Is modified atkins diet therapy applicable for adults with intractable epilepsy patients? - a short trial in adult volunteers

Abstract

Background: The Atkins diet modified for epilepsy patients (modified Atkins diet: MAD) was reported to be a substitute for the classical ketogenic diet. Recently, it has been shown that this diet is effective not only for intractable childhood epilepsy but also for intractable adulthood epilepsy and Glut 1 deficiency syndrome. In Japan, this diet is difficult to promote, because the menu and the taste are not suitable for Japanese and side effects of this unbalanced diet remain unclear. Methods: To promote this therapy in Japan, the recipes of MAD were modified to adapt to the Japanese population, and evaluated in 10 healthy adult volunteers for 1 week. Subjects' evaluation for taste and hunger, as well as uri-nary and blood laboratory examinations were analyzed. Results: All volunteers evaluated the diet menu as sufficiently palatable, and continued the diet without difficulty for 1 week. However, they felt uneasy with the fatty menu and complained of constipation that was within tolerable levels. As for urinary ketone bodies measured by ketostick, four and six volunteers were 2 to 4+ and 1 to 2+, respectively at the end of the trial. Side effects including variable degrees of weight loss, hypoglycemia, hypercholesterolemia, and hyperuricemia were observed in all subjects. Conclusion: MAD can be used more comfortably as a substitute for the classical ketogenic diet, if the recipes are adapted for Japanese population. The diet would result in a sufficient level of ketosis since our adult volunteers developed mild to moderate ketosis despite only one-week trial without starvation. The long-term side effects should be carefully monitored because even the short-term trial results in some metabolic changes.