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

Tanya J.W. McDonald, Luisa Diaz-Arias, Diane Vizthum, Bobbie J. Henry-Barron, Haley Schlechter, Eric H. Kossoff, Mackenzie C. Cervenka

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalNutritional Neuroscience
DOIs
StateAccepted/In press - 2021

Keywords

  • Epilepsy
  • ketogenic
  • lipids
  • low-density-lipoprotein
  • modified Atkins diet

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Neuroscience(all)
  • Nutrition and Dietetics

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