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*96 There are only four experiments in the medical literature, not including Stefansson and Anderson’s, in which the goal was to induce scurvy in human subjects—in one, four, twenty, and four subjects respectively. In each case, the goal was accomplished and the diets were carbohydrate-and/or sugar-rich.
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*97 According to Lewis Finn, then president of the Delaware Academy of Medicine, Gehrmann’s department at DuPont was “one of the most outstanding industrial medical departments in the country.”
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*98 One DuPont executive, discussed by Pennington in a later report, lost sixty-two pounds on the diet and kept it off for more than two years, while averaging thirty-three hundred calories of meat a day. If he ate any carbohydrates, “even an apple,” Pennington wrote, his weight would climb upward.
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*99 These critiques were written by anonymous “competent authorities.” In this case, the likely authority was Philip White, formerly at Harvard, now beginning his job as secretary of the AMA’s Council on Foods and Nutrition and a columnist for JAMA. He would write a similar dismissal of high-fat, carbohydrate-restricted diets under his own name in 1962, and then edit another anonymous version in 1973.
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*100 Ohlson worried that “the large servings of meat” could get monotonous and that the diet did not meet the recommended daily allowances for essential vitamins recently introduced by the Food and Nutrition Board of the National Research Council. She therefore included in her diet more milk, cheese, and eggs than Pennington had recommended, and expanded the choice of fruits and vegetables.
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*101 Drug studies were encouraged by the relative ease of obtaining money and resources from the pharmaceutical industry, and the absence of funding for dietary treatments.
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†102 In 1989, William Dietz, who now serves as director of the Division of Nutrition and Physical Activity at the Centers for Disease Control, reported that Bistrian and Blackburn’s diet was “especially successful” on obese patients with a genetic disorder called Prader-Willi syndrome, “whose characteristic ravenous appetites appeared to be suppressed.”
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*103 When the authors included only randomized control trials in their calculations, they identified seven relevant studies of this severe carbohydrate restriction and seventy-five of higher-carbohydrate diets. The average weight loss was eight pounds for the carbohydrate-restricted diets and four for the higher-carbohydrate diets.
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*104 Indeed, the AMA’s 1973 critique escaped the issue of hunger by including “anorexia” as one of the “untoward side effects” of the diet. Since anorexia, in this context, is the technical term for loss of appetite, it seemed a peculiar criticism to make of a weight-loss diet.
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*105 The auxiliary “may” is critical here, because Yudkin based his conclusions on three-day dietary records, which are notoriously inaccurate. He then assumed that these three-day records could be extrapolated to the entire two weeks of the study, and from there to what would happen over months or years on the diet.
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*106 When Ted Van Itallie, who worked with Jean Mayer in the 1950s, was asked why Mayer paid so little attention to the prewar German literature on obesity, he said, “Mayer hated the Germans. He shot a few of them in World War II.”
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*107 Brobeck paired each of a dozen lesioned rats with a healthy control rat and fed the lesioned rat precisely the same amount of food that the control rat had consumed on the previous day. “In three pairs of animals,” Brobeck wrote, “the rat with lesions gained more rapidly than the control when they were fed the same amount of food.” Thus overeating could not be the cause of the excessive fattening, because these rats weren’t overeating.
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*108 In reference to the islets of Langerhans, the pancreatic cells that secrete insulin.
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*109“Diet therapy and weight loss are extremely important in reversing this process,” Rosenzweig added, “but the long-term results of these therapies have generally been disappointing, even in patients not receiving insulin.”
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*110 In which the pancreas had been removed.
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*111 Schoenheimer and Rittenberg worked in Harold Urey’s lab at Columbia. Urey had recently discovered deuterium and won the 1934 Nobel Prize in Chemistry for the discovery.
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†112 Wertheimer began his career at the University of Halle in Germany and was expelled from his position in the same purge that sent Schoenheimer to New York. Wertheimer immigrated to Jerusalem, where in the 1940s he became head of pathophysiology and biochemistry at the Hebrew University.
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*113 ATP gives up a phosphate molecule, becoming adenosine diphosphate, or ADP, and releases energy in the process.
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*114 Synthesis of the enzymes required to convert carbohydrates into fat will also increase and decrease in proportion to the carbohydrate content of the diet.
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*115 The VLDL particles we discussed when we talked about heart disease.
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†116 The addition of a phosphate molecule to glycerol to make glycerol phosphate is said to “activate” the glycerol so that it can now be used in this process.
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*117 For this reason, vagotomy, as this surgical procedure is known, was later considered a potential treatment for obese humans with various syndromes of hypothalamic obesity.
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*118 Of Neel’s two primary papers on thrifty genes, this is the one that is rarely read or referenced.
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*119 Brunzell and Bierman fed mildly diabetic patients a diet of 85 percent carbohydrates and no fat, and compared their glucose response with that of patients on a more typical American diet of 45 percent carbohydrates and 40 percent fat. Those on the carbohydrate-rich diet had a slightly lower blood-sugar response, and insulin secretion remained unchanged. Brunzell and Bierman interpreted this to mean that a carbohydrate-enriched diet “increase[s] the sensitivity to insulin of tissue sites of insulin action.”
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*120 This explains why preventing estrogen secretion in female rats—by removing the ovaries—will make them obese, hungry, and sedentary, as we discussed in the previous chapter, whereas replacing the estrogen will make them lean again.
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*121 He told me that I could confirm this observation by simply going to an airport and noticing, as he always did, that it was the overweight who took the escalators and the lean who walked up the stairs.
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*122 From 1990 to 1996, Keen was chairman of the British Diabetic Association. He was also elected honorary president of the International Diabetes Federation in 1991, and was chairman of the WHO Expert Committee on Diabetes in 1980 and 1985.