Atkins Diet May Help Prevent Epileptic Seizures in Difficult-to-Treat Patients

— Researchers at the Johns Hopkins Children's Center in Baltimore, Maryland, are experimenting with the Atkins diet as a possible regimen to prevent epileptic seizures in patients refractory to other therapeutic regimens.

Pediatric neurologist Eric H. Kossoff, MD, told Medscape he got the idea from parents who would say, "Like the Atkins diet?" when he told them he wanted to put their children on the ketogenic diet, a more rigorous high-fat, low-carbohydrate diet used as anticonvulsant therapy for intractable patients.

Both diets mimic starvation, tricking the body into burning fat and producing ketones. "Ketone bodies do something to help reduce epilepsy. Beyond that, we don't know," Dr. Kossoff said here at the 57th annual meeting of the American Epilepsy Society, where he presented a poster on a pilot study of six patients, ages 7 to 52 years.

Two children achieved 100% seizure control, and in an 18-year-old, seizure activity was reduced by 90%. Two middle-aged adults did not improve, and a 12-year-old patient experienced only a 20% reduction in seizure activity.

Both seizure-free patients are still on the Atkins diet -- one for 20 months, according to Dr. Kossoff. He said he has since tested the diet in a dozen patients, and is recruiting 20 children for a larger study.

A big advantage of the Atkins diet is that it is more lenient than the ketogenic diet, which children start in a hospital on a two-day fast, according to Dr. Kossoff. "It is much easier to start," he said. "We can tell them to go to CVS and buy a book."

The researchers began the children on 10 grams of carbohydrates a day, which is less than the 20 grams usually recommended in the Atkins diet, but more than is recommended in the ketogenic diet. "If they are doing well, we give them more carbs," he said. "If they are not doing well, we take away carbs."

Some of the children lost weight initially, but later stabilized, according to the Baltimore researcher. One concern is that the high-protein, high-fat combination in the Atkins diet might be more than the kidneys can handle, according to Dr. Kossoff. The only side effect in the pilot study was a slight cholesterol increase in a 42-year-old patient.

Despite the ubiquity of the Atkins diet, Dr. Kossoff warned against epileptic patients trying it ad hoc. "This is something that should be done under medical supervision," he said. "It is not something that families, parents should be doing on their own."

Here's an email from HSI:

Look! Up in the Sky!

Health Sciences Institute e-Alert

February 5, 2004

Dear Reader,

I've got a good one for you today. This would be troubling, if
it weren't just out and out hilarious.

You may have heard about a new study - published last week in
the prestigious Archives of Internal Medicine - which concludes
with the surprising information that you can eat a high
carbohydrate diet and lose weight without exercising.

And I can leap tall buildings in a single bound.

All you can eat

Researchers at the University of Arkansas recruited 34 subjects
with an average age of 66 years. All the subjects had impaired
glucose intolerance. The 34 were divided into three groups and
supplied with meals for 12 weeks. Two of the groups received a
low-fat, high complex-carbohydrate diet, and the control group
received a comparatively high-fat, low-carb diet (although carbs
made up 45 percent of the food intake - obviously the word "low"
is defined differently in this study than anywhere else in the
world). All of the subjects in one of the high-carb groups
participated in 45 minutes of aerobic exercise, four times each
week.

The meal food portions were large; designed to supply about 150
percent of estimated energy needs. Subjects were told to eat as
much as they pleased. Because all uneaten food was returned, the
researchers were able to determine that there was no significant
difference in total food intake among the groups.

At the end of 12 weeks, the Arkansas team found that the group
that exercised lost 11 pounds on average. The non-exercising
high-carb group lost 7 pounds on average. And the so-called
low-carb group didn't lose any weight at all.

Conclusion: Forget your low-carb diets. Eat all the bagels you
want and you'll lose weight - even if you don't exercise.

Reality check

This study has three glaring problems: 1) A 12-week dietary
study can't begin to predict the long-range effects of a diet,
2) The low-carb diet wasn't low in carbs at all, and 3) There's
no way on earth that you can eat your fill of carbs, get no
exercise, and lose weight. As one eating disorder expert told
the Associated Press: It "flies in the face of 100 years of
data." He predicted that recommending such a diet, combined with
no exercise, would be "a public health disaster." And this comes
from someone who describes himself as an advocate of low-fat,
high-carbs!

Nevertheless, the media had a "told you so" field day. And the
smirking headline from Reuters Health said it all: "Revenge of
the high-carb diet - ha! It works, too."

The really amazing thing is that this study appeared in the
Archives of Internal Medicine, instead of the Archives of Inept
Research. A casual look at the details reveals that the study
was obviously designed to stack the deck so that the supposed
low-carb diet would be the loser.

The high-carb diet included lots of fruits and vegetables (much
more than the low-carb diet), as well as high-fiber cereal and
vegetarian chili. But the menu for the low-carb group included
macaroni and cheese and French fries! And on an all-you-can-eat
basis!

Let's see, which way will I lose more weight over just 12 weeks?
With fruits, vegetables and high-fiber, or macaroni and cheese
with supersized orders of French fries?

This is a textbook example of a junk study.

Fantasy land

The most misguided report about this research came from CBS
News. In an article titled "Fighting Diabetes With Carbs," CBS
implies that the high-carb diet used in the study is a good
choice for people who are pre-diabetic. Well, it's a slightly
better choice than macaroni and cheese and French fries, I'll
give it that.

The CBS report describes the high-carb diet as "Lots of bagels,
lots of fruit and vegetables." For the most part, the fruits and
veggies are no problem. But bagels? It's a rare bagel that's not
a refined carbohydrate, which means it creates a blood sugar
spike, which, over time, contributes to insulin resistance,
which leads to type 2 diabetes. And if your veggies include
potatoes, then those starches are converted to sugar, which
creates a blood sugar spike, etc., etc.

Fighting diabetes with these types of carbs is like fighting a
house fire with a flame-thrower.

Dr. William J. Evans, the lead author of the Arkansas study,
told Reuters Health, "If you simply reduce fat in the diet, and
allow people to eat as much carbohydrates as they want, they
lose weight."

One headline called this high-carb plan the "Anti-Atkins." You
could more accurately call it Anti-Science.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.