc
Muhier
in a calorically
unrestricted
essentially,
of protein
and fat.
Medical
BASAL
ox
the
energy
needs
of the
tissues,
being
fully
supplied
from
the body’s
own re-
From
intake
expenditure
the
output;
it
caloric
caloric
pyex-
has
11cr
beell pointed
out by Dole
et (:1.2
however,
to be an even greater
this
method
of treatment,
in
pathway
of
by inducing
and
source
advantage
total
sOfl
sina
cornes)on(lingly
in basal
reason-
balance
a
restriction
of the whole
for,
when
carbohydrate,
is restricted,
there
is no decline
in the
caloric
expenditure.1
When,
however,
l)asal
the
ate
to general
pattern;
alone,
by regulatory
are disturbed
to
of food.’
strategic
contrast
dietary
enforcing
individuals,
weight.
of carbohydrate,
much
of the
alleviates
to bear
weight
normal
of carbohydrate
striction
removing
brought
it so that
at a normal
weight
level.1
been
presented
for a meta-
block
acid
treatment
composed,
believing
physio-
diet
treatment
has
There
appears,
advantage
to
expect
that,
if the cause
of
can be removed,
these
stillshould
adjust
the caloric
bolic
ruvic
as
ex-
by
stoles.
intake
The
intake
caloric
for
DIETS
MI).
SeIVC
is usually
effected
the
appetite
hut
continue
of body
intake
to output
Evidence
has
tion
the
to be limited
though
these
they
able,
therefore,
the disturbance
intact
mechanisms
tween
caloric
of
necessity
restriction.
in the
the
ic-
1953
with
PENN1NTON,
reduction
appears
to
be
reason
can also
be accomplished
without
caloric
and
A. \V.
By
NUTRiTION
of
the
the
fall
reduction
observes
of the
basal
of weight
of
is of some
importance;
contradictory,
and
studies
have
formation
of
any
Ohlson’s
studies4
no
been
but he
lie feels
made
definite
showed
of 17 per cent
in basal
young
women
of college
to
‘on-
an
av-
calories
age: and
344
THE
Strang
and Evans,
in their
a decline
of 14 per cent,
than
the
face
latter
area.
The
investigators
decline
in
JOURNAL
OF
which
cases,
was
showed
greater
the
weight
or
five
either
CLINICAL
method
that
fatty
based
on
is
metabolically
tissue
sur-
inert
and that,
therefore,
its weight
be taken
into account
when
metabolic
the
it
as-
should
not
calcula-
tions
are
made.
The
discovery
that
fatty
tissue
is metabolically
active,
however,”
seems
to rule out the validity
of metabolic
calculations
based
on
calculation
metabolism
and
its
tageous.3
ideal
weights,
a
which
has been
used
of the obese
appear
decline
Examination
on
low
calorie
method
of
to make
hypernormal
the
diets
of the basic
data
decline
in metabolism
OF THE
ENERGY
reference
to the work
of the
as showing,
also,
that
no
weight-a
sumption
had
DECLINE
1,
was
found
that
obese
individuals,
weight
after
treatment
by
diets,
intake
maintained
considerably
a constant
lower
people
would
of similar
age
seem to indicate
who
low
calorie
weight
on a food
than
that
of other
and dimensions.4
that,
between
groups,
there
exists
a
metabolic
which
would
require
that
the
person
imist
subsist
on
difference
formerly
obese
a subcalorie
intake
suhealoric
diets
in fact,
become
after
weight
reduction
a standard
It would
seem
obese
persons
has,
recommendation.3
that
the situation
with formerly
is very similar
to that
of normal
who
have
accustomed
themselves
to a caloric
intake
below
their
requirement.
In both
there
would
seem
to have
occurred
what
Lusk
referred
to as a “specific
reduction
who
that,
there
was
significant.
a decline
The
which
was
not
one case
studied
ion. “12
The
question
of
greatest
significance
showed
a decline
of
connection
with
the
use
of low
calorie
is true,
as
is
in basal
metabolic
from
the graph).
rate
(B.M.R.)
