Efficacy and tolerability of the modified Atkins diet in adults with pharmacoresistant epilepsy: a prospective observational study.
OBJECTIVE
Evidence from the pediatric population exists for the efficacy of ketogenic diets in reducing seizure frequency in patients with intractable epilepsy. Recent evidence suggests that a Modified Atkins Diet may be a beneficial form of cotherapy for adult patients with pharmacoresistant epilepsy.


METHODS
A prospective, open-label study was performed of adults > 18 years of age with pharmacoresistant epilepsy. Carbohydrates were restricted to 20 g/day. Fluids and calories from protein and fat were allowed ad libitum.


RESULTS
Eighteen patients, ages 18-55 years, were initially enrolled. Using an intent-to-treat analysis, 12% had a >50% seizure reduction after 3 months; 28% after 6 months, and 21% after 12 months. Response at 3 months predicted response at 12 months in 79% of patients. The mean decrease in weight was 10.9 kg and the mean decrease in body mass index (BMI) was 3.8, p = 0.01. Fourteen of 18 patients (78%) completed 12 months of this diet. Patients experienced a decrease in triglycerides from (mean) 1.22 to 0.9 mm (p = 0.02).


CONCLUSIONS
The Modified Atkins Diet demonstrates modest efficacy as cotherapy for some adults with pharmacoresistant epilepsy and may be also helpful for weight loss. Financial and logistical barriers were significant factors for those who declined enrollment and for those who discontinued the study.
Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Mara
M
Smith
Nina
N
Politzer
Debra
D
Macgarvie
Mary-Pat
MP
McAndrews
Martin
M
Del Campo
D000293:Adolescent; D000328:Adult; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects / Q000379:methods*; D004040:Dietary Carbohydrates / Q000009:adverse effects / Q000378:metabolism; D004041:Dietary Fats / Q000009:adverse effects / Q000627:therapeutic use; D004044:Dietary Proteins / Q000009:adverse effects / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D004827:Epilepsy / Q000175:diagnosis / Q000178:diet therapy* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins