The use of the ketogenic diet (high in fat, low in carbohydrate) in the treatment of epilepsy offered a unique opportunity to study its effect on the metabolism of children, and with this in view various types of investigations have been carried out in the children's clinic of the Massachusetts General Hospital. Special attention was given to the influence of the different diets on the level of sugar in the circulating blood and the respiratory quotients.
Benedict and Higgins1 studied the influence of carbohydrate on the respiratory exchange of adults; some of their patients with a low respiratory quotient were receiving a diet which was almost free from carbohydrate. Higgins, Peabody and Fitz2 tested themselves on diets high in fat and low in carbohydrate and obtained a low respiratory quotient. Hawley, Johnson and Murlin3 also found a low respiratory quotient in adult students on a similar diet.
TALBOT FB, BATES V. EFFECT OF KETOGENIC DIET ON THE BLOOD SUGAR AND THE RESPIRATORY QUOTIENT OF CHILDREN. Am J Dis Child. 1935;50(4):827-839. doi:10.1001/archpedi.1935.01970100003001