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May 24, 1941


JAMA. 1941;116(21):2403-2404. doi:10.1001/jama.1941.02820210049012

The ketonuria observed in the depancreatized dog and in the diabetic human being was early believed to be related to an altered carbohydrate metabolism. Hirschfeld1 in 1895 showed that the factor common to all conditions of ketosis was the lack of carbohydrate in the food or, as in the diabetic patient, from his metabolism. The fact that ketosis appeared to be definitely related to carbohydrate starvation led many investigators to study the quantitative relationships between dietary carbohydrate and fat, on the one hand, and the degree of ketosis, on the other. From such investigations, notably by Zeller2 and by Lusk3 and his pupils, arose the hypothesis that the burning of carbohydrate in the body in some way prevents the appearance of ketosis and that carbohydrate is therefore "antiketogenic." The aphorism "fats, or acetone bodies, burn in the fires of carbohydrates" became the classic textbook description of fat

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