Laurance W. Kinsell

Effects of Co-ingestion of Fat and Protein Upon Carbohydrate-Induced Hyperglycemia

The effects of test “loads” containing 50 gm. glucose (CHO); 50 gm. glucose + 30 gm. protein + 40 gm. fat (CHO + P + F) ; 50 gm. glucose + 30 gm. protein (CHO + P); 50 gm. glucose + 40 gm. fat (CHO + F) on plasma glucose, FFA, insulin, and alpha amino nitrogen have been evaluated in adult-onset diabetics. In comparison with CHO, CHO + P + F results in much lesser elevation of plasma glucose. The effect of CHO + P + F is greater than the sum of the effects of CHO+P and CHO+F. Apparently the CHO+P+F pattern is attributable to relatively or absolutely increased insulin release plus modified glucose and protein absorption. On the basis of theoretical and clinical observations, there appears to be good reason to consider the use of diets containing considerable amounts of protein and fat in adult- and juvenile-onset diabetics.

Calories do count

Abstract There have been statements in the medical and the lay literature to the effect that weight loss occurs more rapidly with diets high in fat and protein asc compared to equi-caloric diets containing large amounts of carbohydrate. In the present study, subjects have been maintained for many weeks on constant calorie intake. At intervals, the composition of the diet has been changed, the fat intake varying from 12 to 83 per cent, protein from 14 to 36 per cent, and carbohydrate from 3 to 64 per cent of total calories. In any given subject, the rate of weight loss was essentially constant throughout the entire study. It is therefore obvious that the significant factor responsible for weight loss is reduction of calories, irrespective of the composition of the diet.

The combination of ACTH-cortisone-hydrocortisone with antibiotics in the management of overwhelmingly severe infections: Theory and practice based on three years' experience

Summary Data are presented which may support the concept that the addition of ACTH and cortisone therapy to wellindicated antibiotic therapy in patients suffering from severe infections results in reduction of morbidity and mortality in such patients. Such combined therapy should be used with a full knowedge of the potential hazards as well as the potential assets involved.

THE USE OF ACTH AND CORTISONE IN THE TREATMENT AND IN THE DIFFERENTIAL DIAGNOSIS OF MALIGNANT EXOPHTHALMOS: A PRELIMINARY REPORT

Excerpt The present report comprises the findings in nine patients who have been studied during the past two years, all of whom presented the complaint of exophthalmos of severe or moderately sever...

The Effect of a Fish-oil Fraction on Plasma Lipids

Since the original report from this laboratory in 1952 many investigators have confirmed that the substitution in the diet of vegetable fats containing large amounts of linoleic acid (e.g., corn, cottonseed, safflower, soy oil) for fats containing predominantly saturated fatty acids (e.g., fat from meat, eggs, and dairy products) will result in a marked fall in plasma lipids in most human subjects. It has further been demonstrated that the addition of sufficient amounts of polyunsaturated fats to (a) fat-free diets or (b) diets containing significant amounts of saturated fats will result in a significant fall in the level of plasma lipids. The amount of vegetable fat required under the latter set of conditions is of considerable magnitude and from a clinical standpoint is unfeasible because of the increase in dietary calories. Recently, Ahrens and his associates reported that menhaden oil, a fish oil with an iodine value in excess of 150, had at least as great an effect upon plasma lipids as an equal amount of vegetable oil containing more than 50 per cent of linoleic acid. On the basis of existing information there is some reason to believe that the efficacy of a fat in lowering plasma lipids may be in a measure proportional to the total number of double bonds present in its fatty acids. Conceivably, a highly unsaturated fat containing fatty acids of proper molecular configuration would be capable of lowering plasma lipids when added in relatively small quantities to a diet containing considerable quantities of saturated fat. Accordingly, the ethyl esters of menhaden oil were fractionated by appropriate methods with the yield of the fish oil fraction shown in figure 1. The gas-liquid chromatographic pattern of menhaden oil fatty acids is shown at the top of this figure, the menhaden ethyl ester fraction in the center, and a standard fatty acid mixture is shown at the bottom for orientation purposes. It is apparent that the fractionated material contains very much larger amounts of long-chain highly unsaturated material than the original menhaden oil. The

Effect of Vegetable Fat on Hypercholesterolemia and Hyperphospholipidemia: Observations on Diabetic and Nondiabetic Subjects Given Diets High in Vegetable Fat and Protein

As previously reported, the administration of formula diets containing large amounts of vegetable fat to nondiabetic patients, with or without elevation in serum lipids, results in a major decrease in the level of cholesterol and phospholipids in the plasma. This statement applies to patients with such diverse conditions as simple obesity, nephrosis, myxedema, hyperthyroidism, rheumatoid arthritis, retinitis pigmentosa, etc. In the present paper will be described the findings in diabetic patients, and in one patient with familial hypercholesterolemia, maintained on formula and non-formula diets containing large amounts of fat which, as indicated in specific instances, is of vegetable, of animal, or of mixed origin.

Plasma, bile and fecal sterols in relation to diet.

Abstract Cholesterol metabolism was studied during the ingestion of 3 diets differing only in the degree of saturation of their fat contents. The iodine numbers of fats in the diets were 44.8 (diet I), 131 (diet II) and 10 (diet III). On changing from diet I to diet II there was a considerable increase in rate of excretion of sterols in feces and in sterol concentrations in bile. On changing from diet II to diet III there was a progressive decrease in fecal excretion of cholesterol metabolites. Thus, relative saturation-unsaturation of dietary fat appears to modify the excretory pattern of cholesterol and its metabolites. Prompt diet-induced changes in concentration of cholesterol and its metabolites in bile indicate the need for further evaluation of the quantitative aspects and physiologic significance of the mechanisms involved.

Effect of Insulin in Hypertriglyceridemia

Summary Infusion of insulin to hyper-glyceridemic subjects results in decreased plasma glyceride levels as compared to control infusions. Protamine can prevent this insulin-induced decrease. It is tentatively concluded that insulin accelerates removal of glycerides from the plasma by peripheral tissues.

DIETARY MODIFICATION OF THE METABOLIC AND CLINICAL EFFECTS OF ACTH AND CORTISONE

Excerpt The accumulation of knowledge and the development of concepts regarding the place of ACTH and cortisone in clinical medicine have followed an interesting pattern during the past three years...

The correlation of hepatic structure and function.

Abstract From study of liver biopsy sections and chemical liver function tests one can only hope for present purposes to obtain rather gross information as to the activity of the process which has resulted or is resulting in liver damage, and information as to the extent and duration of the process. Activity is correlated histologically with phagocytic cell infiltration and with hepatocellular change as manifested by widespread multinucleation, abnormalities of cell shape and size, and abnormalities of staining characteristics. The chemical abnormalities which indicate activity are the cephalin cholesterol flocculation and thymol turbidity tests as well as elevation of the serum bilirubin and/or icterus index. Extent and duration of the hepatotoxic process are manifested histologically by hepatocellular change and by fibrosis. The chemical changes which are found in liver damage of widespread extent and/or long duration are abnormal bromsulfalein retention, diminished hepatic glycogen storage and elevation of the serum bilirubin and/or icterus index. It is to be emphasized that the above observations are extremely superficial and have nothing to recommend them but their simplicity. From the foregoing it is evident that our knowledge of liver histology and physiology is in need of many additions; and that when such additional knowledge is obtained, revision of the present archaic classification of liver disease will be in order. An approach to such a reclassification is presented.