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Eric H Kossoff - One of the best experts on this subject based on the ideXlab platform.
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The modified Atkins Diet in children with Prader-Willi syndrome
Orphanet journal of rare diseases, 2020Co-Authors: Grace Felix, Eric H Kossoff, Bobbie Barron, Caitlin Krekel, Elizabeth Getzoff Testa, Ann O. ScheimannAbstract:Prader-Willi Syndrome (PWS) is the most common genetic cause of obesity. Various Dietary strategies have been used for weight management for people with PWS. This was a clinical feasibility study to test the use of the Modified Atkins Diet (low carbohydrate and high fat) for children with PWS ages 6–12 years who were overweight/obese. Participants went on the Modified Atkins Diet for 4 months and then returned to have anthropometry repeated including repeat labs and behavior questionnaires. Seven children (ages 6–12) were enrolled in the study. Four participants completed the 4-month Diet trial; two were unable to comply with the Diet and stopped prematurely. One patient lost 2.9 kg; the others maintained their weight. Adverse effects were increases in LDL (expected based on larger studies) and hypercalciuria (with no renal stones) for one patient. Positive effects on hyperphagia and behavior were noted subjectively by families. The Modified Atkins Diet can be a feasible low carbohydrate option for children with Prader-Willi Syndrome for weight management. Long-term use of the Diet in patients with Prader-Willi Syndrome needs to be studied further.
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Improving compliance in adults with epilepsy on a modified Atkins Diet: A randomized trial
Seizure, 2018Co-Authors: Tanya J.w. Mcdonald, Bobbie J. Henry-barron, Elizabeth A. Felton, Erie G. Gutierrez, Joanne Barnett, Rebecca Fisher, Mon Yi Lwin, A. Jan, Diane Vizthum, Eric H KossoffAbstract:Abstract 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.
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Impact of the modified Atkins Diet on cardiovascular health in adults with epilepsy.
Epilepsy & behavior : E&B, 2017Co-Authors: Tanya J.w. Mcdonald, Eric H Kossoff, Elizabeth V Ratchford, Bobbie J. Henry-barron, Mackenzie C. CervenkaAbstract:Abstract Aim The current study investigated biochemical and vascular markers of cardiovascular health in adult patients with epilepsy treated with long-term (greater than 1 year) ketogenic Diet therapy compared with controls. Method Anthropometric measures, serum fasting lipid panel, apolipoproteins A-1 and B, lipoprotein sub-fractions as well as common carotid intima-media thickness (cIMT), and plaque presence were assessed in 20 adult patients with epilepsy on a modified Atkins Diet (MAD) for > 1 year started as an adult compared with 21 adult patients with epilepsy naive to Diet therapy. Results Patients treated with MAD had significantly lower weight, body mass index, waist and hip circumference, percent body fat, and serum triglyceride levels when compared with control patients. In contrast, they had significantly higher serum levels of small low-density-lipoprotein (LDL) particles and were significantly more likely to have LDL pattern B in which small LDL particles predominate when compared with controls. However, there was no significant difference in cIMT or plaque presence between groups. Conclusion Our results provide clinical evidence demonstrating the cardiovascular safety of a high-fat, low-carbohydrate Diet used in adults with epilepsy for at least 12 months. It also highlights potential markers of cardiovascular risk – small dense LDL particles – that should be closely monitored in adults treated with Diet therapy long-term.
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Blackwell Publishing, Inc. C © 2006 International League Against Epilepsy A Modified Atkins Diet Is Effective for the Treatment of Intractable Pediatric Epilepsy
2015Co-Authors: Eric H Kossoff, Jane R Mcgrogan, Renee M. Bluml, Diana J. Pillas, James E. Rubenstein, Eileen P. ViningAbstract:does the ketogenic Diet, without restrictions on calories, fluids, protein, or need for an inpatient fast and admission. Our objective was to evaluate the efficacy and tolerability of a modified Atkins Diet for intractable childhood epilepsy. Methods: Twenty children were treated prospectively in a hospital-based ambulatory clinic from September 2003 to May 2005. Children aged 3–18 years, with at least three seizures per week, who had been treated with at least two anticonvul-sants, were enrolled and received the Diet over a 6-month period. Carbohydrates were initially limited to 10 g/day, and fats were encouraged. Parents measured urinary ketones semiweekly and recorded seizures daily. All children received vitamin and cal-cium supplementation. Results: In all children, at least moderate urinary ketosis de-veloped within 4 days (mean, 1.9). Sixteen (80%) completed th
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Glycemic modulation in neuro-oncology: experience and future directions using a modified Atkins Diet for high-grade brain tumors
Neuro-oncology practice, 2015Co-Authors: Roy E. Strowd, Eric H Kossoff, Mackenzie C. Cervenka, Bobbie Henry, Adam L. Hartman, Jaishri O. BlakeleyAbstract:Dietary glycemic modulation through high-fat, low-carbohydrate Diets, which induce a state of systemic ketosis and alter systemic metabolic signaling, have been incorporated into the clinical management of patients with neurological disease for more than a century. Mounting preclinical evidence supports the antitumor, proapoptotic, and antiangiogenic effects of disrupting glycolytic metabolism through Dietary intervention. In recent years, interest in incorporating such novel therapeutic strategies in neuro-oncology has increased. To date, 3 published studies incorporating novel Dietary therapies in oncology have been reported, including one phase I study in neuro-oncology, and have set the stage for further study in this field. In this article, we review the biochemical pathways, preclinical data, and early clinical translation of Dietary interventions that modulate systemic glycolytic metabolism in the management of primary malignant brain tumors. We introduce the modified Atkins Diet (MAD), a novel Dietary alternative to the classic ketogenic Diet, and discuss the critical issues facing future study.
