Six-month effects of modified Atkins diet implementation on indices of cardiovascular disease risk in adults with epilepsy.

Autor: McDonald TJW; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Diaz-Arias L; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Vizthum D; Institute for Clinical and Translational Research, Johns Hopkins University, Baltimore, MD, USA., Henry-Barron BJ; Institute for Clinical and Translational Research, Johns Hopkins University, Baltimore, MD, USA., Schlechter H; Institute for Clinical and Translational Research, Johns Hopkins University, Baltimore, MD, USA., Kossoff EH; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Cervenka MC; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Nutritional neuroscience [Nutr Neurosci] 2022 Jul; Vol. 25 (7), pp. 1548-1557. Date of Electronic Publication: 2021 Jan 23.
DOI: 10.1080/1028415X.2021.1875301
Abstrakt: Background/aims: Ketogenic diet therapies (KDTs) offer a needed therapeutic option for patients with drug-resistant epilepsy. The current study investigated biochemical and anthropometric indices of cardiovascular disease (CVD) risk in adults with epilepsy treated with KDT over 6 months.
Method: 65 adults with epilepsy naïve to diet therapy were enrolled in a prospective longitudinal study and instructed on modified Atkins diet (MAD) use. Seizure frequency, anthropometric measures, blood levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 and B, and lipoprotein sub-fractions were assessed at baseline, 3 months, and 6 months.
Results: Subsequent to study enrollment, 34 participants were lost to follow-up, elected not to start, or stopped MAD prior to study completion, leaving a total of 31 participants in the study at 6 months. Compared to baseline, participants on MAD showed significant reductions in median seizure frequency/week, weight, body mass index, waist and hip circumference, and percent body fat at 3 and 6 months. Compared to baseline, participants on MAD for 3 months showed significantly increased levels of total, small and medium LDL particles, ApoB and ApoB/A1 ratio. At 6 months, only small LDL particles and ApoB levels remained elevated and levels of ApoA1 had risen, suggesting possible compensatory adaptation over time.
Conclusions: This study provides evidence demonstrating the efficacy and cardiovascular safety of 6 months of MAD use by adults with epilepsy. It also highlights an index of CVD risk - small LDL particles - that should be closely monitored. Trial registration: ClinicalTrials.gov identifier: NCT02694094..
Databáze: MEDLINE
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