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Modified Atkins Diet Effective in Children with Intractable Epilepsy: Presented at AES

By Fran Lowry

WASHINGTON, DC -- December 8, 2005 -- A modified version of the Atkins diet that strictly limits carbohydrates and enhances fat consumption is an effective and well tolerated therapy in children with intractable epilepsy, report researchers from Johns Hopkins Children's Center.

"The modified Atkins diet is better tolerated by children and may be easier for parents and children to follow than the highly restrictive ketogenic diet," said Eric H. Kossoff, MD, Pediatric Neurologist, Johns Hopkins University, Baltimore, Maryland, United States.

The ketogenic diet has proven effective in controlling pediatric epilepsy since its introduction in 1921 but has several drawbacks and adverse effects, Dr. Kossoff said during his presentation on December 5^th at the 59^th Annual Meeting of the American Epilepsy Society (AES).

The regimen is restrictive and requires painstaking measurement of all foods and liquids to ensure the proper ratio of fats, carbohydrates and protein necessary to produce ketones. Before children go on the diet, they must be hospitalized and go on a fast, while their families learn the particulars of the diet. Adverse effects of the ketogenic diet include the development of kidney stones, constipation, and retarded growth.

Similarly to the ketogenic diet, the modified Atkins diet also produces ketones, but without the restrictions on calories, fluids, and protein. As well, there is no need for an inpatient fast and admission to hospital.

The Johns Hopkins researchers conducted a prospective 6-month study to evaluate the effects of a modified Atkins diet in 20 children, aged 3 to 18, with intractable epilepsy of various etiologies. Carbohydrates were limited to 10 g per day and low carbohydrate processed foods were avoided for the first month. The children's medications were not changed. Patients measured urinary ketones semiweekly and recorded seizures daily. All children received vitamin and calcium supplementation.

Of the 16 children who completed the study, 13 had a >50% improvement in seizures, 7 had a >90% improvement, four of whom were seizure free. Medications were successfully reduced in seven patients. Ten families chose to increase carbohydrates to 15 g per day; one such patient had subsequent increased seizures. Four of five patients with absence epilepsy had a >50% improvement at 6 months, and two of these patients were free of seizures, Dr. Kossoff reported.

"The key here is ketosis -- the production of ketones -- which both diets create," Dr. Kossoff said. "This study suggests that for some children, we need not be so restrictive in allowing protein, weighing foods and counting calories."


[Presentation title: A Modified Atkins Diet Is Effective for the Treatment of Intractable Pediatric Epilepsy: Results from a Prospective Trial. Abstract A.01]

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