Makiko Osawa - One of the best experts on this subject based on the ideXlab platform.
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A modified Atkins Diet is promising as a treatment for glucose transporter type 1 deficiency syndrome
Developmental medicine and child neurology, 2011Co-Authors: Yasushi Ito, Susumu Ito, Hirokazu Oguni, Miyako Oguni, Makiko OsawaAbstract:Aim Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is a metabolic encephalopathy that can be effectively treated with a ketogenic Diet. The aim of this study was to consolidate the effectiveness of the modified Atkins Diet (MAD) as an alternative treatment for GLUT1-DS. Method Six Japanese males with GLUT1-DS were selected for treatment with the MAD. Their age at the time the MAD was instituted ranged from 7 to 16 years and the duration of treatment ranged from 1 to 42 months. All participants had early-onset epilepsy. Each participant’s neuropsychological activity, seizure frequency, neurological status, and electroencephalographic (EEG) findings were compared before and after the introduction of the MAD. Results After initiation of the treatment, all individuals showed +2 to +3 urinary ketosis on a ketostick test check. Epileptic seizures and other paroxysmal events decreased markedly in all individuals. Interictal EEG showed improvement in the background activity and disappearance of epileptic discharges. Along with an increased vigilance level, improvement in motivation and cognitive function was also achieved. Non-paroxysmal permanent ataxia, spasticity, dysarthria, and dystonia were moderately improved in four individuals and slightly improved in the remaining two. Preprandial transient aggravation of neurological symptoms completely disappeared in all participants. There were no significant side effects. Interpretation For the treatment of GLUT1-DS, the MAD is less restrictive, more palatable, and easier to maintain than the conventional ketogenic Diet, but its effectiveness was similar. Thus, MAD treatment is promising for individuals with GLUT1-DS and their families.
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modified Atkins Diet therapy for a case with glucose transporter type 1 deficiency syndrome
Brain & Development, 2008Co-Authors: Susumu Ito, Hirokazu Oguni, Yasushi Ito, Keiko Ishigaki, Junko Ohinata, Makiko OsawaAbstract:Glucose transporter type 1 deficiency syndrome (GLUT-1 DS), giving rise to impaired glucose transport across the blood-brain barrier, is characterized by infantile seizures, complex motor disorders, global developmental delay, acquired microcephaly, and hypoglycorrhachia. GLUT-1 DS can be treated effectively with a ketogenic Diet because it can provide an alternative fuel for brain metabolism; however, the excessive restriction of food intake involved frequently makes it difficult for patients to initiate or continue the Diet. Recently, the modified Atkins Diet, which is much less restrictive in terms of the total calorie and protein intake than the classical ketogenic Diet, has been shown to be effective and well tolerated in children with intractable epilepsy. We successfully introduced the modified Atkins Diet to a 7-year-old boy with GLUT-1 DS, whose caregivers refused ketogenic Diet treatment because of strong concerns over restricting the Diet. The modified Atkins Diet should be considered for patients with GLUT-1 DS as an alternative to the traditional ketogenic Diet.
Anne M Comi - One of the best experts on this subject based on the ideXlab platform.
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A pilot study of the modified Atkins Diet for Sturge-Weber syndrome.
