A Modified Atkins Diet Is Effective for the Treatment of Intractable Pediatric Epilepsy

Abstract

Summary:Purpose: The Atkins diet may induce ketosis as does the ketogenic diet, without restrictions on calories, fluids, protein, or need for an inpatient fast and admission. Our objective was to evaluate the efficacy and tolerability of a modified Atkins diet for intractable childhood epilepsy.Methods: Twenty children were treated prospectively in a hospital-based ambulatory clinic from September 2003 to May 2005. Children aged 3-18 years, with at least three seizures per week, who had been treated with at least two anticonvulsants, were enrolled and received the diet over a 6-month period. Carbohydrates were initially limited to 10 g/day, and fats were encouraged. Parents measured urinary ketones semiweekly and recorded seizures daily. All children received vitamin and calcium supplementation.Results: In all children, at least moderate urinary ketosis developed within 4 days (mean, 1.9). Sixteen (80%) completed the 6-month study; 14 chose to remain on the diet afterward. At 6 months, 13 (65%) had >50% improvement, and seven (35%) had >90% improvement (four were seizure free). Mean seizure frequency after 6 months was 40 per week (p = 0.005). Over a 6-month period, mean serum blood urea nitrogen increased from 12 to 17 mg/dl (p = 0.01); creatinine was unchanged. Cholesterol increased from 192 to 221 mg/dl, (p = 0.06). Weight did not change significantly (34.0-33.7 kg); only six children lost weight. A stable body mass index over time correlated with >90% improvement (p = 0.004).Conclusions: A modified Atkins diet is an effective and well-tolerated therapy for intractable pediatric epilepsy.

The Neuropharmacology of the Ketogenic Diet

“…It is already clear that different dietary regimens, such as the Atkins diet [87] or the low glycemic index diet [88], confer seizure protection, but there may be differences from the classical ketogenic diet, if only in palatability and side effects. An insight into the underlying mechanisms should allow dietary therapy to be optimized, maximizing efficacy while minimizing side effects.…”

Should animal fats be back on the table? A critical review of the human health effects of animal fat

“…Moreover, trials of ketogenic diets in the treatment of final stage cancer patients and in experimental systems (Tisdale et al 1987;Breitkreutz et al 2005;Zuccoli et al 2010;Ho et al 2011;Klement and Kaemmerer 2011;Schmidt et al 2011;Chang et al 2013) have occurred, with some interesting results of reduction in tumour size, reduction of cachexia, or delay of initiation of cancer. Ketogenic diets continue to be used to treat some classes of epilepsy (Freeman et al 1998;Kossoff et al 2006;Neal et al 2008), and have been suggested for other mental disorders or dementias including Alzheimer's disease and Parkinson's disease (VanItallie and Nufert 2003;Kim et al 2007;Kossoff and Hartman 2012). A random controlled trial of an additive to the normal diet, AC-1202, consisting of short-and medium-chain TAG derived from coconut oil and that are metabolised to ketone bodies, has shown some improvement in Alzheimer's disease sufferers from ketone body production (Henderson et al 2009).…”

Dieta cetogênica e dieta de Atkins modificada no tratamento da epilepsia refratária em crianças e adultos

“…[4][5][6] A DAM induz cetose, mas sem restrições a líquidos, calorias e proteínas e não requer jejum, pesagem dos alimentos e hospitalização. 7 Como a DAM é um tratamento recente para epilepsia refratária, poucos estudos ainda foram apresentados.…”