title: Potential life-threatening cardiac arrhythmias associated with a conventional hypocaloric diet.
abstract: Nine obese children (mean age 12.7 years, mean overweight 74.2%) were treated for 3 weeks with a very low calorie diet containing high quality protein. Eight patients (patients A) received a commercially available diet (240 kcal/1004 kJ/day) and 1 patient (patient B) a homemade dietary regimen (500 kcal/2100 kJ/day). Both preparations were supplemented with micronutrients; however, the daily intake of minerals was significantly less in patient B. All patients were monitored for the appearance of cardiac arrhythmias by frequent 24-hour Holter recordings. In patients A the mean loss of body weight was 9.4 +/- 2.4 kg, patient B lost 8.7 kg. The mean daily nitrogen balance was negative (patients A: 10.2 g/day, patient B: 6.8 g/day). Frequent blood chemistry evaluations were unremarkable. On the 14th day of treatment patient B developed arrhythmias (ventricular couplets, non-sustained ventricular tachycardias); in patients A no ventricular dysrhythmias were observed. Our data suggest that very low calorie diets containing protein of high biologic value can be associated with potentially dangerous arrhythmias.
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D001835:Body Weight; D002648:Child; D004038:Diet, Reducing / Q000009:adverse effects*; D004044:Dietary Proteins / Q000008:administration & dosage; D004562:Electrocardiography; D002149:Energy Intake; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy; D012306:Risk; D014131:Trace Elements / Q000172:deficiency*
chemical_list: D004044:Dietary Proteins; D014131:Trace Elements