Efficacy and tolerability of the modified Atkins diet in young children with refractory epilepsy: Indian experience

Mehta, Ranju Kumari; Goel, Shaiphali; Sharma, Suvasini; Jain, Puneet; Mukherjee, Sharmila Banerjee; Aneja, Satinder

doi:10.4103/0972-2327.194463

Cited by 18 publications

(3 citation statements)

References 8 publications

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“…The most common research type was retrospective cohort study (39.4%, n = 126), 69–194 followed by prospective cohort study (21.9%, n = 70) 195–264 . The remaining quantitative study designs included case series (10.7%, n = 34),…”

Section: Resultsmentioning

confidence: 99%

The use of ketogenic diets in children living with drug‐resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review

Cameron,

Allan,

Kay Cooper

2024

J Human Nutrition Diet

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BackgroundThe ketogenic diet (KD) is a high fat, moderate protein and very low carbohydrate diet. It can be used as a medical treatment for drug‐resistant epilepsy (DRE), glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency. The aim of this scoping review was to map the KD literature, with a focus on epilepsy and associated metabolic conditions, to summarise the current evidence‐base and identify any gaps.MethodsThis review was conducted using JBI scoping review methodological guidance and the PRISMA extension for scoping reviews reporting guidance. A comprehensive literature search was conducted in September 2021 and updated in February 2024 using MEDLINE, CINAHL, AMED, EmBASE, CAB Abstracts, Scopus and Food Science Source databases.ResultsThe initial search yielded 2721 studies and ultimately, data were extracted from 320 studies that fulfilled inclusion criteria for the review. There were five qualitative studies, and the remainder were quantitative, including 23 randomised controlled trials (RCTs) and seven quasi‐experimental studies. The USA published the highest number of KD studies followed by China, South Korea and the UK. Most studies focused on the classical KD and DRE. The studies key findings suggest that the KD is efficacious, safe and tolerable.ConclusionsThere are opportunities available to expand the scope of future KD research, particularly to conduct high‐quality RCTs and further qualitative research focused on the child's needs and family support to improve the effectiveness of KDs.

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Section: Resultsmentioning

confidence: 99%

The use of ketogenic diets in children living with drug‐resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review

Cameron,

Allan,

Kay Cooper

2024

J Human Nutrition Diet

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“…Constipation and vomiting were the most common adverse events, followed by weight loss, anorexia, and lethargy. Only one child experienced severe metabolic acidosis and terminated the diet 36 . MAD, as an adjuvant treatment in refractory infantile spasms, also produced much the same side effects, such as constipation, lethargy, recurrent chest infections, and weight loss 37 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of modified Atkins diet therapy for drug‐resistant epilepsy in children and adults: A systematic review and meta‐analysis

Budiputra,

Budiputri,

Elsa

2023

Neurology & Clinical Neurosc

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IntroductionDiet‐based treatments have been proposed for drug‐resistant epilepsy (DRE), and the Modified Atkins Diet (MAD) is an alternative. This study aimed to assess the efficacy and safety of MAD as an adjunctive therapy for reducing seizures in patients with drug‐resistant epilepsy.MethodsA literature search was done on six databases. Randomized controlled trial (RCT) studies were included, comparing DRE patients of all ages on standard antiseizure medications (ASD) who received MAD compared to no‐dietary or other dietary interventions. The outcomes are the seizure frequency reduction and the adverse events. Cochrane risk‐of‐bias tool and GRADE were used to assess study quality and the overall certainty of evidence. The effect size of the efficacy of MAD was computed as risk ratio (95% CI). Subgroup analysis based on each type of comparator was done.ResultsTen RCT studies (905 participants) were included, comparing MAD to no dietary intervention, ketogenic diet (KD), and low glycemic index treatment (LGIT). Overall, MAD is constantly and significantly more efficacious than no dietary intervention in reducing seizures ≥50% (RR 7.90, 95% CI 4.59–13.62), ≥90% (RR 4.61, 95% CI 2.05–10.36), and inducing complete seizure‐free (RR 7.79, 95% 2.61–23.22) with high certainty. Other dietary therapies and MAD did not differ significantly from one another in terms of efficacy. The risk of adverse events in MAD is insignificantly higher than in others (RR 1.19, 95% 0.92–1.55).ConclusionThe Modified Atkins Diet has better seizure reduction than no diet intervention but is comparable to other dietary interventions with a negligible increased risk of adverse events.

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“…In the West, the MAD has been used predominantly in adolescents and adults. However, it has been found useful even in infants and young children and is a more feasible option than KD in these populations in low resource settings 25,26…”

Section: Types Of Kd In Current Practicementioning

confidence: 99%

<p>Current Perspectives On The Role Of The Ketogenic Diet In Epilepsy Management</p>

Goswami¹,

Sharma²

2019

NDT

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Drug-refractory epilepsy is a commonly prevalent pediatric neurological illness of global significance. Ketogenic diet (KD) is a time-tested therapeutic modality for refractory epilepsy, which has reemerged as a robust alternative to anti-epileptic pharmacotherapy. There is a growing body of evidence which supports the anti-seizure efficacy, safety profile and feasibility of KD use in childhood epilepsy. In addition, this modality has been recognized to reduce anti-epileptic exposure, improve cognition and behavioral profile of patients as well as improve the quality-of-life of care-givers. Current indications of KD include refractory epilepsy syndromes, selected metabolic disorders (such as pyruvate dehydrogenase deficiency) and a host of varied neurological entities. KD research has broadened the knowledge-base about its mechanisms of action. Four types of KD are in vogue currently with varying nutritional constitution, palatability, administration protocols and comparable efficacy. KD initiation and maintenance are the result of concerted effort of a team of pediatric neurologist/epileptologist, nutritionist and patient’s primary care-giver. Consensus is being formulated about various practical aspects of KD such as patient-selection, parental counseling, baseline work-up, dietary prescription, nutritional supplementation, concurrent anti-epileptic drug administration, follow-up and treatment-duration. Novel applications of KD include its use in neonatal epilepsy and super-refractory status epilepticus and tailor-made formulations such as cooking oil-based KD in predominantly rice-fed populations. Increasing body of clinical experience, improved nutritional designs and translational research are promoting KD as a major therapeutic modality. Currently, KD forms a core essence in the armamentarium against refractory epilepsy. In this review, we summarize the recent advances and current perspectives in the use of KD in refractory epilepsy.

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Efficacy and tolerability of the modified Atkins diet in young children with refractory epilepsy: Indian experience

Cited by 18 publications

References 8 publications

The use of ketogenic diets in children living with drug‐resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review

The use of ketogenic diets in children living with drug‐resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review

Efficacy and safety of modified Atkins diet therapy for drug‐resistant epilepsy in children and adults: A systematic review and meta‐analysis

<p>Current Perspectives On The Role Of The Ketogenic Diet In Epilepsy Management</p>

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