American Journal of Clinical Nutrition, Vol 1, 52-65, Copyright © 1952 by The American Society for Clinical Nutrition, Inc.

The Therapeutic uses of LOW FAT, LOW CHOLESTEROL DIETS

I. Treatment of Essential Familial Xanthomatosis

¹ From the Departments of Dermatology and Therapeutic Research. University of Pennsylvania School of Medicine, and the Pepper Laboratory of the Hospital of the University of Pennsylvania

Nine patients with proved essential familial xanthomatosis were placed on a low fat, low cholesterol diet and followed for periods ranging from eight months to seven years. The diet was adjusted to contain approximately 20 Gm. total fat and 100 mg. cholesterol daily.

All patients showed a significant fall in serum cholesterol levels while adhering to the diet. In the patients without tendon lesions the serum cholesterol returned to normal or near normal limits. In those with tendon xanthomata the response was much slower, less dramatic, and incomplete.

Cutaneous xanthomata, when not accompanied by tendon tumors, involuted partially or completely. Reduction in size of the lesions began two or three months after initiation of therapy. No change was noted in those patients having both tendon and cutaneous lesions. One child developed tendon lesions while on the diet.

All patients with angina pectoris improved clinically.

Progressive improvement of ballistocardiographic pattern was seen in two patients and in one the record deteriorated concomitant with what was probably a small infarct. Reappearance of pulsation in previously nonpalpable leg vessels and lessening of intermittent claudication observed in two patients indicates improvement in major peripheral arterial circulation. It thus appears that adherence to a low fat, low cholesterol diet can produce amelioration of atherosclerotic symptoms, perhaps by promoting resorption of atheromatous deposits.