BOSTON—The Modified Atkins Diet may reduce seizure frequency in adults with pharmacoresistant epilepsy, according to research presented at the 63rd Annual Meeting of the American Epilepsy Society. Overweight patients may see additional benefits in the reduction of long-term complications of obesity.
Analyzing Diet Adherence and Seizure Frequency
Jose Martin del Campo, MD, of the Toronto Western Hospital, University Health Network, University of Toronto, and colleagues assessed 22 patients at baseline and at three, six, and 12 months after starting the diet. Participants and caregivers kept detailed food intake and seizure diaries throughout the study, and reports were collected at each visit.
Weight, BMI, and urinary ketosis were evaluated at each visit. Lipid profiles, electrolytes, and CBC were evaluated every six months. Patients consulted with a dietitian, received instructions on how to follow the diet, and were told to limit their carbohydrate intake to 20 g/day. There were no requirements regarding fluids and calories in the form of fat and protein.
A total of 17 patients were included in the three-month analysis, and 14 patients were included in the analyses at six and 12 months.
The researchers observed no improvement in seizure reduction in 41% of patients at three months, 58% of patients at six months, and 50% of patients at 12 months. A seizure reduction of less than 50% was seen in 47%, 14%, and 29% of patients at three, six, and 12 months, respectively. Between 51% and 75% reduction was seen in 6%, 21%, and 14% of patients at three, six, and 12 months, respectively. In addition, 6%, 7%, and 7% of patients showed a reduction in seizure frequency greater than 75% at three, six, and 12 months, respectively.
“Response to the Modified Atkins Diet at three months predicted response at 12 months in 75% of patients,” Dr. del Campo and coauthors stated. “Therefore, a three-month trial of the Modified Atkins Diet may be sufficient to determine if it’s an effective and sustainable treatment. Ketosis was not related to efficacy of the diet, and this may have implications for theories regarding its mechanism in inducing seizure reduction.”
A Mutlticenter Study Is Needed to Establish Clinical Guidelines
Dr. del Campo’s team noted several study limitations, mainly relating to the small sample size. “Importantly, data relating to food intake and seizure frequency were all self-reported and therefore may have been construed,” Dr. del Campo and coauthors stated.
In addition, human Parkinson’s disease patients also have similar mitochondrial defects to those seen in mutant Drosophila; thus, the studies in Drosophila are key to understanding the fundamental cellular defects in Parkinson’s disease patients.”
“A multicenter study on the efficacy, mechanism, and associated health benefits of the Modified Atkins Diet in the treatment of intractable epilepsy in adult populations is needed to establish effective clinical use guidelines,” the researchers concluded.
—Laura Sassano