Macro partitioning
The modified Atkins diet (carbohydrate restriction to 15g/day with ad libitum fat/protein/calories) produces significant seizure reduction in adults with intractable epilepsy, with efficacy correlating with weight loss.
For adults with drug-resistant epilepsy, a modified Atkins diet (15g carbs/day, unlimited fat/protein) can significantly reduce seizures, especially if weight loss occurs. It is less restrictive than traditional ketogenic diets, potentially improving adherence, though about one-third of patients discontinue due to perceived restrictiveness. A 2-month trial is suggested to assess efficacy.
Using an intent-to-treat analysis, 47% had a >50% seizure reduction after 1 and 3 months on the diet; 33% after 6 months... Body-mass index (BMI) decrease correlated with efficacy at 3 months, p = 0.03.
Why this rating
Prospective, open-label study with a small sample size (n=30) and no control group, limiting generalizability and causal inference compared to RCTs.
Source
A Prospective Study of the Modified Atkins Diet for Intractable Epilepsy in Adults
Eric H. Kossoff et al. · Epilepsia · 2007
DOI 10.1111/j.1528-1167.2007.01256.x
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