Is Modified Atkins Diet Therapy Applicable for Adults with Intractable Epilepsy Patients? - A Short Trial in Adult Volunteers

Background: The Atkins diet modified for epilepsy patients (modified Atkins diet: MAD) was reported to be a substitute for the classical ketogenic diet. Recently, it has been shown that this diet is effective not only for intractable childhood epilepsy but also for intractable adulthood epilepsy and Glut 1 deficiency syndrome. In Japan, this diet is difficult to promote, because the menu and the taste are not suitable for Japanese and side effects of this unbalanced diet remain unclear.Methods: To promote this therapy in Japan, the recipes of MAD were modified to adapt to the Japanese population, and evaluated in 10 healthy adult volunteers for 1 week. Subjects' evaluation for taste and hunger, as well as urinary and blood laboratory examinations were analyzed.Results: All volunteers evaluated the diet menu as sufficiently palatable, and continued the diet without difficulty for 1 week. However, they felt uneasy with the fatty menu and complained of constipation that was within tolerable levels. As for urinary ketone bodies measured by ketostick, four and six volunteers were 2 to 4+ and 1 to 2+, respectively at the end of the trial. Side effects including variable degrees of weight loss, hypoglycemia, hypercholesterolemia, and hyperuricemia were observed in all subjects.Conclusion: MAD can be used more comfortably as a substitute for the classical ketogenic diet, if the recipes are adapted for Japanese population. The diet would result in a sufficient level of ketosis since our adult volunteers developed mild to moderate ketosis despite only one-week trial without starvation. The long-term side effects should be carefully monitored because even the short-term trial results in some metabolic changes.