Mulier8
found
per
in
cent
(calculated
a decline
of
only 3.8 per cent in the B.M.R.
of 25 children,
but pointed
out that
the pelidisi
of Pirquet*
is a better
standard
in this age group
than
is
average
decline
of 12.2 per
They
did not consider
this
the rates
did not fall
of normal,
customarily
clinical
tests
of the
however,
such
note
that
dence
that,
is a
fall
use
of lQw
According
in the
in
data
give
obese
metabolic
calorie
to
B.M.R.
because
the arbitrary
limit
used
in interpreting
metabolism.
It seems,
physiological
The
basic
seem
to
by
an
below
to take
significant
of the various
overwhelming
adult
rate
at
inevi-
least,
there
attendant
on
height
in
centimeters
is
grams
of
a normal
person.
the
cube
approximately
of
the
the
sitting
weight
Downloaded from https://academic.oup.com/ajcn/article-abstract/1/5/343/4786830
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on 21 May 2018
it
that
the reserve
stores
in an amount
sufficient
needs
of the organism.
that
a fall
that
the
has
are
declined,
fulfilled
in basal
with
undernutriin
diets
generally
is
believed,
of fat are drawn
upon
to meet
the metabolic
It might
be reasoned
metabolic
rate
means
of
tissues
for
requirement
the
only
energy
and that
their
metabolic
needs
in any case.
Another
interpreta-
tion,
however,
could
be that
mal
that
metabolic
a decline
rate
below
for each
individual,
this
rate
indicates
less
than
an optimal
eral
state
basal
metabolism
of
the
diets.
Pirquet,
coincident
there
amount
is an
of energy
optiand
that
is being
made
available
for the metabolic
work
of the
tissues.
This
interpretation
would
be in accord
with
Benedict’s
view
that
the
basal
metabolism
is “a very
good
index
of the gen-
experiments
as this
it is more
appropriate
of the actual
changes
in the
variables.
vestigators
*
in
cent. in the
significant
metabolism
whether
the
usual
surface
area
rule.
Calculations
from
the graphs
of the eight
eases
studied
Keeton
and
Bone’#{176}show
that.
there
was
of
food the rest of his life if he chooses
to control
his weight
by this
means.
Continuance
of
actually,
considered
12.5
This
two
the
no
Moller7
5
IN BASAL
reported
by
No.
EXPENDITURE
lost
individuals
advan-
of those
reveals
[Vol.
SI(NIFICANCE
decline
occurs,
stems
from
their
introduction
of a special
formula
for calculating
metabolic
rates
from
the
ideal,
rather
than
from
the
actual
NUTRITION
in
or
caloric
level
of vital
would
nutrition
at
customarily
interpreted,
olism
tests
are
the
diagnosis
thyroid
in ordinary
gland
rarely
and
;14
clinical
activities.”3
appear
the
The
to he an
cellular
however,
of great
index
level.
basal
value
As
metabexcept
in
treatment
of diseases
of the
and
very
well
be that
range
of error
it may
practice
the
July-August
is
A.W.
1953]
too
wide
for
which
uses
precision.
The
answer
decline
in metabolic
rate
calorie
diets
reflects
ment
of
to
the
merely
require
question
PENNINGTON
greater
obese
a lessened
on
should
be possible
for
nutrient
material
to
the
which
low
be
whether
of the
345
they
no
are
of
the
the
tissues,
or, on the other
hand,
it signifies
that the tissue
requirements
and
are
not
being
tate
an
mental
inquiry
matters
duced
when
obesity
unrestricted
diets
alone,
is limited.
fulfilled,
to
necessi-
into some
of the most
in metabolic
theory.
fundaMeta-
bolic
theory,
in its
answer
oxidize
the
the
question:
amount
would
seem
broadest
scope,
attempts
to
on the
Rubner’s
matter
con’cept
has
of
a rigidly
fixed caloric
expenditure,
determined
by the requirement;
this in turn
is determined
by the surface
area of the body.
