Interest in the occurrence of ketosis is no longer confined to diabetes. The production of undue amounts of ketone substances associated with an augmented output of organic acids—ketonic acidosis—and a lowering of the alkali reserve is often encountered in childhood. Sometimes it is the accompaniment of cyclic vomiting. The phenomena may develop quite suddenly in apparently healthy children. The dietary and metabolic aspects of ketosis have been elucidated in recent years. Ketogenesis is an outcome of inadequate metabolism of carbohydrate in the body. The dictum that "fats burn in the flame of the carbohydrates" has long been accepted; and Woodyatt4 has added the appropriate interpretation that when the proportion of fats is too great for the fire it "smokes" with unburned fats and ketone substances.
The present consensus has led to the adoption of a ketogenic-antiketogenic ratio as expressive of the relative proportions of the proximate principles in our nutriment
NONDIABETIC KETOSIS IN CHILDREN. JAMA. 1927;89(24):2043-2044. doi:10.1001/jama.1927.02690240035014