*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.
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*123 Fat synthesis and accumulation.
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*124 The progressive addition of carbohydrates was similar to a common treatment of diabetics in the pre-insulin era: Diabetics would be fasted to lower their blood sugar to healthy levels; then protein and fat calories would be increased gradually, until glucose appeared in their urine. That would be considered the critical calorie level, and the diabetics would never be allowed to eat any more than that.
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*125 Van Itallie, Stunkard, Bray, Cahill, and Dwyer.
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*126 Van Itallie attributed this ineffectiveness, as was common at the time, to the fact that “a varied diet reduced in energy content remains highly palatable” and so too tempting. “Even the Lord’s Prayer does not call for resisting temptation,” he would say; “it asks that the supplicant be not led into temptation.”
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†127 This does not include several texts specifically on the psychology and behavioral treatment of obesity.
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