The importance of the diet in cardiac failure has apparently not been fully appreciated. The Karell diet is usually mentioned in the discussion of the treatment of advanced cardiac failure with edema. While this diet greatly promotes the elimination of excess fluid, it is obviously inadequate because of its low energy value. Various modifications of the Karell diet have been recommended, but in each instance the caloric value has not been sufficient to maintain a normal metabolism.1
In advanced cardiac failure, not only the heart but also the entire body is in an exhausted condition. The diet should thus not impose an excess load but still provide sufficient energy. The sodium chloride should be reduced and the liquid intake restricted when edema is present, though not to the degree ordinarily practiced. Milk is a very desirable constituent of the diet because of the ease with which it is assimilated
SMITH FM, GIBSON RB, ROSS NG. THE DIET IN THE TREATMENT OF CARDIAC FAILURE. JAMA. 1927;88(25):1943–1947. doi:10.1001/jama.1927.02680510001001
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