Ketogenic Diet Abstracts

We have a special Dietary Therapies section on our website and more specificially, a monthly series of articles written by or assigned through Eric Kossoff, MD. Last month Dr. Kossoff had two articles published. We present here on the abstracts and also links to related articles. / The Editors

A prospective study of the modified atkins diet for intractable epilepsy in adults.

PMID: 17919301 Epilepsia. 2008 Feb;49(2):316-9.

This prospective, noncontrolled study represents the first prospective study of the modified Atkins diet in adults, as opposed to children. 30 adults were started on the modified Atkins diet at Johns Hopkins Hospital, restricting carbohydrates initially to 15 grams per day and eating more fat. Weights, ketones, seizures, and laboratory studies were followed after 1, 3, and 6 months.

After 3 months, 47% of patients had a >50% seizure reduction, and after 6 months, 33% were similarly improved. Surprisingly, a drop in weight correlated at 3 months with efficacy, whereas urinary ketosis did not.

Cholesterol increased from 187 to 201 mg/dL, but otherwise the diet was well-tolerated, although somewhat restrictive. When the modified Atkins diet led to seizure reduction, it was relatively quick, usually within 2 weeks. These results suggest that the modified Atkins diet is a reasonable new option for adults typically not offered the traditional ketogenic diet.

When do seizures usually improve with the ketogenic diet?

PMID: 18028405 / Epilepsia. 2008 Feb;49(2):329-33.

In this article, children started on the ketogenic diet at both Johns Hopkins Hospital and Children's Memorial Hospital were reviewed to find out when (using seizure calendars) the first sign of improvement occurred (if it did occur). Both centers were surprised to find that when the diet works, it works very very quickly. Most children responded within 5 days, and 75% by 14 days. Contrary to prior thoughts about the ketogenic diet sometimes taking months to work, in this series, if it did not lead to seizure improvement by 2 months, it did not happen.

This important information both teaches neurologists that the restrictive ketogenic diet works quickly or not at all in most children, making months of dietary treatment unnecessary in those children without clinical signs of improvement. Interestingly, both centers found that fasting led to a quicker response than starting the diet without a fast, a mean of 9 days more quickly.

Reviewed by Steven C. Schachter: 02/29/08

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