A modified high-fat, low-carbohydrate Atkins diet plus medications may reduce seizures in patients with difficult-to-treat epilepsy, according to a study published online January 4, 2023. neurology®the medical journal of the American Academy of Neurology.
“For people with drug-resistant epilepsy, or who have been unable to find effective treatments to reduce their seizures, there are lifestyle changes that can be combined with standard medications to reduce the number of seizures. It is encouraging to confirm that there is,” said the study.Author Manjari Tripathi, MD, DM, All India Institute of Medical Sciences, New Delhi. “Our study found that this combination could cut the chance of seizures by more than half.”
The modified Atkins diet combines the Atkins diet with the ketogenic diet and includes foods such as soy products, heavy cream, butter, oils, leafy greens, and animal proteins such as eggs, chicken, fish, and bacon. . The ketogenic diet has been shown to be effective in reducing seizures, but its stringent requirements and restrictions can make it difficult to follow.
The study included 160 adults and adolescents who had had epilepsy for an average of 10 years or more and had at least 27 seizures per month despite trying an average of 4 antiepileptic drugs at their maximum tolerated doses. They were randomly assigned to receive either standard drug therapy alone or drugs and a modified Atkins diet for 6 months.
Participants recorded seizures and meals. We were given meal lists, sample menus and recipes. Carbohydrate intake was limited to 20 grams per day. Federal dietary guidelines recommend 225 to 325 grams of carbohydrates per day.
After six months, the researchers found that 26% of those who took both the medication and the modified Atkins diet experienced a 50% or more reduction in seizures, compared with just 3% of those who took medication alone. Four people in the diet group were seizure-free by the end of the study, while none in the medication-only group were seizure-free.
The study also looked at quality of life, behavior and side effects at 6 months of age. The group that received medication and followed the modified Atkins diet showed improvements in all domains compared to the group that received medication alone.
Tripathi noted that 33% of participants were unable to complete the study due to poor food tolerance, no benefit or lack of follow-up due to COVID-19. However, Tripathi said the tolerance of his modified Atkins diet is better than that seen with ketogenic diets.
“Although the modified Atkins diet may be an effective treatment for controlling seizures, more research is needed to identify genetic biomarkers and other factors associated with response to this diet.” added Tripathi. “This has the potential to improve patient care by promoting targeted accuracy based on early use of this diet.”
A limitation of this study is that some seizures may not have been reported as seizures were self-reported or reported by caregivers.
This research was supported by the Ministry of Biotechnology, India.
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