286 ROLLIN T. WOODYATT 



and protein, the protein must be as low as possible and the carbohydrate 

 as high as possible for 1 gram of carbohydrate yielding 1 gram of glucose 

 and 4 calories provides for the normal oxidation of 1.5 grams of higher 

 fatty acid. On the other hand, 1 gm. of protein having the same caloric 

 value as carbohydrate yields less glucose to support fat combustion, and 

 in addition yields acetone bodies itself. If the body weight of the patient 

 be 50 kg. and if 1 gm. of protein per kg. is selected as a conservative mini- 



P 



mum, then P becomes 50 grams and F = 2 -f* - - becomes F = 2 



& 



C -(- 25. From the above G =. 100 gm. Now the glucose yielded by the 

 50 gm. of protein will be .58 X 50, or 29 grams, leaving 100 29 

 or 71 gm. to be distributed between carbohydrate and fat. In other words, 

 C + .1 F = 71, or F = 170 10 C. But also, F = 2 C + 25, so 

 2 C + 25 == 710 10 C, solving which: C == 57 gm. (57.08). Sub- 

 stituting this value for C in F = 2 C + 25 we find F = 139 grams 

 (139.16). Then the optimal food combination that will fulfill the con- 

 ditions and relations specified is: 



Carbohydrate =' 57 grams 

 Protein 50 grams 



Fat 139 grams 



Calories 1680 



Proving this diet it will be found that G == 57.08 -f (.58 X 50) plus 

 (.1 X 139.1) = 99.98 as called for. Also F A = (.44 X 50) plus 



F A 



(.9 X 139.1) = 147.19. And pr- = 1.47. The small error arises 



CJT 



from the dropping of decimals in equation (3). 



It is apparent that any addition of any foodstuff to this diet would 

 make G>100. If, on the other hand, one added more fat, say 10 grams, 

 and subtracted 1 gm. of carbohydrate, G would remain 100 and the calories 



F A 



would be increased by 86, but this would make ->1.5. The effect of 



changing the protein can be seen by comparing the caloric value of a series 

 of optimal food combinations with the protein rising from to 2.0 gm. 

 per kg. (See Table III.) 



(6) Remarks. Cases are not infrequently seen which show ketonuria 

 when the ratio of F A to G in the diet is much lower than 1.5. This is true 

 especially in some children and some migrainic adults. Also it will fre- 

 quently be found possible to administer diets in which the diet ratio is 2.0, 

 2.5 or 3.0 and even higher without the appearance of ketonuria for long 

 periods of time. This would appear to be especially true of emaciated 

 individuals. Analysis of the quantities of carbohydrate, protein and fat 

 actually catabolizing in the latter cases has in several instances revealed 



