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August 5, 1974

Dietary Prudence

JAMA. 1974;229(6):691. doi:10.1001/jama.1974.03230440049036

The Golden Age of the "special diet" is over. We may still prescribe low-calorie diets for the obese, low-carbohydrate or low-fat diets for the diabetic, and salt-free diets for the hypertensive and the edematous, but our enthusiasm is at a low ebb. Not even the current vogue of the "prudent diet" for the preventions of coronary artery disease can lift us from the dietary doldrums.

In some instances special diets have been reduced in importance or made unnecessary by the use of drugs and other therapies. Saluretics have spared many patients the depressing monotony of salt-free meals. Similarly, xanthine oxidase inhibitors have made it possible to relax the strictures of unpalatable low-purine diet. And dialysis has permitted a more liberal protein intake for the uremic patient.

Bypassed with the aid of drugs or rendered otherwise obsolete, such diets arouse no fond nostalgic memories. Their decline causes no second thoughts. But