Along with helping some people shed unwanted pounds,
the popular low-carbohydrate, high-fat Atkins diet also may
have a role in preventing seizures in children with
epilepsy, say researchers at the
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 anticonvulsant
medications. Findings of the study, presented Dec. 9 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, 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
said. "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 said, 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 said. "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 designed originally
for weight loss, Kossoff said it is possible that 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, he said.
In the Johns 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, which is 20
grams a day. Carbohydrate intake was gradually increased
for some patients. Five 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 said 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.