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May 13, 1961


JAMA. 1961;176(6):521-522. doi:10.1001/jama.1961.03040190043014

It has been suggested by Johnson1 that the terms hyperketonuria and hyperketonemia should replace ketonuria and ketonemia in describing ketosis. The ketones under consideration include acetoacetate, acetone, and B-hydroxybutyrate, formed from acetoacetyl coenzyme A in the liver. Ketosis develops when more ketones are formed than are oxidized or excreted. The ability of ketogenic regimens and other procedures to produce ketosis varies greatly.2

The first regimen was starvation. The second consisted of oleomargarine and saltine crackers, which provided either 1,000 or 2,000 kg-Cal/day, of which 2% were from protein, 20% from carbohydrate, and 78% from fat. A third regimen consisted of dried meat and lard, and contained no carbohydrate; 30% of the calories were from protein, 70% from fat. The resulting ketosis was quite different in degree from one subject to another. The excretion of total ketone bodies in the urine was correspondingly variable. Cold weather favored ketosis. Johnson

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