Twenty-four hour electrographic recordings were made on 36 grossly obese children and adolescents during a 3-week weight reduction regimen with a 525 kcal (2196 kj) mixed diet at weekly intervals. One hundred and ten Holter ECGs were analysed. Weight loss during the treatment was calculated to be 5.7 +/- 1.6 kg. Average and minimal heart rate decreased constantly throughout the study period from 83.9 +/- 9 to 75 +/- 9/min and 53 +/- 6 to 45 +/- 6/min, respectively (P less than 0.01, P less than 0.005). During the second week maximal heart rate increased significantly but returned to baseline values in the third week. Neither before nor during the period of therapy were any dysrhythmias monitored. Dietary regimens containing 500-700 kcal, based on a mixed composition of foods with sufficient amounts of minerals, can be regarded as a safe therapeutic tool in the treatment of obese children and adolescents.
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