Atkins diet may reduce seizures in children with epilepsy

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Contact: Jessica Collins

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Johns Hopkins Medical Institutions

Atkins diet may reduce seizures in children with epilepsy

Along with helping some people shed unwanted pounds, the popular
low-carbohydrate, high-fat Atkins diet may also have a role in
preventing seizures in children with epilepsy, say researchers at the
Johns Hopkins Children's Center.

In a limited study of six patients, including three patients 12 years
old and younger on the Atkins regimen for at least four months, two
children and one young adult were seizure-free and were able to reduce
use of anti-convulsant medications. Findings of the study, scheduled
for presentation today at the American Epilepsy Society Meeting in
Boston, also showed that seizure control could be long-lasting on the
diet, with the three patients continuing to be seizure-free for as
long as 20 months.

The researchers caution that because of the small number of study
subjects, their look at the relationship between the Atkins diet and
seizure control should not lead to its routine use in children with
epilepsy, nor at this point should the Atkins diet be used to replace
the ketogenic diet the rigorous high-fat, low-carbohydrate diet
already proven to reduce or eliminate difficult-to-control seizures in
some patients.

The common elements in both diets are high fat and low carbohydrate
foods that alter the body's glucose chemistry. The ketogenic diet
mimics some of the effects of starvation, in which the body first uses
up glucose and glycogen before burning stored body fat. In the absence
of glucose, the body produces ketones, a chemical byproduct of fat
that can inhibit seizures. Children who remain seizure-free for two
years on the ketogenic diet often can resume normal eating and often
their seizures don't return. The Atkins diet, while slightly less
restrictive than the ketogenic diet, also produces ketones.

"We just don't know yet how effective the Atkins diet is in reducing
seizures or if it comes close to the benefits of the ketogenic diet,
but our report raises new questions about the ideal level of calorie
and protein restriction imposed by the ketogenic diet," said the
study's lead author, Eric Kossoff, M.D., a pediatric neurologist at
the Children's Center.

"By learning more about how the Atkins diet works to control seizures,
we should learn more about which patients may benefit best from either
or both of these diets," he added. "It may be, for example, that some
of those who can't tolerate the restrictiveness of the ketogenic diet
could be helped with Atkins."

In the short term, Kossoff says it's possible the Atkins diet could be
used in selected patients as a "trial run" for individuals considering
the ketogenic diet in the future. "Success on the Atkins diet may be a
good indication of patient compliance and efficacy of the ketogenic
diet," he adds. "Because the Atkins diet is easy to read and versions
of it are available in paperback at bookstores, families can easily
follow this kind of a strict, low-carbohydrate diet on their own for
several weeks to determine if this is something they can adhere to."

Also, because the Atkins diet was originally designed for weight loss,
Kossoff says it is possible patients following the diet to reduce
seizures may lose weight in the process. If that does occur, and a
patient's weight has reached unhealthy levels, the patient should be
instructed to increase calorie intake by eating more fats and
proteins.

In the Hopkins study, patients began with 10 grams of carbohydrates
per day, more than the typical amount provided on the ketogenic diet,
but fewer than used in the induction phase of the Atkins diet (20
grams/day). Carbohydrate intake was gradually increased for some
patients. Five out of the six patients attained ketosis (the state of
producing ketones) within days of starting the Atkins diet and
maintained moderate to large levels of ketosis for periods of six
weeks to 24 months.

Kossoff says that Hopkins researchers will further examine the role
the Atkins diet plays in the management of epilepsy in a larger
clinical study of 20 children with epilepsy, which began in September
2003 and already has enrolled several patients.

Co-authors of the current study were Gregory L. Krauss, Jane R.
McGrogan, and John M. Freeman of the Department of Neurology at the
Johns Hopkins Hospital.


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