This cofleel)t
was opposed
vigorously
by Rubner’s
teacher,
Voit,
who insisted
that,
while
the tissues
have
a certain
foodstuffs,
maximal
capacity
the am o u ut they
is
the
normal
is enabled
to
utilize
it
otherwise
than
is
Consequently,
fatty
acids
causing
the
tissues
to
Ketogenesis,
key
the qualto them
to
calorically
than
the
requirement
one’s pocket.”
Voit’s
would
seem to find
greater
support
zation
in studies
of glucose,15
show
acids,16
by
tissues
the
which
fatty
is influenced
tions
of these
substances
decline
in metabolism
weight
reduction
by low
might
reserve
reasonably
stores
bilized
rapidly
needs
of the
w’ould
OF FAT
seem
drinking
the
mo-
that
the
DURING
to
oxidation
fat
be the
of
adequately
mobilization
a sufficient
can
degree,
be
reduced,
to
be
and
it
Downloaded from https://academic.oup.com/ajcn/article-abstract/1/5/343/4786830
by Washington University, Law School Library user
on 21 May 2018
the
on
this would
the
obese,
in
the
energy
the
indicate
voluntary
requirements
tissues
by
the
fat
to
deposits,
a corre-
experiments
introduced
in which
into
the
a very
precise
adjust-
intake21
and
the
effect
would
nutrients
were added
limiting
factor
reduction.
When
in-
caloric
on the
it
be the
to the
same
meta-
the
of
then,
body’s
an inwould
appetite,
the disproportion
between
caloric
expenditure
which
is necessary
draw
If fat
of
seem
bolic
pool
from
without
or from
own
reserve
stores.
Mobilization
creased
quantity
of utilizable
fat,
metabolic
of
stimulated
water
seems
whether
ity
be
upon
in the
actual
inhibition
of
urged
ment
primarily
toward
and
utilization
of
the dubious
abil-
can
quota
be
Animal
are
treatment
larger
to
materials
obese
to direct
measures
increased
mobilization
instead
of relying
upon
upofl
applicability
extent.
in the
in
and
nutrient
the
an
fat,
to
diets;
sponding
UTILIZATION
caloric
restriction
the adipose
deposits.
unrestricted
concenti’a-
the
them
reduction
the
REDUCTION
desirable
of weight
of the body’s
would
decline
meet
of both
increased,
would
possibility
creased
mobilization
and
the
appetite
tissues.
WEIGHT
oxidize
the utiliketones’T
the blood.
The
of the
obese
during
calorie
diets, therefore.
to
tissues.’9
ketogenic
response
to fat feeding
is
than
it is in the lean.2#{176} A greater
than
ordinary
in
enough
mobihi-
adipose
that
and
be taken
to indicate
that
body
fat are not being
of
STIMULATIoN
It would
by
cause
increased
the
becomes
therefore,
the
metabolism
any
more
for gold will put it into
concept
of the metabolism
the
quan-
Ketonemia,
amounts.’6’1’
for energy.”
be
larger
concentration
and
the
requirement
possibly
blood
the
much
is
by
from
ketones
special
“The
“cannot
in
and
it appears,
the organism
could.’8
acids
be
pro-
of protein
which
followed
of fatty
have
blood.’2
said,
fat
would
by calorically
carbohydrate,
Ketogenesis,
by
for
tissues,
situation
is treated
in
which
tities
whom
the
rate
is the
mechanism
then
calories
of the
metabolic
ketogenic.
zation
work
it seems,
this
of
would
of
c’o#{241}sisting essentially
fat
of
by
Voit
in
This,
furthermore,
for metabolizing
actually
me taho-
lize is influenced
by the quantity
and
ity of the nutrient
materials
brought
decline
A diet
what
causes
the body
to
of nutrient
materials
that
it does?
