A prospective study of the modified Atkins diet for intractable epilepsy in adults.
Level 4 - case-series / case-control
Prospective, single-arm open-label interventional study without a control group
PubMed 17919301 · doi:10.1111/j.1528-1167.2007.01256.x
What was done
A prospective, open-label trial evaluated the modified Atkins diet in 30 adults (ages 18–53) with intractable epilepsy experiencing at least weekly seizures despite prior use of at least two anticonvulsants. Carbohydrate intake was limited to 15 g/day, fats were encouraged, and fluids, protein, and calories were unrestricted. Outcomes were assessed via intention-to-treat analysis.
What was found
By intention-to-treat analysis, 47% of patients achieved >50% seizure reduction at 1 and 3 months, and 33% at 6 months. Among responders, median time to improvement was 2 weeks (range: 1–8 weeks). Mean weight loss was 6.8 kg (p < 0.001), and body-mass index decrease correlated with efficacy at 3 months (p = 0.03). Ten patients (30%) discontinued the diet prior to 3 months. Reported side effects included increases in mean total cholesterol (187 to 201 mg/dL), blood urea nitrogen (13 to 16 mg/dL), and urine calcium-to-creatinine ratio (0.14 to 0.19).
Why it matters
This study indicates that a modified Atkins diet may reduce seizure frequency in adults with refractory epilepsy without requiring the strict caloric and protein limitations of the classic ketogenic diet.
Limits
The trial was uncontrolled and open-label, precluding blinding and raising risk of bias. The sample size was small (n = 30), adherence was challenging with a 30% discontinuation rate by month 3, and follow-up was limited to 6 months.
Cited by
- supports Dr. Eric Kossoff and Dr. John Freeman published research around 2007 or 2008 establishing that the modified Atkins diet can effectively treat epilepsy in adults.