Cardiac effects of starvation and semistarvation diets: safety and mechanisms of action

• Published in: The American journal of clinical nutrition Vol. 56; no. 1; pp. 230S - 234S
• Main Author: Fisler, JS
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Bethesda, MD Elsevier Inc 01.07.1992; American Society for Clinical Nutrition
• Subjects: Arrhythmias, Cardiac - etiology; Biological and medical sciences; cardiac disease; cardiac function; Cardiomegaly - etiology; CARDIOPATHIE; Death, Sudden, Cardiac - etiology; Diet, Reducing - adverse effects; DIETA TERAPEUTICA; ELECTROCARDIOGRAFIA; ELECTROCARDIOGRAPHIE; Endocrine glands; Energy Intake; ENFERMEDADES CARDIACAS; ENFERMEDADES CARENCIALES; FREQUENCE DU POULS; Heart - physiopathology; Heart Diseases - etiology; Humans; INANICION; INANITION; MALADIE DE CARENCE; Medical sciences; MORTALIDAD; MORTALITE; Obesity; Obesity - complications; Obesity - diet therapy; PULSACIONES; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); REDUCCION DEL PESO; REGIME ALIMENTAIRE THERAPEUTIQUE; REGIME POUR REDUCTION DE POIDS; SISTEMA NERVIOSO AUTONOMO; starvation; Starvation - complications; Starvation - physiopathology; Sympathetic Nervous System - physiopathology; SYSTEME NERVEUX AUTONOME; VALEUR CALORIQUE; VALOR CALORICO; very-low-calorie diet; very-low-calorie regime; VLCD; Weight Loss; starvation; Obesity; very-low-calorie regime; cardiac disease; cardiac function; very-low-calorie diet; VLCD
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/56.1.230S

A major concern with the use of starvation or semistarvation diets for weight reduction in severely obese people has been the reports of sudden death due to ventricular arrhythmias. Obesity per se is associated with cardiovascular changes, including left ventricular hypertrophy and prolongation of the QT interval. With weight loss, the mass of the heart and left ventricle decrease, but some signs of left ventricular dysfunction remain. The effect of weight loss on the electrocardiogram abnormalities of obesity appears to depend upon diet duration and upon whether protein and mineral nutritional status is maintained. Copper, potassium, and magnesium deficiencies may play important roles in promoting an electrically unstable heart. Stress, by eliciting autonomic imbalance, may act upon an electrically unstable heart to provoke acute arrhythmias in a subset of the obese population with QT interval prolongation.