Modified Atkins Diet (low carbohydrate) for Seizures

What is the Modified Atkins Diet for Seizures?

The Modified Atkins diet was established in 2003 at John Hopkins Hospital, Baltimore, as an attempt to create a more palatable less restrictive form of the Traditional Ketogenic (low carbohydrate) Diet. The first published trial was in 2006 showing over 50% of children on the diet have a greater than 50% reduction in seizures.  There has now been over 22 trials published showing similar results. 

How is the Modified Atkins Diet different from the Traditional Ketogenic Diet?

The Modified Atkins Diet is a lower ratio ketogenic diet that induces ketosis.  Generally it follows a 1:1 ratio  of fat: carbohydrate + protein however, there can be variations up to a ratio of 2:1,  The Traditional Ketogenic Diet is usually a 4:1 or 3:1 ratio.  There are no calorie or fluid restrictions, no weighing of food, no hospital admission or fasting period and education can be provided in an outpatient setting. The Modified Atkins Diet allows families more independence and the ability to share food at family meals. 

What is the difference between the Atkins Diet and Modified Atkins Diet for Seizures?

The diets are very similar. Both are low carbohydrate, high fat diets which can be used long term. Weight loss can occur on either diet and they both induce urinary ketosis.  However, the Modified Atkins differs in that high fat foods are strongly encouraged (rather than allowed), carbohydrate intake is more restrictive (around 10-15gm carbohydrate per day) and weight loss in not the primary goal.

What do I need to do before starting the diet?

It is ideal to see a neurologist prior to a visit to the Dietitan, so they can ensure there are no contraindications for beginning the diet.  Baseline blood work will need to be completed and food intake recorded for three days.  It can take a few days to get organised before starting the diet and it is recommended to read and surf the internet to get information, ideas and recipes.  Some helpful sites include: 

www.atkins.com

www.atkinsforseizures

www.epilepsy.com

www.hopkinsneuro.org/epilepsy

www.modifiedmom.wordpress.com

www.lowcarbnz.co.nz  

www.myketocal.com

How long do I stay on the diet?

As long as needed.  The diet is usually trialled for an initial 3 month period with results can be seen between 2 weeks and a few months depending on seizure frequency.  If the diet is effective people usually see results by having less frequent seizures or less severity of seizures.  If this is the case, people usually remain on the Modified Atkins Diet for up to two years.

Are there side effects of the Modified Atkins diet?

It is thought the side effects are less common than the Classic Ketogenic Diet as it is less restrictive.  Weight loss can occur which may be beneficial for some people.  Blood lipids may become elevated however; these are usually corrected when coming off the diet. Because there is a small risk of developing kidney stones, it is important to be under the supervision of a healthcare professional.

What are the keys to successful implementation of the diet?

It is ideal if the individual and the family are fully committed to the diet and where possible share the same foods at meal times.  It is important to be well organised, plan and prepare meals ahead of time.  Try new recipes and be creative with the menu.  It is a lifestyle change and takes time to adjust so keep positive and look at the big picture.  There are also some great resources and support groups available to help including:

www.matthewsfriends.org

www.charliefoundation.org

Who can help?

ABC Nutrition Dietitian, Anna Keeley (NZRD), specialises in the Modifed Atkins Dietary approach for managing seizues. Anna is based at the ABC clinic in Auckland. For those outside of the Auckland area, Anna is able to run Skype consultations.

"My daughter Samantha and I have been on a journey of discovery ever since she was diagnosed with epilepsy. The medication has only worked to a certain degree so that's when we started looking at alternative treatments. We met Anna Keeley at almost the very beginning of this journey when things weren't going so well for Sam with the side effects etc of the drugs. The neurologist, Samantha and I decided to try the Modified Atkins Diet. This has been the best thing that we could have done and has changed the way Samantha feels about everything. Anna has grown with us during this time with her new knowledge and ideas about how we proceed. Anna is helpful with ideas, she is kind and thoughtful when things get a bit rough. I would recommend Anna to anyone needing a dietician." Carol, mother of Samantha