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Karl J. Niedershuh, MA
Swarthmore, Pa

JAMA. 1990;263(21):2885-2886.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

A recent commentary by Wadden et al¹ on the irresponsible use of very-low-calorie diets hints at the possibility of yet another epidemic of sudden cardiac death among the obese and desperate. In this light, it should be noted that research has yet to explain adequately the appearance of prolonged QT intervals or malignant ventricular arrhythmias in patients who undergo rapid and substantial weight loss.

Sours et al² found that supplemented fasting deaths could not be explained by such factors as the quality or quantity of medical care, the biologic quality of the protein supplement, or electrolyte balance as determined by potassium intake. More recent research has challenged the assumption that nutritional depletion or lean tissue loss precipitated these deaths.^3,4 These studies suggest that a portion of the obese population is at increased risk of developing malignant arrhythmias in response to stress, regardless of the . . . [Full Text PDF of this Article]

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