Current
thought
l)een
largely
colored
by
no
There
a shortage
metabolic
whether
expected.
tissues
to utilize
maximum
extent
capable.
question
performing
require-
the
the
effecting
intake
and
for
weight
such
a plan
of treatment
is used,
caloric
intake
would
according
to
the needs
of each
This
appears
to
individual
from
day to
be a great
advantage,
day.
for
daily
variations
in
and
other
factors
affect
vary
physical
the
energy
activities
requirements;
the
THE
346
and
for
weight
loss
under
these
sues, first,
nutriment
the
would
appetite
proceed
to
the
make
up
eniphasized.
Evans
when
this
some
obese
weight
on
ler
found
a day.3
in
method
adipose
intake
of
tis-
of the
leaving
The
of
the
have
obese
often
for
been
that
they
range
UI)
There
is, therefore,
observation
that,
the
of treating
individuals
an
case,
time remainder.
requirements
constant
weight
calories
remarkable
OF CLINICAL
any
a considerable
quota
by the organism,
large
caloric
maintaining
to 4500
nothing
in
circumstances
furnish
required
JOURNAL
obesity
must,
of necessity,
3000
calories
lose
or more
in
mum
the
of
OF
practical
8 ounces
mended
for
use
of
OF THIS
TREATMENT
of this method
meat
has been
a minirecom-
of the
three
and to emphasize
to be eaten,
one
that
part
fat, as well as lean,
of fat to three
parts
has
of the
been
suggested
as
This
is the
general
adopted
by choice
has been
followed.22
when
day;
meat
is
of
diet
has
been
allowed
in
an
not to interfere
with
ketofound
that
100 Gm. of carbo-
hydrate
would
reduce
amount
viduals.23
seems
The
to
very
ketogenesis,18
and Evans,
containing
only
hydrate,
were
ketogenic,24
showed
tion.
In
unrestricted
day have
a very
favorable
most
of the
calories,
of a few
are
foods
not
containing
20 Gm.
of carbohydrate
Liberal
lowed.
Salt
value
eases
ac-
on a calorically
diet,
60 Gni. of carbohydrate
been allowed,
although
in a few
tity
of carbohydrate,
foods,
it has seemed
retention,
and
5
sug-
be increased
known,
often
this
A
vised,
may
exist.
weight
general
hygienic
regimen
including
regular
rest,
slee)ing.
A half-hour
walk,
in a
of the
has
been
adwithout
overor the
the
are supplied
by fat
fast,
the l)I’oportion
in
the
after
can
equivalent
stimulating
ganisni.
Since
th
readily
understandable
following
matters
set
the
state.’5
The
by calorically
depends
upon
uneffec-
obese
use
of
fM
must
have
guide
to
patient
sheet
of instructions,
forth
above,
has
proved
satisfactory
been
by,
the
the
and
the
four
past
instructhe paon many
Although
some
may
find
reason
to
certain
details,
it has seemed
best to
it in its entirety,
in the form
in which
been
effectively
used.
The
essential
on which
a calorically
unrestricted
appears
to
stimulating
ferent
from
work-that
the oxidation
that
of low
of the chief tasks
the new orientation.
of
in applying
quan-
Reasoning
calorie
diets
ters applicable
average
of about
vertently
be
carried
over
in an ordinary
serving.
calorically
fectiveness.
unrestricted
Such,
diet,
seems,
associated
has
sufficiently
of fat-is
quite
calorie
diets;
and
various
a list
Downloaded from https://academic.oup.com/ajcn/article-abstract/1/5/343/4786830
by Washington University, Law School Library user
on 21 May 2018
or-
a concise.
go
dietary
otherwise
indecisive
with
of certain
obesity,
and
the
of
grams,
in
to provide
have
been
both
for
by
embodying
prepared
during
veam’s.
Like
most
sheets
tions,
its form
is didactic:
tient
is likely
to become
points.
question
present
it has
?principle
overby
post-absorptive
tively
has
the usual
be increased
in
helpful
treatment
with
which
metabolism
may
Salt, as is well
familiar
an
report
extent
not explainable
by the
which
may
be retained.
diet
pci’
cases
seemed
necessary.
they
are familiar
amounts
of water
has been
restricted,
of this in the
often
associated
time
protein-sparing
a more drastic
reduction
has
Since
most
patients,
though
with
but.
different
indidiets of Strang
40 Gm. of carboand
these
diets
patients
one
entire
success
of treatment
restricted
diets,
it seems,
Carbohydrate
amount
calculated
genesis.
