The impact of the modified Atkins diet on lipid profiles in adults with epilepsy.
OBJECTIVE
The modified Atkins diet (MAD) is a high fat, low carbohydrate ketogenic diet used to treat intractable seizures in children and adults. The long-term impact on fasting lipid profiles (FLPs) remains unknown. This study was designed to detect significant lipid changes in adults on MAD.


METHODS
Patients were observed prospectively. A FLP was obtained in all patients at the first visit then serially. Patients were started on a 20 g per day net carbohydrate limit MAD. They were screened for risk for coronary heart disease and counseled to reduce saturated fats by a registered dietitian if deemed at risk. Patients that remained on MAD for 3 or more months with one or more follow-up FLP were included.


RESULTS
Thirty-seven patients (14 male), mean age 33 years (SD 13, range 18-59) met study criteria. Median diet duration was 16 months (range 3-41). Total cholesterol and low-density lipoprotein (LDL) increased significantly over the first 3 months of MAD (P = 0.01 and 0.008, respectively), but were not significantly different from baseline after 1 year of treatment (P = 0.2 and P = 0.5, respectively). High-density lipoprotein levels trended upward in the first 3 months (P = 0.05) and triglycerides remained unchanged (P = 0.5). In 12 patients followed for 3 or more years, no cardiovascular or cerebrovascular events were reported.


CONCLUSIONS
Although total cholesterol and LDL increased over the first 3 months of the MAD, these values normalized within a year of treatment, including in patients treated with MAD for more than 3 years.
a Department of Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Mackenzie C
MC
Cervenka
a Department of Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Katlyn
K
Patton
b Department of Biostatistics, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Ani
A
Eloyan
c Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Bobbie
B
Henry
a Department of Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.|d Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Eric H
EH
Kossoff
D000293:Adolescent; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D055423:Diet, Ketogenic / Q000009:adverse effects*; D004042:Dietary Fats, Unsaturated / Q000627:therapeutic use*; D004827:Epilepsy / Q000097:blood / Q000178:diet therapy* / Q000652:urine; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D007659:Ketones / Q000652:urine; D008077:Lipoproteins, LDL / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
D015415:Biomarkers; D004042:Dietary Fats, Unsaturated; D007659:Ketones; D008077:Lipoproteins, LDL; D002784:Cholesterol
Cholesterol; Epilepsy; Hyperlipidemia; Ketogenic diet; Lipoprotein; Modified Atkins diet; Seizure; Triglycerides