Improving compliance in adults with epilepsy on a modified Atkins diet: A randomized trial
| Autor: | Eric H. Kossoff, Rebecca Fisher, Tanya J. W. McDonald, Joanne Barnett, Diane Vizthum, Erie G. Gutierrez, A. Jan, Mackenzie C. Cervenka, Elizabeth A. Felton, Mon Yi Lwin, Bobbie J. Henry-Barron |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Drug Resistant Epilepsy animal structures Time Factors food.diet medicine.medical_treatment law.invention 03 medical and health sciences Epilepsy 0302 clinical medicine food Randomized controlled trial law Seizures Urine ketones medicine Humans 030212 general & internal medicine Seizure frequency Atkins diet Cross-Over Studies business.industry Body Weight General Medicine Ketosis medicine.disease Treatment Outcome Neurology Patient Compliance Female Neurology (clinical) business Diet Ketogenic 030217 neurology & neurosurgery Treatment Arm Diet High-Protein Low-Carbohydrate Ketogenic diet Follow-Up Studies |
| Zdroj: | Seizure. 60 |
| ISSN: | 1532-2688 |
| Popis: | Purpose To determine whether use of a ketogenic formula during the first month of the modified Atkins diet (MAD) in adults with drug-resistant epilepsy (DRE) improves seizure reduction and compliance compared to MAD alone. Methods Eighty adults (age ≥18 years) with DRE and ≥4 reliably quantifiable seizures/month were enrolled. All participants were trained to follow a 20 g/day net carbohydrate limit MAD. Patients were randomized to receive one 8-ounce (237 mL) tetrapak of KetoCal®, a 4:1 ketogenic ratio formula, daily in combination with MAD during the first month (treatment arm) or second month (control/cross-over arm). Patients recorded urine ketones, weight, and seizure frequency and followed up at 1 and 2 months. Results By 1 month, 84% of patients achieved ketosis (median of 4–4.5 days). At 1 month, the treatment arm had a significantly higher ketogenic ratio and more patients with a ≥1:1 ketogenic ratio compared to the control arm. There was no difference in median seizure frequency, proportion of responders (≥50% seizure reduction), or median seizure reduction from baseline between groups. However, patients treated with KetoCal® during the first month were significantly more likely to continue MAD for 6 months or more. Conclusion Although supplementing MAD with a ketogenic formula in the first month did not increase the likelihood of reducing seizures compared to MAD alone, significantly more adults remained on MAD long-term with this approach. This suggests a potential strategy for encouraging compliance with MAD in adults with DRE. |
| Databáze: | OpenAIRE |
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