Potential life-threatening cardiac arrhythmias associated with a conventional hypocaloric diet

Int J Cardiol. 1987 Jan;14(1):55-63. doi: 10.1016/0167-5273(87)90178-1.


Nine obese children (mean age 12.7 years, mean overweight 74.2%) were treated for 3 weeks with a very low calorie diet containing high quality protein. Eight patients (patients A) received a commercially available diet (240 kcal/1004 kJ/day) and 1 patient (patient B) a homemade dietary regimen (500 kcal/2100 kJ/day). Both preparations were supplemented with micronutrients; however, the daily intake of minerals was significantly less in patient B. All patients were monitored for the appearance of cardiac arrhythmias by frequent 24-hour Holter recordings. In patients A the mean loss of body weight was 9.4 +/- 2.4 kg, patient B lost 8.7 kg. The mean daily nitrogen balance was negative (patients A: 10.2 g/day, patient B: 6.8 g/day). Frequent blood chemistry evaluations were unremarkable. On the 14th day of treatment patient B developed arrhythmias (ventricular couplets, non-sustained ventricular tachycardias); in patients A no ventricular dysrhythmias were observed. Our data suggest that very low calorie diets containing protein of high biologic value can be associated with potentially dangerous arrhythmias.

MeSH terms

  • Adolescent
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Body Weight
  • Child
  • Diet, Reducing / adverse effects*
  • Dietary Proteins / administration & dosage
  • Electrocardiography
  • Energy Intake
  • Female
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Obesity / diet therapy
  • Risk
  • Trace Elements / deficiency*


  • Dietary Proteins
  • Trace Elements