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MINNEAPOLIS — Following a low-carb, high-fat modified Atkins diet alongside medication may reduce seizures in those with difficult-to-treat cases of epilepsy.

“For people with drug-resistant epilepsy, or those who have been unable to find effective treatment to reduce seizures, it’s encouraging to see that there are lifestyle changes that can be combined with standard drug therapy to reduce the number of seizures,” says study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in a media release. “Our study found that this combination may reduce the chance of seizures by more than half.”

The modified Atkins diet combines components of both the full Atkins diet and a ketogenic diet. It includes plant protein like soy products, fats like heavy cream, butter, and oils, leafy green vegetables, and animal protein like eggs, chicken, and fish. Currently, there’s evidence pointing to the ketogenic diet as an effective nutritional therapy for seizures. However, since the diet can be restrictive, it becomes difficult to follow long-term.

The researchers recruited 160 adults and adolescents who had epilepsy for over 10 years on average and had at least 27 seizures per month despite trying an average of four anti-seizure medications at the maximum dose. Researchers randomly assigned them to receive either drug therapy alone or in addition to a modified Atkins diet.

Over six months, the participants logged their seizures and meals, and were provided with food lists, sample menus, and recipes to support them. Their carbohydrate intake was limited to 20 grams per day. This is a significant difference compared to federal dietary guidelines that recommend between 225 and 325 grams per day for the average adult.

The right diet and medication could cure seizures completely

After six months, the team found that 26 percent of people on the diet had over a 50-percent reduction in seizures compared to just three percent of the people who only took medication. In fact, four people in the diet group were free of seizures entirely by the end of the study. No one in the control group could say the same.

The modified Atkins diet is less restrictive than the ketogenic diet, but it can still be difficult for someone who normally doesn’t eat this way to follow. Thus, the team also examined each participant’s quality of life, behavior, and side-effects at the six-month mark. The diet group showed an improvement in all of these areas. However, Tripathi notes that one-third didn’t finish the study due to either poor diet tolerance, absence of benefit, or difficulty with follow-up due to COVID-19. Despite this, she still emphasizes that tolerance of the modified Atkins diet is still better than the ketogenic diet overall.

Tripathi believes that while these findings provide a good starting place for interventions, more detailed work is necessary to get a better picture.

“While the modified Atkins diet may be an effective treatment in controlling seizures, further research is needed to identify genetic biomarkers and other factors associated with the response to this diet,” the researcher concludes. “This may improve patient care by encouraging targeted precision based earlier use of this diet.”

The findings are published in the journal Neurology.

About Shyla Cadogan, RD

Shyla Cadogan is a DMV-Based acute care Registered Dietitian. She holds specialized interests in integrative nutrition and communicating nutrition concepts in a nuanced, approachable way.

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