The Atkins Diet: Possible Treatment for Epilepsy

February 5, 2004—The Atkins diet may be effective for controlling seizures in children, according to a preliminary study in Neurology (2003;61:1789–91).

Dr. Robert Atkins first introduced the Atkins diet in the 1960s, and then again in the 1990s, when its promise of promoting weight loss while still allowing consumption of large amounts of fat became popular. Most calories consumed on the Atkins diet come from fat and protein, while carbohydrate intake is severely restricted. The breakdown of fats in the relative absence of carbohydrates leads to the formation of substances called ketones, which suppress the appetite and cause fat to leave sites of storage in the body.

A stricter version of the Atkins diet, called the ketogenic diet, has been used for almost 80 years to treat people with epilepsy. The ketogenic diet further limits protein and carbohydrate intake, with most of the calories being derived from fat. It also restricts calories to 75% of the recommended daily allowance. Under normal circumstances, the body mostly uses carbohydrates for fuel. The shift from burning carbohydrates to burning fats for energy greatly increases the production of ketones. It is not known exactly how the production of ketones aids in seizure control, but the results achieved using the ketogenic diet are comparable to those seen with drug therapy: one third of children experience complete cessation of seizures, one third have a decrease in seizure activity, and another third do not respond to treatment with the diet. Adults generally do not respond as well as children to the ketogenic diet, as it is harder for them to achieve high levels of ketones in the body.

Because the ketogenic diet is very strict and requires careful medical supervision, it is not always a feasible option for all individuals with seizure disorders.

The current study evaluated the efficacy of the Atkins diet for treatment of epilepsy in people whose seizures were not controlled with medications. Six people, ranging in age from 7 to 52 years, participated in the study. Ketones in the urine were measured as an indicator of response to the diet and expected seizure control. Two children, ages seven and ten years old, had no seizures while on the Atkins diet for five and four months, respectively. Another (18 years old) had a significant (90%) reduction in seizure activity while on the diet for 20 months. These three participants all remain on the diet. One other participant (12 years old) had a 20% reduction in seizure activity, but was unable to remain on the diet longer than 45 days because it was too restrictive. The diet was ineffective for two participants, 42 and 52 years of age, who remained on the diet for three and eight months, respectively. As is the case with the ketogenic diet, the Atkins diet appears to be more beneficial for younger patients.

While the results of this small study are promising, the authors do not advocate the use of the Atkins diet in place of the ketogenic diet until larger studies can confirm the benefit. The study does, however, present interesting questions regarding the current use of the ketogenic diet for epilepsy. Half of the participants in the current study responded favorably to the Atkins diet. This may indicate that the ketogenic diet need not be as restrictive as it is in protein and calories to achieve seizure control.

The Atkins diet may be a useful therapy in the interim period before people can be seen at an epilepsy center to be started on the ketogenic diet or if they are not able to travel to an epilepsy center at all. Medical supervision is recommended to ensure patient safety and to monitor for seizure control. If a good response is achieved on the Atkins diet, the ketogenic diet may not need to be initiated.

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Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Beauchamp is a co-founder and practicing physician at South County Naturopaths, Inc. in Wakefield, RI. Her emphasis is on women’s health, pediatrics, and detoxification.

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