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Further research into use of Atkins-type diet to treat children's epilepsy

15 December, 2005

New research, complementing earlier studies, suggests that a modified version of the Atkins diet is nearly as effective at controlling seizures in children with epilepsy as the ketogenic diet.

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 new research was led by Dr Eric Kossoff, from Johns Hopkins Children's Center
and examined 20 children (ages three to 18) who were having between
four and 470 seizures a week and whose epilepsy was unresponsive to
drug therapy.

The
children were put on a diet that included fewer carbohydrates than the
standard Atkins diet for six months. Of the 16 who completed the study,
13 had a greater than 50 per cent improvement in seizures, seven had a
greater than 90 per cent improvement and four were seizure-free. A
third of patients did not benefit from the diet. Side effects overall
were low, with one child developing a complication that did not warrant
stopping the diet, despite a brief hospitalisation. The majority of
children gained weight in the study.

While
the ketogenic diet has proven effective in controlling paediatric
epilepsy since its introduction in the 1920s, the researchers
highlighted several drawbacks and side effects. The highly restrictive
diet requires accurate measurement of all foods and liquids to ensure
consumption of the proper ratio of fats, carbohydrates and protein. The
diet starts with a brief fast and hospital stay during which time
families are trained in the rigours of the diet. Side effects can
include kidney stones, constipation and slowed growth.

The
modified Atkins diet, the researchers say, has 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
diet, researchers concluded.

Dr Kossoff commented:

"Our
findings suggest relatively good efficacy compared to the ketogenic
diet. 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
key here is ketosis - the production of ketones - which both diets
create. This study suggests that for some children, we need not be so
restrictive in allowing protein, weighing foods and counting calories.
That should make it a little easier for parents and children to do."

Dr
Kossoff warned that parents should not try any diet for epilepsy
without supervision and careful medical management by a specialised
health care team. He and his colleagues also warn that the newly tested
diet should be seen only as a first step in acquainting families with
the rigours of the ketogenic diet. It may also be an option for
adolescents and adults, not typically offered the ketogenic diet.