A modified version of a popular low-carbohydrate, high-fat diet is nearly as effective at controlling seizures as the highly restrictive ketogenic diet, Johns Hopkins Children's Center researchers report.
"Our findings suggest relatively good efficacy compared to the ketogenic diet," said Eric Kossoff, M.D., a pediatric neurologist at Johns Hopkins Children's Center. "With 20 patients, our study wasn't large enough to say patients and physicians should replace the proven, but highly restricted ketogenic diet, but the results are encouraging and intriguing."
The common elements in both the ketogenic and Atkins diets are relatively high fat and low carbohydrate foods that alter the body's chemistry. The ketogenic diet mimics some of the effects of starvation, in which the body first uses up glucose and glycogen before burning stored body fat. In the absence of glucose, the body produces ketones, a chemical by-product of fat that can inhibit seizures. Children who remain seizure-free for two years on the ketogenic diet often can resume normal eating without the return of seizures.
The modified Atkins diet is better tolerated by children and may be easier for parents and children to follow, said Kossoff, who presented the study's findings today in Washington, D.C. at a meeting of the American Epilepsy Society.
While the ketogenic diet has proven effective in controlling pediatric epilepsy since its introduction in 1921, it has several drawbacks and side effects. The highly restrictive regimen requires accurate measurement of all foods and liquids to ensure consumption of the proper ratio of fats, carbohydrates and protein necessary to produce ketones. The diet starts with a brief fast and hospital stay during which time families are trained in the rigors of the diet. Side effects can include kidney stones, constipation and slowed growth.
The modified Atkins diet also produces ketones, but requires no restrictions on calories, fluids and protein, and does not require a hospital admission and fast to begin. It also does not require the accurate weighing and measuring of foods, which may translate to better compliance with the regimen, researchers concluded.