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Sudden death associated with very low calorie weight reduction regimens
The American Journal of Clinical Nutrition
|April 1, 1981
Summary
Sudden cardiac deaths from ventricular arrhythmia occurred in individuals on prolonged very low-calorie, protein-rich diets. These deaths were linked to rapid weight loss and starvation-like cardiac changes, suggesting caution with such extreme weight reduction regimens.
Area of Science:
- Cardiology
- Nutritional Science
- Public Health
Background:
- Very low-calorie diets (VLCDs) are used for rapid weight reduction.
- Protein-sparing modified fasts (PSMFs) are a type of VLCD.
- Concerns exist regarding the cardiac safety of prolonged VLCDs.
Purpose of the Study:
- To investigate sudden cardiac deaths associated with prolonged VLCD use.
- To identify common factors and cardiac changes in fatal cases.
- To assess the safety of extreme weight reduction regimens.
Main Methods:
- Retrospective case study of 17 individuals who died suddenly.
- Analysis of dietary history, medical supervision, and supplementation.
- Review of electrocardiograms and pathological specimens.
Main Results:
- All deaths were linked to ventricular arrhythmia after prolonged VLCD use (median 5 months).
- Common factors included marked obesity, extreme calorie restriction (300-400 kcal/day), and rapid weight loss.
- Cardiac changes consistent with starvation were observed.
Conclusions:
- Prolonged use of VLCDs, particularly protein-rich ones, is associated with fatal ventricular arrhythmias.
- Deaths appear independent of medical supervision or potassium supplementation.
- VLCD use should be curtailed pending further safety studies.
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