Peters
vary
in
low calorie
fluid
exercise
the proper
proportion
an exclusive
is at least
1, No.
subclinical
degree
more
often
than
is realized!.
The
clinical
inhl)ression
is gained
that,
with
some
individuals
at least,
salt interferes
with
weight
loss on calorically
unrestricted
diets
to
body
night
each
lean
meat
proportion.
meals
causes
[Vol.
exercise,
before
breakfast.
also
has
been
recommended.
The
reason
for this
is that,
while
60 per cent
of the energy
needs
of the
APPLiCATION
METHOD
there
gests
that
the
by this means.23
all
day.
PRACTICAL
because
water
is use(l,
NUTRITION
it is to establish
with
the
use
been
so ingrained
to such
diets
can
it
into
of
that
quite
the
use
impairing
was
the
disalso
concept
of obesity
as a defect
of carbohydrate
metabolism,
devised
by
the
physician,
diet
of
its
fate
the
unrestricted
low
matmad-
althe
calorically
difone
based
a
efof
on
a
W.
July-August
A. W. PENNINGTON
1953]
Harvey,
from
Claude
Harvey’s
Bernard,
diet,
reflections
and starchy
meat
in ad
upon
the
lectures
which
he attended
in
which
attempted
to avoid
foods,
libitum
specifically,
amounts,
Liebig,
of
1856.26
sweet
as
spread
success2’
and
had! a permanent
influence
on the treatment
of obesity.
However,
since
certain
details
of the diet could
not find
a rationale
in the
prevailing
physiology
of
With
DIET
this
diet
you
follow
a definite
Have
a regular
hour
for going
sleep,
never
breakfast.
fore
a minute
more
than
It is not necessary
the
“modified
Banting”
the many
century.
The
sheet
diet
routine
which
to bed.
that,
and
to walk
is unlimited.
Set
allow
fast,
You
can
to one
part
proportion
is three
parts
of lean
fat enough,
proportion.
so get
Good
extra
meats
beef
are
beef,
fresh
pork,
just
use
before
paprika,
it is cooked.
Season
the meat
celery
seed,
lemon,
chopped
flavoring
Do
not
and
pork
which
does
use
time least
not
kidney
roast
chops.
contain
particle
course
of each meal:
This
have
a choice
of an ordinary
potatoes,
sweet
use
Be
diets,
its
calorie
it
diets
of
for
the
calorically
has
which
years28
is as
important
alarm
clock
your
fat.
slice
steak,
You
been
in
is as follows:
as
for
use
(lur-
diet
the
eight
hours
Most
eat
befull
three
big
meals
of fresh
meat
with
the
as you
want.
The
as much
a
fat.
propel
of the
meat
you
buy
is not
and fry it to
roast
lamb,
make
lamb
up the
chops,
propel’
stewed
is all
right
with
black
parsley,
if you
grind
it yourself
pepper
before
it is cooked
or
or celery
tops,
or use other
Do
not
use
foods
smoked
ham, canned
chicken,
or fish
or spiced
meat,
or salted
butter.
boiled
lost
low
of instructions
diet
four
of
features
Finally,
salt.
Second
meal
you
not
fat,
beef,
of salt.
bacon.
canned
potatoes,
suceesion
time for a thirty-minute
walk
but it is necessary
to walk the
eat
Hamburger
as soup,
bologna,
banana,
a pear,
raspberries
At the end of each
meal
a
OBESITY
This
of the
underwent
retaining
only
those
to current
theory.
identity
among
time nineteenth
thirty
minutes
regularly.
Breakfast,
lunch,
and dinner
are all the same
type.
day and lose seven
pounds
of excess
weight
a month.
