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Survey of Very-Low-Calorie Weight Reduction Diets: II. Total Fasting, Protein-Sparing Modified Fasts, Chemically Defined Diets

Survey of Very-Low-Calorie Weight Reduction Diets: II. Total Fasting, Protein-Sparing Modified... Abstract The US Public Health Service stated that "because of the potential hazards of starvation diets and the need for continuous medical supervision..., such diets should never be self-administered."1 Total fasting produces a number of detrimental side effects, including severe ketosis, hyperuricemia, negative nitrogen balance, hyponatremia, hypokalemia, hypoglycemia, neutropenia, alopecia, and increased renal loss of phosphate and magnesium.2,3 Even in trials of intermittent fasting under close medical supervision, patients experienced hyperuricemia, sodium depletion, ketosis, and hyperketonemia. Duncan et al4 reported atrial fibrillation in three patients with cardiovascular disease who exercised while following an intermittent fasting protocol. Fasting as a weight reduction regimen became popular following the publication of Fasting: The Ultimate Diet, by Allan Cott5 in 1975 (Table). Cott stated that "fasting brings a welcome physiological rest for the digestive tract and the central nervous system. It normalizes metabolism." In addition, the total fasting approach was recommended References 1. Obesity and Health , Public Health Service publication 1485. 1966, p 56. 2. Bray GA (ed): Obesity: Comparative Methods of Weight Control . Westport, Conn, Technomic Publishing Co Inc, 1980. 3. Benoit FL, Martin RL, Watten RH: Changes in body composition during weight reduction in obesity. Ann Intern Med 1965;63:604-612.Crossref 4. Duncan CG, Hunscher MA, Cristofori FC, et al: Intermittent total fasts and obesity: Implications, results, and preventable hazards. Postgrad Med 1965;38:523-535. 5. Cott A: Fasting: The Ultimate Diet . New York, Bantam Books, 1975, p 58. 6. Cott A: Fasting is a Way of Life . New York, Bantam Books, 1977. 7. Duncan CG, Jenson WK, Cristofori FC, et al: Intermittent fasts in the correction and control of intractable obesity. Am J Med Sci 1963;245: 515-520.Crossref 8. Johnson D, Drenick EJ: Therapeutic fasting in morbid obesity. Arch Intern Med 1977;137:1281-1282.Crossref 9. Swanson DW, Dinello FA: Follow-up of patients starved for obesity. Psychosom Med 1970;32:209-214.Crossref 10. Genuth SM, Castro JH, Vertes V: Weight reduction in obesity by outpatient semistarvation. JAMA 1974;230:987-991.Crossref 11. Bistrian BR: Clinical use of a protein-sparing modified fast. JAMA 1978;240:2299-2302.Crossref 12. Bistrian BR: Recent developments in the treatment of obesity with particular reference to semistarvation ketogenic regimens. Diabetes Care 1978;1:379-384.Crossref 13. Bistrian BR, Blackburn GL, Flatt JP, et al: Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast. Diabetes 1976;25:494-504.Crossref 14. Watters JM, Freeman JB: Parenteral nutrition by peripheral vein. Surg Clin North Am 1981;61:593-604. 15. Blackburn GL: 'Liquid protein diets' and 'protein-sparing modified fast.' New Engl J Med 1978;299:419.Crossref 16. Sours HE, Frattali VP, Brand CD, et al: Sudden death associated with very low calorie weight reduction regimens. Am J Clin Nutr 1981; 34:453-461. 17. Gotto AM, Vertes V, Jackson D: Obesity: A new approach to an old problem. Heart Lung 1980;9:719-725. 18. Baird MI, Parsons RL, Howard AN: Clinical and metabolic studies of chemically defined diets in the management of obesity. Metabolism 1974; 23:645-657.Crossref 19. Howard AN: Very low calorie semi-starvation semi-synthetic diets in the treatment of obesity. Nutr Metabol 1973;21( (suppl 1) ):59-61.Crossref 20. McKee G (ed): The Cambridge Diet , in Nutrition and the M.D. Van Nuys, Calif, PM Inc, 1980, vol 6, p 2. 