Page 75 - GTM-2-1

Global Translational Medicine Mass balance

the etiology, that is, the root cause. According to Oxford much the same impact on body composition as a low
Learner’s Dictionaries, “etiology” refers to “the cause of a carbohydrate non-ketogenic diet .
[37]
disease or medical condition.” Although obesity has only Dietary ketosis can reduce the feeling of hunger , and
[38]
one etiology, that is, chronic positive mass balance, it thereby reduce the intake of nutrient mass; however, this
has numerous risk factors, each of which increases, with does not undermine the Law of Conservation of Mass.
a certain probability, the occurrence of a positive mass
balance; however, none of these risk factors are capable 18. Nutrition facts label
of creating any kind of mass. It is still a matter of balance
between intake and expenditure, but in this case, mass The nutrition facts label on packaged food was updated in
balance. 2016 to reflect updated scientific information, including
information about the association between diet and
[39]
17. Dietary ketosis per se does not affect chronic diseases, such as obesity and heart disease . One
body mass or fat mass of the most prominent updates of the new food labeling
regulations released by the Food and Drug Administration
When the rate of mobilization of fatty acids from (FDA) is found on the calorie line; the font for calories
adipose tissue is accelerated, such as during a very-low- has been significantly enlarged and emboldened for
carbohydrate/high-fat ketogenic diet, the liver produces first-glance reference. This well-intentioned update was
ketone bodies: acetoacetate, beta-hydroxybutyrate, based on the rationale that caloric values may be easily
and acetone (a spontaneous breakdown product of comprehended without having to examine the food label
acetoacetate). Since the liver cannot utilize ketone bodies, in detail. Humans need energy (i.e., the capacity to do
they flow from the liver to extrahepatic tissues (e.g., brain work), but calories have no impact on body mass; thus, the
and muscle) for use as fuel. calorie line should be replaced or complemented with the
Although it has been suggested that dietary ketosis mass line (e.g., “Nutrient Mass” or “Mass”).
could accelerate the reduction of body mass and fat mass, It is also worth noting that the concept of “light
dietary ketosis per se does not affect body mass or fat product” is misleading. In reality, these products are often
mass if we disregard the scant urine ketone excretion in “heavy products.” When the energy fraction from dietary
the initial phase. Mass does not mysteriously disappear. fat increases, while the energy content remains the same,
Looking at equation (13) in relation to MBM in Arencibia- mass intake decreases due to the significantly higher energy
Albite , it is not necessary to include an extra term for the density of fat compared with other energy substrates.
[3]
energy expenditure fraction derived from ketone bodies, as A high-carbohydrate “light product” containing 200 kcal
the oxidation of ketone bodies is essentially fat oxidation. provides more mass than a high-fat product containing
For example, the β-oxidation of one palmitic acid molecule 200 kcal. This fact should have a significant impact on
yields eight acetyl-coenzyme A molecules, in which two of the prevailing legislation and the operation of the food
these react to generate four acetoacetate molecules. Hence, industry.
the oxidation of four acetoacetate molecules is equivalent In short, dietary fats are therefore not problematic
to that of one palmitic acid molecule. For further details, in relation to weight management, as they provide a lot
refer to 2.2.1. At energy balance the oxidized macronutrient of energy relative to their mass. Dietary fats are only a
distribution that results in the EE avg is equal to macronutrient problem when they are used to make high-carbohydrate
distribution in the EIa vg in Arencibia-Albite . food highly palatable. The “light product” concept should
[3]
It is impossible to study the matter precisely in a feeding be removed from legislation as soon as possible because it
trial setting, as there would be a small difference in the misleads consumers in many situations.
nutrient mass intake between the comparison groups, 19. A flawed paradigm leads to
that is, a very-low-carbohydrate diet group versus an
isocaloric low-carbohydrate diet group. More specifically, misinterpretation of research data
the nutrient mass intake of the first group is inevitably In research literature, there is plenty of feeding trial reports
slightly lower than that of the latter. Remember that when that seem to support the EBT. A flawed paradigm, however,
the energy fraction from dietary fat increases, while energy almost always leads to incorrect interpretations and
intake is fixed, nutrient mass intake decreases due to the conclusions. There are many research reports claiming that
significantly higher energy density of fat compared with the more effective weight loss effect of low-carbohydrate
other energy substrates. Vidić et al. have also investigated diets compared to isocaloric high-carbohydrate diets is
the matter and came to a conclusion that a ketogenic diet attributed to a methodological error (e.g., under-reporting
with sustained hyperketonemia above 1 mol/L has pretty of food consumption and low sensitivity of research

Volume 2 Issue 1 (2023) 11 https://doi.org/10.36922/gtm.222