Low Basal Metabolic Rates Obtained by Low Calorie Diets in Coronary Artery Disease

Abstract

That a diminished food intake results in lowered basal metabolic rates has been known for many years. It is only necessary to mention the classical work performed by Benedict 1 and reviewed by Lusk. 2 In view of the fact that the basal metabolic rate is raised in congestive heart disease, tachycardia, severe dyspnea, and in diastolic hypertension, 3 we wished to determine the rates of patients who had sustained an acute coronary artery occlusion and who were placed on a diminished food intake.

An adequately balanced 800 calorie diet containing 80 gm. of carbohydrate, 50 gm. of protein, and 30 gm. of fat was prescribed. Care was taken to include adequate vitamins. The fluid intake was limited to 1,000–1,200 cc. per day. Basal metabolic rates were determined frequently and control readings were obtained either at the beginning of the experiment or when the patient's diet was increased. In no case was there any pulmonary congestion or evidence of myocardial decompensation at the time readings were made. In addition to the 7 patients, (Cases I to VII) who suffered from coronary thrombosis we are including one case of severe anginal syndrome caused by coronary artery sclerosis (Case VIII). The latter was always ambulatory and, although a sick man, travelled to and from our clinic. After discharge from the hospital the patients returned regularly for the basal metabolism test.

Graphs of the first 4 patients followed 3 or more months are presented as well as tables of all 8 cases. In the latter for the sake of brevity only the basal metabolic readings characteristic of each particular level of feeding are recorded. It will be observed that in 2 to 4 weeks, the basal metabolic rate ranged between —20 and —30%.∗