- Researchers say a modified Atkins diet along with medication may help reduce seizures in people with epilepsy that is difficult to treat.
- They report that study participants who were on the high-fat, low-carbohydrate diet along with medication had a significant reduction in seizures compared to participants who used drug therapy alone.
- Experts say more study is needed, but these findings may help guide medical professionals in recommending therapies for epilepsy.
Medication, electrical implants, and brain surgery are among the interventions that can limit dangerous and sometimes deadly epileptic seizures.
However, experts say there is a fourth method that is both non-invasive and free of side effects: diet.
A high-fat, low-carbohydrate ketogenic diet has been used since the 1920s to control epileptic seizures, notably among children. Ketones, formed when the body uses fat for energy, are believed to act as an anti-seizure agent in the brain.
“When the brain is forced to run off of these secondary energy sources in the absence of large amounts of carbohydrates, there is something in that change in metabolism that improves control over epilepsy,” Dr. Tyler Allison, a neurologist at Children’s Mercy Kansas City and a fellow of the American Academy of Neurology, told Healthline.
Now, researchers are saying that a ketogenic diet can also reduce seizures among adults with drug-resistant epilepsy and those who have not responded to other types of anti-seizure interventions.
In a new study published in the journal Neurology, the researchers report that a modified version of the high-fat, low-carb Atkins diet, combined with medication, appears particularly effective in reducing seizures among adults and adolescents.
The study involved 160 adults and adolescents who had epilepsy for more than 10 years on average and had an average of 27 seizures per month. These individuals had tried an average of four anti-seizure medications at the maximum tolerated dose without success.
Researchers led by Dr. Manjari Tripathi of the All India Institute of Medical Sciences in New Delhi report that 26% of study participants who had both drug therapy and followed the modified Atkins diet had more than a 50% reduction in seizures after six months, compared to less than 3% of the participants who had drug therapy alone.
Quality of life, behavior, and side effects measures also improved among the study group that received both the diet and medication, the study authors wrote.
“It’s encouraging to see that there are lifestyle changes that can be combined with standard drug therapy to reduce the number of seizures,” said Tripathi in a press statement. “Our study found that this combination may reduce the chance of seizures by more than half.”
The diet used in the study combines the Atkins diet and a ketogenic diet that includes food items such as soy products, heavy cream, butter, oils, leafy green vegetables, and animal protein such as eggs, chicken, fish, and bacon.
Participants were limited to 20 grams of carbohydrates daily, compared to U.S. federal dietary guidelines that recommend between 225 and 325 grams of carbs daily in a 2,000 calorie diet.
“The modified Atkins diet is less restrictive than the traditional ketogenic diet and may be easier to follow,” Trista Best, a registered dietitian at Balance One Supplements, told Healthline.
“The modified Atkins diet involves restricting carbohydrate intake to about 10 to 20 grams per day and increasing intake of protein and fat,” she added. “The diet may be easier to follow than the traditional ketogenic diet because it does not require strict calorie or protein intake limits and does not involve frequent monitoring of ketone levels.”
Allison said the findings “may point in the direction that the amount of carbohydrates allowed could be further adjusted to allow for more ease with following the diet over the long-term, as strict control over carbohydrates can be very difficult for patients, especially children.”
“I’m not sure the data that exists for the modified Atkins diet’s degree of seizure control is significant enough at this time that I would recommend it over the stricter ketogenic diet, but further studies would help the flesh this out more,” added Allison.
“[A] 50 percent reduction is similar to what we see with the traditional ketogenic diet that requires tighter carbohydrate control and more medical management,” said Allison.
Tripathi said follow-up studies are needed to identify genetic biomarkers and other factors associated with the response to the modified Atkins diet.
“This may improve patient care by encouraging targeted precision based earlier use of this diet,” she said.
Allison noted that increasing the amount of fat in the diet to the degree needed for both the ketogenic diet and the modified Atkins diet leads to the body being more acidic.
“Higher acidity can lead to other medical problems with bones and organs of the body, so it’s important to follow up with a healthcare provider knowledgeable about the diet to make sure that your body tolerates it,” he said.
An estimated one-third of adults with epilepsy have seizures that cannot be stopped with medication. The new study builds upon a literature review
The earlier study by researchers at the Mid-Atlantic Epilepsy and Sleep Center also found that 9% in the ketogenic treatment group and 5% in the modified Atkins group had a greater than 90% reduction in seizures.