21. Three trying "improved" crash diet land in the hospital. Medical World News . (Jan 4) , 1982, pp 61-62. 22. Wilson JHP, Lamberts SWT: Nitrogen balance in obese patients receiving very low calorie liquid formula diets. Am J Clin Nutr 1978;32: 1612-1616. 23. Baird IM: Low-calorie-formula diets—are they safe? in Howard AN (ed): Proceedings of a Satellite Symposium: Third International Congress in Obesity, Italy, October 1980: Evaluation of Very-Low-Calorie Diets . London, John Libbey & Co Limited, pp 19-26. 24. Hickey N, Daly L, Bourke G, et al: Outpatient treatment of obesity with a very-low-calorie formula diet. Proceedings of a Satellite Symposium: Third International Congress in Obesity , Italy, October 1980. Evaluation of Very Low-Calorie Diets. London, John Libbey & Co Limited, pp 27-29. 25. Lee R, Linder P: The ultra-low calorie diet revisited. Obesity Bariatric Med 1982;11:4. 26. FDA seeking information on the Cambridge diet. Food Chemical News , (Dec 7) , 1981, pp 26-29. 27. Public Health Advisory , Michigan Department of Public Health, April 29, 1982. 28. Fisler JS, Drenick EJ, Blumfield DE, et al: Nitrogen economy during very low calorie reducing diets: Quality and quantity of dietary protein. Am J Clin Nutr 1982;35:471-486. 29. Rudman D: Protein-energy malnutrition , in Isselbacher KJ, Adams RD, Braunwald E, et al (eds): Harrison's Principles of Internal Medicine , ed 9. New York, McGraw-Hill Book Co, 1980, pp 407-441. 30. Viart P: Hemodynamic findings during treatment of protein-calorie malnutrition. Am J Clin Nutr 1978;31:911-926. 31. Chandra RK: Immunocompetence in undernutrition. J Pediatr 1972; 81:1194-1200.Crossref 32. Bistrian BR, Sherman M, Blackburn GL, et al: Cellular immunity in adult marasmus. Arch Intern Med 1977;137:1408-1411.Crossref 33. Howard AN: Possible complications of long-term dietary treatment of obesity , in Medical Complication of Obesity . Proceedings at the Serono Symposium. London, Academic Press Inc, 1979, pp 349-363. 34. Newmark SR, McLeroy MA, Sublett D: The defined formula diet: A therapeutic modality to achieve short-term weight reduction in outpatient obese subjects. Obesity/Bariatric Med 1980;9:162-166. 35. Van Itallie TB: Liquid protein mayhem. JAMA 1978;240:144-145.Crossref 36. Protein diets. FDA Drug Bull 1978;8:2-4. 37. Gregg MB: Deaths associated with liquid protein diets. MMWR 1977;26:383. 38. Singh BN, Gaarder TD, Kanegae T, et al: Liquid protein diets and torsade de pointes. JAMA 1978;240:115-119.Crossref 39. Brown JM, Yetter JF, Spicer MJ, et al: Cardiac complications of protein-sparing modified fast. JAMA 1978;240:120-122.Crossref 40. Michiel RR, Sneider JS, Dickstein RA, et al: Sudden death in a patient on a liquid protein diet. N Engl J Med 1978;298:1005-1007.Crossref 41. Liquid protein and sudden cardiac deaths: An update. FDA Drug Bull 1978;18:18-19. 42. Lantiqua RA, Amatruda JM, Biddle TL, et al: Cardiac arrhythmias associated with a liquid protein diet for the treatment of obesity. N Engl J Med 1980;303:735-738.Crossref 43. Linn R: The Last Chance Diet . Secaucus, NJ, Lyle Stuart, 1976. 44. Recommended Dietary Allowances , ed 9. Washington, DC, National Research Council, National Academy of Sciences, 1980. 45. Van Itallie TB: Dietary approaches to the treatment of obesity , in Stunkard AJ (ed): Obesity . Philadelphia, WB Saunders Co, 1980, pp 249-261. 46. Stunkard AJ, McLaron-Husa M: The results of treatment of obesity: A review of the literature and report of a series. Arch Intern Med 1959;103:79-85.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Survey of Very-Low-Calorie Weight Reduction Diets: II. Total Fasting, Protein-Sparing Modified Fasts, Chemically Defined Diets

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American Medical Association
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Copyright © 1983 American Medical Association. All Rights Reserved.
