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A recent study suggests that following a modified Atkins diet in conjunction with medication may help prevent seizures in hard-to-treat epilepsy. kolderal/Getty Images
  • Epilepsy is a common neurological condition, but some cases may be difficult to treat.
  • New research suggests that following a modified version of the Atkins diet in conjunction with medication may be an effective way to manage hard-to-treat epilepsy.
  • The modified Atkins diet is similar to the Ketogenic diet but with fewer restrictions, which some people living with epilepsy may find more appealing.

Epilepsy is a common neurological condition. It causes seizures, which are abnormal bursts of electricity in the brain.

Some people have drug-resistant epilepsy, where they do not respond to first-line treatment. This means that the first two medications prescribed do not adequately control the condition.

Now, researchers from the All India Institute of Medical Sciences in New Delhi have found that a combination of dietary changes used alongside standard drug therapy may be effective in reducing seizures.

According to their study, following a modified Atkins diet, a diet high in fat and low in carbohydrates, in addition to medication, may be an effective way to manage epilepsy.

The findings were recently published in Neurology, the medical journal of the American Academy of Neurology.

The use of fasting and other dietary regimens to manage epilepsy dates back to at least 500 BC.

The ketogenic diet (KD) was originally developed during the 1920s to mimic the effects of fasting for epilepsy treatment. The Atkins diet is a modified version of the original keto diet.

The keto diet has been shown to be effective in reducing seizures in some people. However, many people find it difficult to follow due to its strict requirements.

Acceptable foods on the keto diet include soy products, heavy cream, butter and oils, leafy green vegetables, and animal protein sources such as eggs, chicken, fatty fish, and bacon.

A modified Atkins diet is less restrictive. Key aspects of the modified version include:

  • Foods are not weighed and measured; there are no fluid or calorie restrictions, but carbohydrate counts are monitored.
  • Fats are strongly encouraged, but they are not weighed or measured. Most people will consume plenty of dairy and oils.
  • There are no restrictions on proteins. Typically 35% of calories for a person on the modified Atkins diet come from protein.

The study participants included both adults and teenagers with epilepsy who had been experiencing an average of 2 or more seizures per month, despite taking at least three different anti-seizure medications.

In total, 160 people were randomized to either continue taking their usual medications or to also follow the modified Atkins Diet.

The participants were asked to track the number of seizures they experienced and the food they ate.

They received information about what foods they could eat as well as meal plans and recipes. They were asked to limit the number of carbohydrates to 20 grams per day.

For comparison, federal dietary guidelines recommend eating between 225 and 325 grams of carbs per day.

After 6 months, the researchers found that 26% of people who followed the modified Atkins diet in addition to taking their usual medications had more than a 50% reduction in seizures compared to only 3% of the people who only took medications.

Four people (5%) in the group following the diet were completely free of seizures by the end of the study, while none in the medication-only group had this result.

The researchers also studied the quality of life, behavior, and side effects after 6 months.

They found that the group that followed the modified Atkins diet, in addition to taking their usual medications, had improvements in these areas compared to the group that only took medications.

Still, the researchers highlighted that 52 participants (33%) did not finish the study, either because they couldn’t tolerate the diet, they didn’t see any benefits, or they couldn’t continue the study due to the COVID-19 pandemic.

Researchers also noticed the modified Atkins diet seemed to be better tolerated than the keto diet.

Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center, not involved in this research, explained the key findings to Medical News Today:

“A ketogenic diet has been shown to decrease the frequency of seizures in epilepsy patients but is a restrictive diet. It is easier for parents to make kids, who cannot choose what they are eating, to follow a true ketogenic diet. The proposed ‘Modified Atkins Diet’ as being an adjuvant to medical therapy, as this diet is less restrictive, is attractive. The proposal that changing your diet can decrease your seizures is always attractive but often does not pan out in the real world where maintaining any diet can be hard to do.”

Dr. Segil noted that in countries where obtaining seizure medications easily can be difficult, the diet-medication combination may be more likely to be used in these places compared to the United States, where seizure medications are easily obtained.

“I would like to see this study repeated at a U.S. epilepsy center to see if the results are reproducible,” Dr. Segil highlighted.

“Asking patients to change their diet with the goal of having less seizures would be helpful in managing patients with intractable epilepsy.”

Dr. Siegel added that epilepsy patients who can maintain a ketogenic diet have been shown to decrease seizures in the past.

“A ketogenic diet is very hard to maintain while a modified Atkins diet is more doable and not as restrictive. While in a ketogenic state your brain processes ketones which are less epileptogenic than other substances,” Segil said.

Dr. Huma U. Sheikh, a board certified neurologist in New York City, also not involved in the study, told MNT that “this confirms previously supported data that a ketogenic diet can be helpful in treating epilepsy. The [previous] studies were done mostly in children but now this has been expanded to adults as well.”

“It will be important to outline the exact proportions of diet which consisted of fat versus other types of nutrients,” Dr. Sheikh explained.

“This will cause many physicians to seriously have their patients consider eating a lot more protein in their diets than carbs. This will give more credence to the ketogenic diet, but it is important to make sure that patients are aware of what is considered healthy fats and not eat things that could ultimately be detrimental to their health.”

– Dr. Huma U. Sheikh, board certified neurologist

When asked what the implications of this research are for patients, Dr. Segil said, “diet may effectively be used in addition to seizure medications to decrease the frequency a patient has seizures.”

“This paper does not say changing your diet will get rid of your seizures, but notes seizures may decrease in frequency if you watch what you eat while taking seizure medications,” he concluded.