Epilepsy research, 2010Co-Authors: Eric H Kossoff, Jennifer L Borsage, Anne M ComiAbstract:The modified Atkins Diet (MAD) is a Dietary treatment for epilepsy which does not restrict fluids or calories. This theoretically makes the MAD safer than the ketogenic Diet for children with Sturge-Weber syndrome (SWS). Five children aged 4-18 years with SWS and at least monthly intractable seizures were started prospectively on the MAD for 6 months. All children had urinary ketosis and seizure improvement, including 3 with > 50% seizure reduction.
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A pilot study of the modified Atkins Diet for Sturge—Weber syndrome
Epilepsy Research, 2010Co-Authors: Eric H Kossoff, Jennifer L Borsage, Anne M ComiAbstract:The modified Atkins Diet (MAD) is a Dietary treatment for epilepsy which does not restrict fluids or calories. This theoretically makes the MAD safer than the ketogenic Diet for children with Sturge-Weber syndrome (SWS). Five children aged 4-18 years with SWS and at least monthly intractable seizures were started prospectively on the MAD for 6 months. All children had urinary ketosis and seizure improvement, including 3 with > 50% seizure reduction.
Suvasini Sharma - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of a simplified modified Atkins Diet for use by parents with low levels of literacy in children with refractory epilepsy: A randomized controlled trial
Epilepsy research, 2016Co-Authors: Suvasini Sharma, Anuja Agarwala, Puneet Jain, Shaiphali Goel, Satinder AnejaAbstract:Abstract Purpose This study was planned to develop and evaluate a simple, easy-to-understand variation of the modified Atkins Diet, for use by parents with low levels of literacy in children with refractory epilepsy. Methods This study was conducted in two phases. In the first phase, a simplified version of the modified Atkins Diet was developed. In the second phase this was evaluated in children aged 2–14 years who had daily seizures despite the appropriate use of at least two anticonvulsant drugs, in an open-label randomized-controlled-trial. Children were randomized to receive either the simplified modified Atkins Diet or no Dietary intervention for a period of 3 months with the ongoing anticonvulsant medications being continued unchanged in both the groups. Reduction in seizure frequency was the primary outcome-measure. Data was analyzed using intention to treat approach. Adverse effects were also studied. (Clinical trial identifier NCT0189989). Results Forty-one children were randomly assigned to the Diet-group, and 40 were assigned to the control-group. Two patients discontinued the Diet during the study period. The proportion of children with >50% seizure reduction was significantly higher in the Diet group as compared to the control group (56.1% vs 7.5%, p Conclusion A simplified version of the modified Atkins Diet was developed for use by parents with low levels literacy. This Diet was found to be feasible, efficacious and well tolerated in children with refractory epilepsy.
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Review Article The Modified Atkins Diet in Refractory Epilepsy
2016Co-Authors: Suvasini Sharma, Puneet JainAbstract:Copyright © 2014 S. Sharma and P. Jain.This is an open access article distributed under theCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Themodified Atkins Diet is a less restrictive variation of the ketogenic Diet. This Diet is started on an outpatient basis without a fast, allows unlimited protein and fat, and does not restrict calories or fluids. Recent studies have shown good efficacy and tolerability of this Diet in refractory epilepsy. In this review, we discuss the use of the modified Atkins Diet in refractory epilepsy. 1
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Efficacy and tolerability of the modified Atkins Diet in young children with refractory epilepsy: Indian experience.
Annals of Indian Academy of Neurology, 2016Co-Authors: Ranju Mehta, Puneet Jain, Suvasini Sharma, Shaiphali Goel, Sharmila B. Mukherjee, Satinder AnejaAbstract:Background: The modified Atkins Diet (MAD) has been used predominantly in older children, adolescents, and adults. There is a paucity of data on the use of the MAD in refractory epilepsy in young children. Objectives: This study was planned to evaluate the efficacy and tolerability of the MAD in refractory epilepsy in young children. Methods: This study recruited children aged 9 months to 3 years with refractory seizures. Children received MAD for 6-month with the on-going anticonvulsant medications being continued unchanged. Reduction in seizure frequency was the primary outcome measure. Adverse effects were also studied. Results: Thirty-one children with daily seizures were studied with a median age of 18-month (range 9-30 months). West syndrome was the most common epilepsy syndrome (26, 86.6%). Twenty-one children remained on Diet at 3 months and 13 at 6 months. The children who achieved >50% seizure reduction were 17 (54.8%) at 3 months and 9 (29%) at 6 months. Refusal to eat was a significant problem seen in eight children. Three children discontinued the Diet due to adverse effects. Conclusion: The MAD was found to be feasible, effective, and well-tolerated.
