News - Modified
Atkins diet to treat epilepsy in children
17 January 2006
Doctors have found that a modified version
of the popular Atkins diet is nearly as
effective for treating seizures in children
as the ketogenic diet, while being much
less restrictive. In their pilot study of
twenty children over six months, two thirds
had improved seizure control on the diet.
Both the Atkins and ketogenic diets are
high in fat and low in carbohydrates. This
combination alters the body's chemistry.
Fat is burnt for energy in the absence of
glucose, derived from carbohydrates in food.
By-products of the metabolic processes breaking
down fat are chemicals called ketones, which
can inhibit seizures, though the exact mechanism
of this effect is not known. A child who
has stayed seizure-free for two years on
the ketogenic diet can often return to a
normal diet without seizures coming back.
The ketogenic diet is highly restrictive,
and can be prescribed to control seizures
in children. It requires parents to measure
out accurately the right amount of all foods
and liquids, to make sure the child gets
the right combination of fats, carbohydrates
and protein necessary to produce ketones.
When children begin the diet they must fast
for a short period in hospital. Side effects
can include kidney stones, constipation
and slowed growth.
The modified Atkins diet also produces
ketones, but it doesn't restrict the number
of calories the child can have, or the amount
of fluid or protein they can consume. There
is no fasting to begin the diet. Accurate
weighing and measuring of foods and fluids
is not required, which may allow patients
to follow it better.
In this study, presented at the American
Epilepsy Society's 59th Annual Meeting
in December, twenty children aged between
three and eighteen years were treated with
the modified Atkins diet for six months.
All had intractable epilepsy, with a number
of different seizure types and epilepsy
syndromes. Before the diet, they experienced
an average of 162 seizures a week, and were
being treated with an average of 6.5 anticonvulsant
medications. They were put on a regimen
that included fewer carbohydrates than the
standard Atkins diet: up to 10 g daily,
with encouragement to consume foods that
are high in fat.
A total of sixteen patients stayed on the
modified Atkins diet for the whole of the
study and 14 children remained on it after
the study. Thirteen study participants experienced
a more than 50% drop in seizure frequency
after 6 months on the diet, and seven had
an improvement of more than 90%. Four patients
became seizure free. At the end of the study,
average seizure frequency had fallen to
forty seizures per week. A high level of
ketones was achieved on average within two
days of starting the diet.
The study was too small to suggest that
the modified Atkins diet should replace
the traditional tried and tested ketogenic
diet. It could instead be used to familiarise
families with the tough requirements of
the full ketogenic diet. Adolescents and
adults, who are not usually offered treatment
with the ketogenic diet as it has a poor
record of success in this age group, might
also benefit from the new diet.
Please note: Parents should not start any
diet for epilepsy without a doctor's supervision
and specialised medical management.
