Eugene J Fine

Eugene J Fine

Sep 23, 2016

Group 6 Copy 4,490
6

What did Dr. Owen and Dr. Cahill do? Why was this so important?

In the late 1960's, Drs. Oliver Owen and George Cahill did one of the fundamental experiments in brain metabolism. (Mea culpa-- I identified Dr. Owen as Robert Owen mistakenly, now corrected). They measured what the brain required, macronutrient-wise, and how much of it was needed per day. In particular, patients who were morbidly obese were hospitalized and placed on a zero calorie diet for six weeks for the purpose of weight loss. The patients received adequate hydration and vitamins and minerals, but that was all. Unsurprisingly the patients lost weight. 

But what Owen and Cahill also did is now the stuff of legend. They catheterized both carotid arteries (the arteries that supply the brain with blood flow) as well as the jugular veins (that take blood away from the brain toward the heart). And they measured blood nutrient levels in both blood vessels to determine, from the differences in concentrations, what the brain actually extracted from the blood.

They found that the initial blood specimens, performed under the patients' usual dietary intake circumstances (high carbohydrate), demonstrated that the brain utilized about 130 grams of glucose per day. 

After six weeks of fasting, they found that the patients were fine mentally and emotionally (they tested them in a variety of ways) but their brain now utilized about 1/3 of the glucose compared with before. 2/3 of the brain's needs were now supplied by betahydroxybutyrate, the principle blood ketone body.

In short the brain had adapted to starvation, the most basic of ketogenic diets, and was fine.

Their data, after publication, were immediately misinterpreted by the American Institute of Medicine to say that the brain required 130 grams of glucose per day. Of course, this is exactly what they did not show, as the brain functioned perfectly well with 2/3 of its nutrient supply delivered as ketone bodies.

Sadly (and still mysteriously to me) the AIM's misinterpretation took hold with the traditional dietary community of the time and became a foundation principle of the low fat (high carb) paradigm. It's only now that we're seeing cracks form in that foundation.

An interested supporter, in a comment, was good enough to provide the complete reference for those interested in reading the original classic. I was remiss in not providing the ref, so much thanks:

Owen, O.E., Morgan, A.P., Kemp, H.G., Sullivan, J.M., Herrera, M.G. and Cahill Jr, G.F., 1967. Brain metabolism during fasting. Journal of Clinical Investigation, 46(10), p.1589. Doi: http://dx.doi.org/10.1172%2FJC...

6 comments

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  • Kurt Lass
    Kurt LassBacker
    Thanks for this article. The 2005 retrospective pointed to by George Henderson in the comments finally puts to rest the zombie myth that the brain always requires 130g of glucose to function, much less needs to get it from daily exogenous carbs. This paper is a must read for every clinician, especially GPs and dietitians.
    Feb 12, 2017
  • Adrienne
    Adrienne
    I could really contribute to this in many ways. Please contact me. Email courtoisab@slu.edu
    Oct 14, 2016
  • George Henderson
    George HendersonBacker
    There's an excellent article Oliver Owen wrote in 2005 describing these experiments http://onlinelibrary.wiley.com/doi/10.1002/bmb.2005.49403304246/full
    Sep 25, 2016
  • Eugene J Fine
    Eugene J FineResearcher
    I haven't seen it and I'm very interested to look it up. Thanks.
    Sep 26, 2016
  • Eugene J Fine
    Eugene J FineResearcher
    I've downloaded and read it. It's always interesting to hear the tale as told by the originators of the ideas. We owe a great deal to Dr. Owen and Dr. Cahill. Thank you very much. Gene
    Sep 26, 2016
  • Richard David Feinman
    Richard David FeinmanResearcher
    My recollection is that Cahill told you personally that he knew about the misinterpretation But that he felt it was too late to fix. Is that accurate memory?
    Sep 24, 2016
  • Eugene J Fine
    Eugene J FineResearcher
    Yes he did. But there was never an explanation why the AIM had made the misinterpretation.
    Sep 24, 2016
  • Joris Snellenburg
    Joris SnellenburgBacker
    Thank you for this historical perspective. I was wondering about the origins of the commonly accepted notion that your brain needs glucose, and a lot of it. With the names and the power of Google scholar I was able to find the relevant article for which the reference [1] I found missing from this blog post. Perhaps in future entries they can be included? [1] Owen, O.E., Morgan, A.P., Kemp, H.G., Sullivan, J.M., Herrera, M.G. and Cahill Jr, G.F., 1967. Brain metabolism during fasting. Journal of Clinical Investigation, 46(10), p.1589. Doi: http://dx.doi.org/10.1172%2FJCI105650
    Sep 24, 2016
  • Eugene J Fine
    Eugene J FineResearcher
    Thanks very much for providing the reference. A classic.
    Sep 24, 2016
  • Nick Papageorge
    Nick PapageorgeBacker
    Sad misinterpretation. On purpose?
    Sep 23, 2016
  • Eugene J Fine
    Eugene J FineResearcher
    This requires a little digging to find out. I believe I once knew but I can't recall enough detail to give a good answer.
    Sep 23, 2016

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We've identified that ketone bodies, i.e. fuels in the bloodstream that result from a very low carbohydrate diet, metabolically inhibit growth of 7 cancer cell lines in cell culture, but not 3 normal cell types. Future cancer treatments using diet could become more effective and less toxic. We recently posted this project on Experiment requesting funds for supplies. We need salary for our superb technologist, as the NIH has not funded us, as they are committed to drug therapies.

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