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0003-9926
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1538-3679
DOI
10.1001/archinte.1983.00350070143022
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Abstract

Abstract The US Public Health Service stated that "because of the potential hazards of starvation diets and the need for continuous medical supervision..., such diets should never be self-administered."1 Total fasting produces a number of detrimental side effects, including severe ketosis, hyperuricemia, negative nitrogen balance, hyponatremia, hypokalemia, hypoglycemia, neutropenia, alopecia, and increased renal loss of phosphate and magnesium.2,3 Even in trials of intermittent fasting under close medical supervision, patients experienced hyperuricemia, sodium depletion, ketosis, and hyperketonemia. Duncan et al4 reported atrial fibrillation in three patients with cardiovascular disease who exercised while following an intermittent fasting protocol. Fasting as a weight reduction regimen became popular following the publication of Fasting: The Ultimate Diet, by Allan Cott5 in 1975 (Table). Cott stated that "fasting brings a welcome physiological rest for the digestive tract and the central nervous system. It normalizes metabolism." In addition, the total fasting approach was recommended References 1. Obesity and Health , Public Health Service publication 1485. 1966, p 56. 2. Bray GA (ed): Obesity: Comparative Methods of Weight Control . Westport, Conn, Technomic Publishing Co Inc, 1980. 3. Benoit FL, Martin RL, Watten RH: Changes in body composition during weight reduction in obesity. Ann Intern Med 1965;63:604-612.Crossref 4. Duncan CG, Hunscher MA, Cristofori FC, et al: Intermittent total fasts and obesity: Implications, results, and preventable hazards. Postgrad Med 1965;38:523-535. 5. Cott A: Fasting: The Ultimate Diet . New York, Bantam Books, 1975, p 58. 6. Cott A: Fasting is a Way of Life . New York, Bantam Books, 1977. 7. Duncan CG, Jenson WK, Cristofori FC, et al: Intermittent fasts in the correction and control of intractable obesity. Am J Med Sci 1963;245: 515-520.Crossref 8. Johnson D, Drenick EJ: Therapeutic fasting in morbid obesity. Arch Intern Med 1977;137:1281-1282.Crossref 9. Swanson DW, Dinello FA: Follow-up of patients starved for obesity. Psychosom Med 1970;32:209-214.Crossref 10. Genuth SM, Castro JH, Vertes V: Weight reduction in obesity by outpatient semistarvation. JAMA 1974;230:987-991.Crossref 11. Bistrian BR: Clinical use of a protein-sparing modified fast. JAMA 1978;240:2299-2302.Crossref 12. Bistrian BR: Recent developments in the treatment of obesity with particular reference to semistarvation ketogenic regimens. Diabetes Care 1978;1:379-384.Crossref 13. Bistrian BR, Blackburn GL, Flatt JP, et al: Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast. Diabetes 1976;25:494-504.Crossref 14. Watters JM, Freeman JB: Parenteral nutrition by peripheral vein. Surg Clin North Am 1981;61:593-604. 15. Blackburn GL: 'Liquid protein diets' and 'protein-sparing modified fast.' New Engl J Med 1978;299:419.Crossref 16. Sours HE, Frattali VP, Brand CD, et al: Sudden death associated with very low calorie weight reduction regimens. Am J Clin Nutr 1981; 34:453-461. 17. Gotto AM, Vertes V, Jackson D: Obesity: A new approach to an old problem. Heart Lung 1980;9:719-725. 18. Baird MI, Parsons RL, Howard AN: Clinical and metabolic studies of chemically defined diets in the management of obesity. Metabolism 1974; 23:645-657.Crossref 19. Howard AN: Very low calorie semi-starvation semi-synthetic diets in the treatment of obesity. Nutr Metabol 1973;21( (suppl 1) ):59-61.Crossref 20. McKee G (ed): The Cambridge Diet , in Nutrition and the M.D. Van Nuys, Calif, PM Inc, 1980, vol 6, p 2. 