I've been checking up on this story because I couldn't understand why she died of ketoacidosis.
Ketoacidosis can happen if you are diabetic or have consumed large amounts of alcohol. Neither of those were mentioned.
Lack of protein doesn't cause ketoacidosis, well..not directly. Anyway, my conclusions for those who are interested.
When we reduce carbs, the body makes ketones to help get energy. Those ketones build up to a certain level, but then there is a loop system that releases insulin to prevent too much of a build up which can cause ketoacidosis. Diabetics and alcoholics have a faulty loop back system. Others do not.
The lady must have been on a very low protein diet. She lost a
huge amount of weight considering her BMI in a very short time. This points to a lack of protein as the fastest and silliest way to lose weight is to cut protein. Cut protein, you lose lean mass which is heavier in volume to fat.
She probably thought her diet was healthy enough. Maybe lots of fruits and veg, as many people think thats the only important thing...every else is just for fun
She cuts her protein, loses quickly (lean mass more than fat). Everything indicates to that happening.
Of course, lean mass is everything in your body minus the fat. So to keep her energy stores up and because of the lack of protein, her body turns to her lean for what it needs to function. Basically it cannibalizes itself.
As you lean mass is everything not fat, think bone, blood, heart, lungs, kidneys, liver etc.
So, it wasn't that the lack of protein caused the ketoacidosis, but indirectly it did. Her liver would have failed and ended up not being able to release the much needed insulin. Her loop back system would have possibly been just fine, but the organ that makes it happen had failed.
So ketoacidosis was the final nail in the coffin, rather than being a direct cause of death me thinks.
Fortunately we get enough protein in Cambridge, but a reminder to anyone thinking of doing a DIY VLCD...don't.
Too little protein can kill. Too much protein isn't healthy either as it strains the kidneys. It's a fine balance between them that keeps us well.