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December 1, 1978

Cardiac Complications of Liquid Protein Diets

Author Affiliations

The Mount Sinai Hospital Cleveland
University of California at Los Angeles Medical Center Los Angeles

JAMA. 1978;240(23):2542. doi:10.1001/jama.1978.03290230034018

To the Editor.—  Two articles in a recent issue of The Journal by Singh et al (240:115, 1978) and Brown et al (240:120,1978) report the deaths from refractory ventricular tachycardia and fibrillation of three young women, obese but apparently otherwise healthy, who had been given a program of weight reduction by fasting with liquid protein. Each of the three had been fasting for five or six months and had lost about 41 kg. In each case the ECG on admission was marked by gross QTc prolongation. Singh et al state: "It is not known what proportion of patients using various liquid protein diets have such ECG abnormalities and whether all such patients are at risk for the development of serious arrhythmias."In connection with the programs of supplemented fasting with protein of high biologic availability, carbohydrates, and minerals at The Mount Sinai Hospital of Cleveland and at the University