21. Three trying "improved" crash diet land in the hospital. Medical World News . (Jan 4) , 1982, pp 61-62. 22. Wilson JHP, Lamberts SWT: Nitrogen balance in obese patients receiving very low calorie liquid formula diets. Am J Clin Nutr 1978;32: 1612-1616. 23. Baird IM: Low-calorie-formula diets—are they safe? in Howard AN (ed): Proceedings of a Satellite Symposium: Third International Congress in Obesity, Italy, October 1980: Evaluation of Very-Low-Calorie Diets . London, John Libbey & Co Limited, pp 19-26. 24. Hickey N, Daly L, Bourke G, et al: Outpatient treatment of obesity with a very-low-calorie formula diet. Proceedings of a Satellite Symposium: Third International Congress in Obesity , Italy, October 1980. Evaluation of Very Low-Calorie Diets. London, John Libbey & Co Limited, pp 27-29. 25. Lee R, Linder P: The ultra-low calorie diet revisited. Obesity Bariatric Med 1982;11:4. 26. FDA seeking information on the Cambridge diet. Food Chemical News , (Dec 7) , 1981, pp 26-29. 27. Public Health Advisory , Michigan Department of Public Health, April 29, 1982. 28. Fisler JS, Drenick EJ, Blumfield DE, et al: Nitrogen economy during very low calorie reducing diets: Quality and quantity of dietary protein. Am J Clin Nutr 1982;35:471-486. 29. Rudman D: Protein-energy malnutrition , in Isselbacher KJ, Adams RD, Braunwald E, et al (eds): Harrison's Principles of Internal Medicine , ed 9. New York, McGraw-Hill Book Co, 1980, pp 407-441. 30. Viart P: Hemodynamic findings during treatment of protein-calorie malnutrition. Am J Clin Nutr 1978;31:911-926. 31. Chandra RK: Immunocompetence in undernutrition. J Pediatr 1972; 81:1194-1200.Crossref 32. Bistrian BR, Sherman M, Blackburn GL, et al: Cellular immunity in adult marasmus. Arch Intern Med 1977;137:1408-1411.Crossref 33. Howard AN: Possible complications of long-term dietary treatment of obesity , in Medical Complication of Obesity . Proceedings at the Serono Symposium. London, Academic Press Inc, 1979, pp 349-363. 34. Newmark SR, McLeroy MA, Sublett D: The defined formula diet: A therapeutic modality to achieve short-term weight reduction in outpatient obese subjects. Obesity/Bariatric Med 1980;9:162-166. 35. Van Itallie TB: Liquid protein mayhem. JAMA 1978;240:144-145.Crossref 36. Protein diets. FDA Drug Bull 1978;8:2-4. 37. Gregg MB: Deaths associated with liquid protein diets. MMWR 1977;26:383. 38. Singh BN, Gaarder TD, Kanegae T, et al: Liquid protein diets and torsade de pointes. JAMA 1978;240:115-119.Crossref 39. Brown JM, Yetter JF, Spicer MJ, et al: Cardiac complications of protein-sparing modified fast. JAMA 1978;240:120-122.Crossref 40. Michiel RR, Sneider JS, Dickstein RA, et al: Sudden death in a patient on a liquid protein diet. N Engl J Med 1978;298:1005-1007.Crossref 41. Liquid protein and sudden cardiac deaths: An update. FDA Drug Bull 1978;18:18-19. 42. Lantiqua RA, Amatruda JM, Biddle TL, et al: Cardiac arrhythmias associated with a liquid protein diet for the treatment of obesity. N Engl J Med 1980;303:735-738.Crossref 43. Linn R: The Last Chance Diet . Secaucus, NJ, Lyle Stuart, 1976. 44. Recommended Dietary Allowances , ed 9. Washington, DC, National Research Council, National Academy of Sciences, 1980. 45. Van Itallie TB: Dietary approaches to the treatment of obesity , in Stunkard AJ (ed): Obesity . Philadelphia, WB Saunders Co, 1980, pp 249-261. 46. Stunkard AJ, McLaron-Husa M: The results of treatment of obesity: A review of the literature and report of a series. Arch Intern Med 1959;103:79-85.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1983

References