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Low-Energy Diets and Prolonged QT Intervals

Stuart Frank, MD; Jerry A. Colliver, PhD; Arthur Frank, MD
JAMA. 1987;257(12):1601. doi:10.1001/jama.1987.03390120063018.
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To the Editor.—  In a recent review entitled "Prolonged QT-Interval Syndromes,"1 the author indicates that "prolongation of the QT interval, malignant ventricular arrhythmias, and unexpected sudden death have been reported in patients who have lost considerable weight on the very-low-energy liquid protein diets." Dr Moss states that "sustained use of very-low-energy diets (300 to 400 kcal/d [1260 to 1680 kJ/d]) is dangerous and should be avoided," presumably because they predispose to QT prolongation and malignant ventricular arrhythmias.It has not been established whether the QT prolongation and associated malignant ventricular arrhythmias were due to the weight-reduction program, possible associated electrolyte disturbances, or a variety of medications that these patients were taking, or indeed whether the QT prolongation might be due to or associated with the obesity itself, independent of the weight-reduction program.2 A study of patients with obesity3 found that 28% of such patients have QTc


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