Abstract
Background: There is rekindled interest in extreme diet control after recent demonstration of reversion of diabetes mellitus by extreme diet control as it improves insulin sensitivity. Weight loss in long run is good for cardiovascular functions but increase in fatty acids associated with extreme diet control may be detrimental to cardiac metabolism and function.

Aim and Objective: In this study, we tried to find out the effect of extreme diet control on cardiac functions during a period of 8 weeks and its anticipated beneficial effect on metabolism.

Materials and Methods: Thirty obese volunteers (body mass index [BMI] = 35.8 ± 6) were subjected to biochemical profiling and echocardiography at 1 and 8 weeks following extreme diet control (800 Kcal/day). Results were compared to parameters at the start of study.

Results: There was weight loss at 1 week of extreme diet control (BMI=34.1 ± 5.8 at 1 week as compared to 35.8 ± 6.0 at baseline, P < 0.01) associated with improvement in biochemical parameters, however, there was impairment in both systolic (LVEF by 3%, P = 0.04) and diastolic myocardial functions (E/e’8.5 ± 1.3 to 9.2 ± 1.6, P = 0.01). Biochemical parameters were found to improve along with decrease in BMI at 8 weeks as compared to 1 week along with improvement in systolic myocardial functions (LVEF improved from 62 ± 5 at 1 week to 64 ± 5 at 8 weeks). Diastolic myocardial functions also improved (E/e’ from 9.2 ± 1.6 at 1 week to 7.1 ± 1.5 at 8 weeks).

Conclusion: Extreme diet control results in continuing significant improvement as regards weight loss and biochemical parameters but is linked to temporary but significant cardiovascular impairment at 1 week which may have deleterious effect on coexisting cardiac comorbidity or already compromised cardiac functions. Whereas 8 weeks of extreme dieting resulted in reversion to normal cardiac systolic functions and diastolic functions improved even from their baseline values, thereby signifying its possible therapeutic value in cardiac parameters in obese people in long run.

Key words: Obesity; Extreme Dieting; Cardiac Functions; Echocardiography