In planning reducing diets for obese patients, the aim should be to facilitate the loss of stored fat without damaging the body structure. Older investigators1 advocated high protein diets, but did not agree on the effects of such diets on nitrogen equilibrium. Mason2 expressed the belief that it is unnecessary to maintain obese patients in nitrogen equilibrium, since serious losses of nitrogen do not occur. More recently3 he has pointed out the strong tendency of such patients to conserve nitrogen, and he stated that patients who lose weight most rapidly also lose more nitrogen per day. Strang, McClugage and Evans4 observed early small losses of nitrogen and later an equilibrium when small quantities of carbohydrates were added to low caloric diets.
Because of the rather prevalent view among clinicians that undernutrition subjects the body to bacterial invasion and overnutrition protects against infections, it is important to
KEETON RW, DICKSON D. EXCRETION OF NITROGEN BY OBESE PATIENTS ON DIETS LOW IN CALORIES, CONTAINING VARYING AMOUNTS OF PROTEIN. Arch Intern Med (Chic). 1933;51(6):890–902. doi:10.1001/archinte.1933.00150250074004
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