Ketogenic dietary therapies in adults with epilepsy: a practical guide

Effect of modified Atkins diet in adults with drug‐resistant focal epilepsy: A randomized clinical trial

“…Nevertheless, we believe that patients with a disabling seizure situation who are highly motivated should be given the opportunity to attempt dietary treatment. At present it is not possible to predict who will benefit from this treatment …”

Diet and Headache: Part 2

“…Very low carbohydrate diets or a ketogenic diet (KD) typically restrict the amount of carbohydrates to < 20 g per day . The ratios of fat to the combined amounts of protein and carbohydrate range from 2:1 to 4:1 in most KDs . After several days of a very low carbohydrate diet, the reserves of glycogen are depleted and ketone bodies are produced to maintain energy production within the mitochondria.…”

“…A more relaxed form of a KD has been termed a “modified Atkins” diet. Such diets restrict carbohydrates to a lesser degree than the ketogenic diets and some allow carbohydrates with a low glycemic index . There has only been one case series of a modified Atkins diet in the treatment of migraine .…”

The Expanding Role of Ketogenic Diets in Adult Neurological Disorders

“…The most commonly reported adverse effects associated with KD use in adults with epilepsy and long-term diet use in children with epilepsy are gastrointestinal effects, weight loss and a transient increase in lipids [120,121]. Similar side effects have been reported in clinical studies of KD use in malignant glioma and AD, although a true assessment of risk in these populations is difficult due to the small number of trials, short duration of follow up and heterogeneity in KD therapy applied [70,122].…”

“…Common methodologies to assess and document KD adherence in adults beyond patient self-report include frequent measurements of serum β-hydroxybutyrate or urine acetoacetate concentrations during the first few weeks on the diet and/or collection of dietary food records [57,121,128]. As examples, daily urine ketone assessments are traditionally used in adults with epilepsy during MAD initiation until moderate to large levels of ketosis are reached and serum ketone assessments using drops of blood from a finger stick have been used to guide short-term KD therapy in patients with GBM [53,128].…”