Modified Atkins Diet Beneficial in Drug-Resistant Epilepsy

Adding a modified Atkins diet (MAD) to standard anti-seizure treatments significantly reduces seizure frequency in patients with drug-resistant epilepsy compared with medication alone, new research shows.

In a randomized prospective study, the number of seizures per month dropped by more than half in one quarter of patients following the high-fat, low-carb diet; and 5% of the group were free from all seizure activity after 6 months.

Both adults and adolescents reported benefits from the diet, which is a less strict version of a traditional ketogenic diet that many patients find difficult to follow. MAD includes foods such as leafy green vegetables and eggs, chicken, fish, bacon, and other animal proteins.

Dr Manjari Tripathi

“The use of an exchange list and recipe booklet with local recipes and spices helped in the initiation of MAD with the flexibility of meal choices and ease of administration,” co-investigator Manjari Tripathi, MD, DM, Department of Neurology, All India Institute of Medical Science, New Delhi, told Medscape Medical News.

“As items were everyday household ingredients in proportion to the requirement of the MAD, this diet is possible in low-income countries also,” Tripathi added.

The findings were published online January 4 in the journal Neurology.

Low Carbs, High Benefit

The MAD diet includes around 65% fat, 25% protein, and 10% carbohydrates. Unlike a traditional ketogenic diet, MAD includes no restrictions on protein, calories, or fluids.

Researchers have long known that ketogenic and Atkins diets are associated with reduced seizure activity in adolescents with epilepsy. But previous studies were small, and many were retrospective analyses.

The current investigators enrolled 160 patients (80 adults, 80 adolescents) aged 10-55 years whose epilepsy was not controlled despite using at least three anti-seizure medications at maximum tolerated doses.

The intervention group received training in MAD and were given a food exchange list, sample menu, and recipe booklet. Carbohydrate intake…

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