Managing Epilepsy: Modified Atkins diet

Modified Atkins diet is much in news these days as a method to treat not only epilepsy but also a host of other health issues.

Managing Epilepsy: Modified Atkins diet

So, what exactly is modified Atkins diet and how does it vary from the other types of diet plans?

It is essentially a change in the traditional form of ketogenic diet. It was noticed that some of the families who had been using ketogenic diet for a long time had after a few years of its use, stopped measuring and weighing food items. Their ketones levels were still high while the seizures remained under control.

Effects of modified Atkins diet were initially studied amongst those who had not tried the ketogenic diet plan. The studies were carried out at Johns Hopkins Hospital in 2002 and the first paper on the effect of this diet was thereafter published during 2003. A bigger study was carried out subsequently with 20 children and result published during December 2005. The modified Atkins diet is now 10 years old.

How is modified Atkins diet different?

Although the type of food in both modified Atkins diet as well as Ketogenic diet is similar, there are major key differences between the two.

Atkins diet – no calorie or fluid restrictions.

  • No restrictions on proteins.
  • Fats are encouraged.
  • Foods are neither weighed nor measured, but the carbohydrate count is monitored.
  • Possible to do it from home (no need to be at the hospital).
  • “Modified” Atkins diet allows fewer carbohydrates as compared to the traditional Atkins diet and higher fat intake.

Who does modified Atkins diet help?

 Modified Atkins diet seems to help almost similar numbers as the ketogenic diet (i.e. 50% patients with greater than 50% reduction in seizure, including the 15% seizure-free individuals). As in the case of ketogenic diet, it is used for those patients who get daily seizures and are not responsive to medication.

What is modified Atkins diet like?

  • It has Lots of foods with high fat content such as mayonnaise, bacon, eggs, butter, heavy whipping cream, hamburger, etc.
  • Certain amount of fruits, nuts, vegetables, cheeses, and avocados are used.
  • Fruit2O and other type of flavored waters.
  • Patients eat more amount of food and as the total carbohydrates remain below the figure prescribed by their neurologist the patient can have breads and cakes too!

How does one go about it?

  • Talk with the dietitian and neurologist about starting the modified Atkins diet.
  • Once you are advised, tests are carried out.
  • Amount of Carbohydrates intake is limited.
  • Medications are often left unchanged (i.e. it continues with the modified Atkins diet).

Does it really work?

Studies so far have indicated that yes, they do. Almost half of those on this diet had a 50% reduction in seizures within first 6 months. There were many whose reduce medications had come down.

What about the side effects?

  • The biggest side effect is that patients lose weight which is actually a good thing in most cases.
  • It led to increases in cholesterol in some children.
  • Sometimes, the change in diet and the effect on resultant ketosis makes some children feel sick and kills the desire to drink water.
  • It is for these reasons; it is always recommended that the modified Atkins diet be done under a physician’s supervision.

Importance of monitoring the patient.

It is important that a dietitian keeps track of changes in the patient periodically; a dietitian involvement is a must right from the beginning. As per Dr. Kossoff, urine and blood samples should be monitored every three months. Also, checking of ketones should be done once a week.

When can the diet be stopped?

After a child has been seizure-free for 2 years or so, this diet can be stopped after advice of the doctor. Also, it can be stopped if it’s not found helpful.

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