First
course
of each meal:
One-half
pound
or more
part
diet
unrestricted
ing the past
FOR
itself.
the
modifications,
which
conformed
while
allowing
met with
wide-
A
347
part
rice,
which
containing
contain
salt,
salt,
frankfurters.
such
of the diet is strictly
limited.
portion
of any one of the following:
At
half
melon,
grapefruit,
or blueberries.
have
a cup of black
coffee
of
each
white
grapes,
slice
a
or tea
without
sugar.
Do
five
o’clock.
Your
only
not
men-
saccharine.
sure
to drink
six
glasses
other
beverage
is half a lemon
This diet contains
no bread,
of water
every
in a glass
flour, salt,
day
before
of water
if you desire
it.
sugar,
alcohol,
or anything
else
tioned.
SUMMARY
Restriction
of
to make
possible
calorically
carbohydrate,
the treatment
unrestricted
of protein
and
petite,
necessary
fat.
The
to any
diet
alone,
appears
of obesity
on a
composed
limiting
treatment
appears
to be provided
by
tion and utilization
of fat,
chiefly
factor
on apof obesity,
increased
mobilizain conjunction
with
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on 21 May 2018
the homeostatic
forces
which
normally
late the appetite.
Ketogensis
appears
key factor
in the increased
utilization
Treatment
of obesity
by this method
reguto be a
of fat.
appears
to avoid
encoun-
tered
tails
the
decline
in treatment
of diet and
in the
metabolism
by caloric
restriction.
regimen
are given.
De-
THE
348
JOURNAL
OF CLINICAL
in
REFERENCES
1. PENNiNtroN,
the problem
100,
A. W. : An
of
alternate
J. CLIN.
obesity.
approach
to
NUTRITION
1:
20.
L. K., SCHWARTZ,
I. L., COTZIAS,
J. H., and HARRIS,
C. : Dietary
of hypertension.
III.
The effect of
on
vestigation
3. RYNEARSON,
Charles
appetite
and
32: 185,
E. H., and
1953.
J.
weight.
C Thomas,
Clin.
In-
E. M. : Ketosis
Springfield,
1949,
pp.
fat
patients.
Am.
J. Clin.
in obesity.
investigation
6:
22.
F. A., and STRANO,
J. M.: The treatment
with low calorie diets.
J. A. M. A.
of
obesity
97:
1063,
7. MoLLER,
ment
H.. and
MUUER,
in a group
25, 1934.
and
Lea
and
Leanness.
1940.
and
patients.
Arch.
mt.
E.. and
SHAPIRO,
B.: The
physiology
tissue.
Physiol.
in obese
G.:
fatty
from
Am.
25.
KRISS,
of
G.:
The
Rev.
in
E.,
E.:
Endocrinol.
451,
in
Lectures
obesity.
M., and
in total
A. H.:
SMITH,
16:
HARVEY,
WILLIAM:
27.
The
change
of rats receiving
constituents.
On
Corpulence
a diet deJ. Nutrition
in Relation
Renshaw,
Henry
London,
to
1872,
pp.
122.
A letter on Corpulence,
Adto the Public,
ed. 4. Harrison
and Sons,
1885.
See prefatory
remarks
and cor-
BANTING,
WIuaAM:
dressed
respondence.
A. W.: The
diet.
Delaware
PENNINGTON,
reducing
use
of
fat
in
a weight
State
M.
J.
Ia
obesidad
79,
23:
1951.
Tratam
1948.
W. H.:
Oxidation
Calories
of Nutrition.
p. 58.
and
of
J. Physiol.
BEN-TOR,
Biochem.
The significance
3: 101, 1943.
J. P.: The
metabolism.
functions
Harvey
Med.
and signifion Nutrition.
1924-25,
p. 57.
in Handbook
Chicago,
1943,
supply.
muscle.
MACKAY,
non-obese
Nutr.
3 : 231,
the usual
methods
in treating
J. Med.
Sc. 177: 339, 1929.
metabolism
in inorganic
375, 1938.
of fat.
on the meta-
28:
measurement
Lectures
Philadelphia,
CHALMERS,
M.:
its
WERTHEIMER,
beings.
energy
ficient
in
of Nutrition,
ed. 3. W. B.