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use of the modified Atkins Diet in lennox gastaut syndrome
Journal of Child Neurology, 2015Co-Authors: Suvasini Sharma, Puneet Jain, Naveen Sankhyan, Sheffali Gulati, Anuja AgarwalaAbstract:There is scanty data regarding the efficacy and tolerability of the modified Atkins Diet in children with Lennox-Gastaut syndrome. This study was a retrospective review of children with Lennox-Gastaut syndrome treated with the modified Atkins Diet from May 2009 and March 2011. The Diet was initiated in those children who persisted to have daily seizures despite the use of at least 3 appropriate antiepileptic drugs. Twenty-five children were started on a modified Atkins Diet, restricting carbohydrate intake to 10 g/d. After 3 months, 2 patients were seizure-free, and 10/25 children had >50% reduction in seizure frequency. At 6 months, of 11 patients on the Diet, 3 were seizure free and 8 had >50% reduction in seizure frequency. At 1 year, all 9 children on Diet had >50% reduction in seizure frequency. The side effects of the Diet were mild. The modified Atkins Diet was found to be effective and well tolerated in children with Lennox-Gastaut syndrome.
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The Modified Atkins Diet in Refractory Epilepsy
Epilepsy Research and Treatment, 2014Co-Authors: Suvasini Sharma, Puneet JainAbstract:The modified Atkins Diet is a less restrictive variation of the ketogenic Diet. This Diet is started on an outpatient basis without a fast, allows unlimited protein and fat, and does not restrict calories or fluids. Recent studies have shown good efficacy and tolerability of this Diet in refractory epilepsy. In this review, we discuss the use of the modified Atkins Diet in refractory epilepsy.
Yasushi Ito - One of the best experts on this subject based on the ideXlab platform.
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A modified Atkins Diet is promising as a treatment for glucose transporter type 1 deficiency syndrome
Developmental medicine and child neurology, 2011Co-Authors: Yasushi Ito, Susumu Ito, Hirokazu Oguni, Miyako Oguni, Makiko OsawaAbstract:Aim Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is a metabolic encephalopathy that can be effectively treated with a ketogenic Diet. The aim of this study was to consolidate the effectiveness of the modified Atkins Diet (MAD) as an alternative treatment for GLUT1-DS. Method Six Japanese males with GLUT1-DS were selected for treatment with the MAD. Their age at the time the MAD was instituted ranged from 7 to 16 years and the duration of treatment ranged from 1 to 42 months. All participants had early-onset epilepsy. Each participant’s neuropsychological activity, seizure frequency, neurological status, and electroencephalographic (EEG) findings were compared before and after the introduction of the MAD. Results After initiation of the treatment, all individuals showed +2 to +3 urinary ketosis on a ketostick test check. Epileptic seizures and other paroxysmal events decreased markedly in all individuals. Interictal EEG showed improvement in the background activity and disappearance of epileptic discharges. Along with an increased vigilance level, improvement in motivation and cognitive function was also achieved. Non-paroxysmal permanent ataxia, spasticity, dysarthria, and dystonia were moderately improved in four individuals and slightly improved in the remaining two. Preprandial transient aggravation of neurological symptoms completely disappeared in all participants. There were no significant side effects. Interpretation For the treatment of GLUT1-DS, the MAD is less restrictive, more palatable, and easier to maintain than the conventional ketogenic Diet, but its effectiveness was similar. Thus, MAD treatment is promising for individuals with GLUT1-DS and their families.
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modified Atkins Diet therapy for a case with glucose transporter type 1 deficiency syndrome
Brain & Development, 2008Co-Authors: Susumu Ito, Hirokazu Oguni, Yasushi Ito, Keiko Ishigaki, Junko Ohinata, Makiko OsawaAbstract:Glucose transporter type 1 deficiency syndrome (GLUT-1 DS), giving rise to impaired glucose transport across the blood-brain barrier, is characterized by infantile seizures, complex motor disorders, global developmental delay, acquired microcephaly, and hypoglycorrhachia. GLUT-1 DS can be treated effectively with a ketogenic Diet because it can provide an alternative fuel for brain metabolism; however, the excessive restriction of food intake involved frequently makes it difficult for patients to initiate or continue the Diet. Recently, the modified Atkins Diet, which is much less restrictive in terms of the total calorie and protein intake than the classical ketogenic Diet, has been shown to be effective and well tolerated in children with intractable epilepsy. We successfully introduced the modified Atkins Diet to a 7-year-old boy with GLUT-1 DS, whose caregivers refused ketogenic Diet treatment because of strong concerns over restricting the Diet. The modified Atkins Diet should be considered for patients with GLUT-1 DS as an alternative to the traditional ketogenic Diet.