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January 15, 1968

Weight Reduction With Low-Calorie Diets

JAMA. 1968;203(3):235. doi:10.1001/jama.1968.03140030067029

To the Editor:—  In an incisive, well-written report (202:118, 1967) Dr. E. J. Drenick details the clinical consequences of a 200 to 600 calorie diet. One area of the report deserves special comment. Dr. Drenick suggests that probenecid or allopurinol is to be used in combination with such a diet as "all patients who are fed diets low enough in calories and carbohydrates to produce ketonemia should be treated prophylactically with a uricosuric agent or xanthine oxidase inhibitor" presumably to prevent gouty (arthritic) attacks.In his classical treatise on gout, Talbott defines the clinical characteristics which are the hallmark of the gouty patient.1 Gouty arthritis diathesis is fortunately infrequent in the absence of a genetic predisposition, and usual sexual (predominantly male), chronological (usually middle life and beyond) factors, or previous hyperuricemia or uric acid urinary lithiasis. When such features are absent we would, in the example of Dr.