1921, pp. 97, 239, 246.
Science
WIEmtzucHowsKI,
PETERS,
low
Co., Philadelphia,
F.
KARTIN,
weight
Diets
and
and
RESUMEN
The
BENEDICI,
in
D. D.:
obese
Dis.
MACKAY,
ketonemia
self-regulatory
human
1935.
262,
PETERS,
EVANS,
28.
in
rate
function
19.
47:
bolic
14. DuBois,
E. F.. and
in medical
practice,
Amer.
Med Assoc.,
18.
Child.
amounts
cance
of metabolism.
W. B. Saunders
Co.,
17.
I. Dis.
varying
tion
24.
Disease.
obesity
calories
containing
Their
effect
on loss
Saunders
16.
STAPlE,
69, 109,
of
the
1942-43,
London,
of adipose
15.
Am.
R.: Obesity
Philadelphia,
11. WERTHEIMER,
13.
Treatment
BONE,
LUSK,
23.
26.
Scan-
R. W., and
55:
12.
children.
of
9. RONY,
H.
Febiger.
10. KiarroN,
A.:
TOPPER,
treat-
by
J. Digest.
by
pp. 84, 100.
W. S., and DuBoms, E. F. : Prolonged
diets with a study of kidney function
and
J. Biot. Chem. 87 : 651, 1930.
W. C. : The intermediary
metabolism
of
acids.
Phyeiot.
Rev. 25 : 395, 1945.
F. A., and STRANG,
J. M. : A departure
meat
1931.
E.: Results
of exclusively
dietary
in 46 cases of obesity.
Acta.
med.
74: 341, 1931.
dinav.
8.
Olin.
MCCLELLAN,
277,
1929.
6. EVANS,
ingestion
and
ketosis.
E. G., and OHLSON,
M. A.: Weight reduction of obese women
of college
age.
J. Am.
Dietet.
A. 22: 849, 1946.
5. STRANG, J. M., and EVANS, F. A.: The energy
ex-
4. BROWN,
measured
C. P. : Total
RICHTER,
77.
change
J.
5
1936.
21.
38: 63,
18, 47,
as
following
animals
C. F.: Obesity.
GASTINEAU,
and water
deprivation.
23 : 824, 1944.
E. L., Snzimniu,
J. W., and
starvation
KEENEY,
2. DoLs, V. P.,
G. C., THAYSEN,
protein
1, No.
investigation
1953.
treatment
[Vol.
NUTRITION
J. 50:
glucose
as
90: 440, 1937.
V.: Fat utiliza573, 1952.
of ketosis.
interrelationships
Yale J. Biol. Med.
B. L., MAN,
E. B., WINKLER,
J. P.: Blood
ketones
and
J. Clin.
iento
Restricci#{243}n
parece
hacer
obesidad
calorlas
y
Downloaded from https://academic.oup.com/ajcn/article-abstract/1/5/343/4786830
by Washington University, Law School Library user
on 21 May 2018
and
limitador
parece
proveer
y utilizaci#{243}n de
conj unto
normalmente
las fuerzas
arreglan
ci
genesis
parece
ser
un
de
se encuentra
cal#{243}rica.
Ia
la
las
de
la
aumentada
grasas,
en
que
keto-
importante
en
las
obesidad
ci descenso
del
las
pro-
homeost#{225}ticas
apetito.
La
factor
utilizaci#{243}n de
evitar
a
tratamiento
obesidad
lo
mobilizaci#{243}n
tamiento
lipids
apetito
El
cualquier
parece
A. W.,
factor
y grasas.
requiere
con
de carbono
de la
de
que
48,
serum
sin
dieta
libre
cuanto
principalmente
telna
of foodstuffs
1951.
de los solos hidratos
posible
el tratamiento
con
una
compuesta
aumentada
24:
diet #{233}tico de
restricci#{243}n cal#{243}rica
grasas.
por
del
en ci tratamiento
Detalles
del regimen
El
este
m#{233}todo
metabolismo
por
se
la
traque
restricci#{243}n
presentan.